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1.
Curr Opin Anaesthesiol ; 34(1): 27-32, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33315641

RESUMO

PURPOSE OF REVIEW: Postoperative delirium (POD) is one of the most severe complications after surgery.The consequences are dramatic: longer hospitalization, a doubling of mortality and almost all cases develop permanent, yet subtle, cognitive deficits specific to everyday life. Actually, no global guideline with standardized concepts of management exists. Advances in prevention, diagnosis and treatment can improve recognition and risk stratification of delirium and its consequences. RECENT FINDINGS: Management of POD is a multiprofessional approach and consists of different parts: First, the detection of high-risk patients with a validated tool, preventive nonpharmacological concepts and an intraoperative anesthetic management plan that is individualized to the older patient (e.g. avoiding large swings in blood pressure, vigilance in maintaining normothermia, ensuring adequate analgesia and monitoring of anesthetic depth). In addition to preventive standards, treatment and diagnostic concepts must also be available, both pharmaceutical and nonpharmacological. SUMMARY: Not every POD can be prevented. It is important to detect patients with high risk for POD and have standardized concepts of management. The most important predisposing risk factors are a higher age, preexisting cognitive deficits, multimorbidity and an associated prodelirious polypharmacy. In view of demographic change, the implementation of multidisciplinary approaches to pharmacological and nonpharmacological POD management is highly recommended.


Assuntos
Anestesia/efeitos adversos , Anestésicos/efeitos adversos , Delírio/prevenção & controle , Delírio/terapia , Complicações Pós-Operatórias , Anestésicos/administração & dosagem , Transtornos Cognitivos/prevenção & controle , Transtornos Cognitivos/psicologia , Disfunção Cognitiva/complicações , Delírio/diagnóstico , Delírio/etiologia , Humanos , Hipnóticos e Sedativos/administração & dosagem , Complicações Pós-Operatórias/psicologia , Fatores de Risco
2.
Seizure ; 83: 216-222, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33127274

RESUMO

This is the first of two narrative reviews on cognitive disorders in epilepsy (companion publication : Cognitive disorders in epilepsy II: Clinical targets, indications and selection of test instruments). Its focus is on clinical experience, real-world evidence, and clinical recommendations. Cognitive disorders are a common comorbidity in children and adults with epilepsy. These cognitive disturbances may preceed the onset of seizures and are multifactorial including contributions by pre-existing brain damage, seizures, interictal epileptic discharges, and treatments including medications and surgery. Comorbid cognitive impairments can have a negative impact on the quality of life in people with epilepsy. They are under-identified and frequently not treated. Comorbid psychiatric disorders, such as ADHD can also contribute to a worse cognitive performance and can benefit from pharmacotherapy with CNS stimulants. Likewise, mood disorders cause a subjective perception of poor memory and attention, which can be reversed with antidepressants of the SSRI family. This narrative review discusses these issues from a real-world clinical perspective in children and adults with newly diagnosed and chronic epilepsy. The need for further research to understand and treat these disorders is noted.


Assuntos
Anticonvulsivantes/uso terapêutico , Transtornos Cognitivos/etiologia , Epilepsia/tratamento farmacológico , Convulsões/tratamento farmacológico , Cognição/efeitos dos fármacos , Cognição/fisiologia , Transtornos Cognitivos/psicologia , Epilepsia/psicologia , Humanos , Qualidade de Vida/psicologia , Convulsões/psicologia
3.
Artigo em Inglês | MEDLINE | ID: mdl-33050599

RESUMO

The ecological validity of neuropsychological testing (NT) has been questioned in the sports environment. A frequent criticism is that NT, mostly consisting of pen and paper or digital assessments, lacks relevant bodily movement. This study aimed to identify the determinants of a newly developed testing battery integrating both cognitive and motor demands. Twenty active individuals (25 ± 3 years, 11 males) completed the new motor-cognitive testing battery (MC), traditional NT (Stroop test, Trail Making test, Digit Span test) and isolated assessments of motor function (MF; Y-balance test, 20m-sprint, counter-movement jump). Kendal's tau and partial Spearman correlations were used to detect associations between MC and NT/MF. Except for two items (Reactive Agility A and counter-movement jump; Run-Decide and sprint time; r = 0.37, p < 0.05), MC was not related to MF. Similarly, MC and NT were mostly unrelated, even when controlling for the two significant motor covariates (p > 0.05). The only MC item with (weak to moderate) associations to NT was the Memory Span test (Digit Span backwards and composite; r = 0.43-0.54, p < 0.05). In sum, motor-cognitive function appears to be largely independent from its two assumed components NT and MF and may represent a new parameter in performance diagnostics.


Assuntos
Desempenho Atlético/fisiologia , Transtornos Cognitivos/diagnóstico , Cognição/fisiologia , Testes Neuropsicológicos/estatística & dados numéricos , Transtornos Cognitivos/psicologia , Humanos , Masculino , Movimento , Psicometria , Reprodutibilidade dos Testes , Esportes , Análise e Desempenho de Tarefas
4.
PLoS One ; 15(10): e0238978, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33022001

RESUMO

The recent literature shows that the type of gambling practiced influences problem gambling. This study was aimed at investigating the factors associated with gambling type, including gambling severity, gambling motives, and cognitive distortions. A total of 291 regular male gamblers (229 skill gamblers and 62 mixed gamblers, i.e., those who play at least one game of chance and one skill game) were recruited online and assessed for gambling severity (South Oaks Gambling Screen), gambling motives (Gambling Motives Questionnaire-Financial), cognitive distortions (Gambling-Related Cognition Scale), and psychological distress (Hospital Anxiety and Depression Scale). After controlling for the number of games played and psychological distress, we found that gambling type was significantly associated with gambling severity. Moreover, controlling for psychological distress showed that gambling type was also significantly associated with coping motives and interpretative bias. First, mixed gamblers had higher severity scores and higher coping motivation than skill gamblers; second, skill gamblers seemed more at risk of developing interpretative bias. Thus, the gamblers presented different psychological, motivational, and cognitive profiles according to gambling type, indicating that different clinical interventions may be relevant. Working on coping motives and anxiety and depression symptoms with an abstinence purpose would be more suitable for mixed gamblers. Indeed, working on these points could lead to the gambler reducing or eventually ceasing gambling, as the need to regulate negative emotions through gambling behavior would fade in parallel. Gambling type, psychological distress, gambling motives, and cognitive distortions should be taken into consideration systematically in clinical interventions of patients with plural and mixed practice of games.


Assuntos
Jogo de Azar/psicologia , Adulto , Comportamento Aditivo/psicologia , Cognição , Transtornos Cognitivos/psicologia , França , Jogo de Azar/classificação , Jogo de Azar/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Estresse Psicológico , Inquéritos e Questionários , Adulto Jovem
5.
Eur J Neurol ; 27(12): 2651-2657, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32881133

RESUMO

AIM: The aim of this paper is to describe the clinical features of COVID-19-related encephalopathy and their metabolic correlates using brain 2-desoxy-2-fluoro-D-glucose (FDG)-positron-emission tomography (PET)/computed tomography (CT) imaging. BACKGROUND AND PURPOSE: A variety of neurological manifestations have been reported in association with COVID-19. COVID-19-related encephalopathy has seldom been reported and studied. METHODS: We report four cases of COVID-19-related encephalopathy. The diagnosis was made in patients with confirmed COVID-19 who presented with new-onset cognitive disturbances, central focal neurological signs, or seizures. All patients underwent cognitive screening, brain magnetic resonance imaging (MRI), lumbar puncture, and brain 2-desoxy-2-fluoro-D-glucose (FDG)-positron-emission tomography (PET)/computed tomography (CT) (FDG-PET/CT). RESULTS: The four patients were aged 60 years or older, and presented with various degrees of cognitive impairment, with predominant frontal lobe impairment. Two patients presented with cerebellar syndrome, one patient had myoclonus, one had psychiatric manifestations, and one had status epilepticus. The delay between first COVID-19 symptoms and onset of neurological symptoms was between 0 and 12 days. None of the patients had MRI features of encephalitis nor significant cerebrospinal fluid (CSF) abnormalities. SARS-CoV-2 RT-PCR in the CSF was negative for all patients. All patients presented with a consistent brain FDG-PET/CT pattern of abnormalities, namely frontal hypometabolism and cerebellar hypermetabolism. All patients improved after immunotherapy. CONCLUSIONS: Despite varied clinical presentations, all patients presented with a consistent FDG-PET pattern, which may reflect an immune mechanism.


Assuntos
Encefalopatias/diagnóstico por imagem , /complicações , Idoso , Encefalopatias/psicologia , Encefalopatias/terapia , Doenças Cerebelares/diagnóstico por imagem , Doenças Cerebelares/etiologia , Transtornos Cognitivos/etiologia , Transtornos Cognitivos/psicologia , Feminino , Fluordesoxiglucose F18 , Lobo Frontal/diagnóstico por imagem , Humanos , Imunoterapia , Imagem por Ressonância Magnética , Masculino , Transtornos Mentais/etiologia , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Mioclonia/diagnóstico por imagem , Mioclonia/etiologia , Testes Neuropsicológicos , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Estado Epiléptico/etiologia , Resultado do Tratamento
6.
Hipertens. riesgo vasc ; 37(3): 125-132, jul.-sept. 2020. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-193521

RESUMO

La hipertensión arterial es considerada el principal factor de riesgo vascular modificable que causa daño en forma silente en los vasos del cerebro. Esta injuria vascular cerebral podría ser el núcleo común que justifique los síntomas cognitivos (deterioro cognitivo, demencia y enfermedad de Alzheimer) y conductuales (depresión de inicio tardío) del daño de órgano blanco mediado por la hipertensión arterial. El conocimiento incompleto sobre los complejos vínculos fisiopatológicos que relacionan la hipertensión arterial con los cambios cognitivo-conductuales soslaya la participación del cerebro como órgano blanco subestimando el riesgo cardio y cerebrovascular. La convergencia de deterioro cognitivo, depresión e hipertensión arterial en adultos mayores, advierte sobre la necesidad de una evaluación integral que permita planificar el tratamiento, mejorar pronóstico y contribuir a la disminución del riesgo de demencia y su incidencia


Arterial hypertension is considered the main modifiable vascular risk factor that causes silent damage to brain vessels. This vascular brain injury could be the common nucleus that justifies the cognitive (cognitive impairment, dementia and Alzheimer's disease) and behavioural symptoms (late-life depression) of target organ damage mediated-hypertension. Incomplete knowledge about the complex pathophysiology that links hypertension with cognitive-behavioural changes is overlooking brain involvement and underestimating cardio and cerebrovascular risk. The confluence of cognitive impairment, depression and arterial hypertension in elderly adults, warns of the need for a comprehensive evaluation to plan treatment, improve prognosis and contribute to reducing the risk of dementia and its incidence


Assuntos
Humanos , Hipertensão/fisiopatologia , Hipertensão/psicologia , Transtornos Cognitivos/etiologia , Transtornos Cognitivos/psicologia , Disfunção Cognitiva/prevenção & controle , Transtornos de Início Tardio/fisiopatologia , Doença de Alzheimer/etiologia , Fatores de Risco
7.
PLoS One ; 15(9): e0239040, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32915911

RESUMO

BACKGROUND: Individuals with Down syndrome are predisposed to a number of chronic health conditions, but the relationship between these conditions and cognitive ability is not clear. The primary objective of this systematic review is to assess this relationship by evaluating studies that measure cognitive performance in the context of Down syndrome-associated chronic health conditions. METHODS: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Studies included in this review (1) included children, adolescent, and young adult participants with Down syndrome and one or more co-occurring health conditions; (2) were quantitative; and (3) reported outcomes related to both chronic health conditions and cognitive performance. A set of predetermined chronic health conditions that are common in Down syndrome (e.g. sleep disorders, congenital heart disease, thyroid disease, seizure disorders, and pulmonary hypertension) were selected based on prevalence rates in Down syndrome. RESULTS: Fifteen studies met inclusion criteria. The majority these of studies assessed cognitive performance in association with sleep disorders (47%) and congenital heart disease (47%). Fewer studies reported on the effect of thyroid disease (7%) and seizure disorders (7%) on cognitive ability. None of the studies reported cognitive outcomes related to pulmonary hypertension. Of the chronic health conditions evaluated, associations between sleep disorders and cognitive dysfunction were most common among individuals with Down syndrome. CONCLUSIONS: Individuals with Down syndrome exhibit deficits in cognitive ability, particularly related to attention, executive function and verbal processing. These deficits may be further exacerbated by the presence of chronic health conditions, particularly sleep disorders. Individuals with Down syndrome and co-occurring sleep disorders may benefit from early interventions to mitigate their risk for adverse cognitive outcomes.


Assuntos
Transtornos Cognitivos/complicações , Síndrome de Down/complicações , Síndrome de Down/psicologia , Adolescente , Doenças Cardiovasculares/complicações , Criança , Doença Crônica , Transtornos Cognitivos/psicologia , Epilepsia/complicações , Feminino , Humanos , Pneumopatias/complicações , Masculino , Transtornos do Sono-Vigília/complicações , Transtornos do Sono-Vigília/psicologia , Doenças da Glândula Tireoide/complicações , Adulto Jovem
8.
Neurology ; 95(18): e2565-e2576, 2020 11 03.
Artigo em Inglês | MEDLINE | ID: mdl-32913016

RESUMO

OBJECTIVE: To characterize the cortical macrostructure and microstructure of behavioral and cognitive changes along the amyotrophic lateral sclerosis (ALS)-frontotemporal dementia (FTD) continuum. METHODS: We prospectively recruited 88 participants with a 3T MRI structural and diffusion-weighted imaging sequences: 31 with ALS, 20 with the behavioral variant of FTD (bvFTD), and 37 cognitively normal controls. Participants with ALS underwent a comprehensive cognitive and behavioral assessment and were dichotomized into ALS without cognitive or behavioral impairment (ALSno-cbi; n = 12) and ALS with cognitive or behavioral impairment (ALScbi; n = 19). We computed cortical thickness and cortical mean diffusivity using a surface-based approach and explored the cortical correlates of cognitive impairment with the Edinburgh Cognitive and Behavioral ALS Screen. RESULTS: The ALSno-cbi and ALScbi groups showed different patterns of reduced cortical thickness and increased cortical mean diffusivity. In the ALSno-cbi group, cortical thinning was restricted mainly to the dorsal motor cortex. In contrast, in the ALScbi group, cortical thinning was observed primarily on frontoinsular and temporal regions bilaterally. There were progressive cortical mean diffusivity changes along the ALSno-cbi, ALScbi, and bvFTD clinical continuum. Participants with ALS with either cognitive or behavioral impairment showed increased cortical mean diffusivity in the prefrontal cortex in the absence of cortical thickness. CONCLUSIONS: Cortical mean diffusivity might be a useful biomarker for the study of extramotor cortical neurodegeneration in the ALS-FTD clinical spectrum. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that the cortical microstructure correlates with cognitive impairment in the ALS-FTD continuum.


Assuntos
Esclerose Amiotrófica Lateral/patologia , Esclerose Amiotrófica Lateral/psicologia , Córtex Cerebral/patologia , Transtornos Cognitivos/patologia , Transtornos Cognitivos/psicologia , Demência Frontotemporal/patologia , Demência Frontotemporal/psicologia , Idoso , Esclerose Amiotrófica Lateral/complicações , Transtornos Cognitivos/complicações , Feminino , Demência Frontotemporal/complicações , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neuroimagem , Testes Neuropsicológicos , Comportamento Problema/psicologia
9.
J Stroke Cerebrovasc Dis ; 29(10): 105119, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32912505

RESUMO

BACKGROUND: While both motor and cognitive impairment are common after stroke, the focus of (early) treatment has always been on motor deficit. AIMS: The objective of the current study was to explore the link between motor and cognitive performance in stroke patients and to examine whether motor performance is associated with cognitive functioning at three months post stroke. METHODS: In both stroke patients (n = 142) and controls (n = 135), with the groups matched on age, gender and premorbid IQ, motor functioning was evaluated using both objective (Purdue Pegboard Test) and subjective measures (specific items from the Frenchay Activities Index and Barthel Index). Cognition, specifically information processing speed, working memory and cognitive flexibility, was assessed using objective tasks. The data were analyzed using Pearson product-moment correlation coefficients and logistic regression. RESULTS: Significant correlations between motor and cognitive functioning were found in stroke patients. The objective motor task was stronger than subjective measures in statistically explaining and predicting cognitive deficit, irrespective of stroke severity. CONCLUSIONS: We conclude that motor impairment at three months post-stroke should serve as a 'red flag' for professionals: cognitive impairment is likely and should also be evaluated.


Assuntos
Transtornos Cognitivos/etiologia , Cognição , Atividade Motora , Acidente Vascular Cerebral/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/psicologia , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Estudos Prospectivos , Fatores de Risco , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologia , Acidente Vascular Cerebral/psicologia , Fatores de Tempo
10.
J Stroke Cerebrovasc Dis ; 29(9): 105063, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32807468

RESUMO

BACKGROUND AND OBJECTIVE: After cerebral hemorrhage, cognitive functions and activities of daily living (ADL) are affected by various factors, including hematoma volume and patient age. In the present study, we investigated the effect of age and hematoma volume on cognitive functions and on ADL. METHODS: The sample comprised 274 patients (183 men and 91 women; mean age 58.2 ± 12.5 years) with putaminal hemorrhage who were hospitalized in a convalescent rehabilitation ward. Hematoma volume was estimated from computed tomography imaging at stroke onset. Cognitive functions were evaluated using Raven's Colored Progressive Matrices test (RCPM) and the Mini-Mental State Examination (MMSE) at hospital admission, while ADL score was assessed at discharge using the Functional Independence Measure motor subscale (FIM-M). In the present study, we classified the patients into six groups according to whether they were non-elderly or elderly (cutoff age, 60 years) and whether their hematoma was small, medium, or large (cutoff volumes, 20 and 40 mL, respectively). Subsequently, the scores on the RCPM, MMSE, and FIM-M were compared among the groups. RESULTS: In both age groups, patients with a larger hematoma volume had lower RCPM and MMSE scores. Patients <60 years old exhibited different trends in their RCPM and MMSE scores, such that the RCPM score showed a step-wise decrease according to hematoma volume, while a difference in the MMSE score was only observed at the 20 mL boundary. Most of the younger patients (<60 years of age) attained high FIM-M scores at discharge, as long as their hematoma volume was either medium or small (<40 mL). This age group had higher RCPM scores on admission, which may have contributed to their higher FIM-M scores on discharge. CONCLUSIONS: In the present study, we demonstrated that advancing age increases the effect of hematoma volume on RCPM and MMSE scores and identified differences in the effects observed on these two scores. Thus, it may be important to use the RCPM alongside the MMSE for patient assessment.


Assuntos
Atividades Cotidianas , Transtornos Cognitivos/etiologia , Cognição , Envelhecimento Cognitivo , Hemorragia/diagnóstico por imagem , Hemorragia Putaminal/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , Fatores Etários , Idoso , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/fisiopatologia , Transtornos Cognitivos/psicologia , Feminino , Hemorragia/complicações , Hemorragia/fisiopatologia , Hemorragia/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Valor Preditivo dos Testes , Prognóstico , Hemorragia Putaminal/complicações , Hemorragia Putaminal/fisiopatologia , Hemorragia Putaminal/psicologia , Fatores de Risco
11.
Am J Physiol Gastrointest Liver Physiol ; 319(3): G361-G374, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32726162

RESUMO

Inflammatory bowel diseases (IBDs) are chronic intestinal diseases, frequently associated with comorbid psychological and cognitive deficits. These neuropsychiatric effects include anxiety, depression, and memory impairments that can be seen both during active disease and following remission and are more frequently seen in pediatric patients. The mechanism(s) through which these extraintestinal deficits develop remain unknown, and the study of these phenomenon is hampered by a lack of murine pediatric IBD models. Herein we describe microbiota-gut-brain (MGB) axis deficits following induction of colitis in a pediatric setting. Acute colitis was induced by administration of 2% dextran sodium sulfate (DSS) for 5 days starting at weaning [postnatal day (P)21] causing reduced weight gain, colonic shortening, and colonic inflammation by 8 days post-DSS (P29), which were mostly resolved in adult (P56) mice. Despite resolution of acute disease, cognitive deficits (novel object recognition task) and anxiety-like behavior (light/dark box) were identified in the absence of changes in exploratory behavior (open field test) in P56 mice previously treated with DSS at weaning. Behavioral deficits were found in conjunction with neuroinflammation, decreased neurogenesis, and altered expression of pattern recognition receptor genes in the hippocampus. Additionally, persistent alterations in the gut microbiota composition were observed at P56, including reduced butyrate-producing species. Taken together, these results describe for the first time the presence of MGB axis deficits following induction of colitis at weaning, which persist in adulthood.NEW & NOTEWORTHY Here we describe long-lasting impacts on the microbiota-gut-brain (MGB) axis following administration of low-dose dextran sodium sulfate (DSS) to weaning mice (P21), including gut dysbiosis, colonic inflammation, and brain/behavioral deficits in adulthood (P56). Early-life DSS leads to acute colonic inflammation, similar to adult mice; however, it results in long-lasting deficits in the MGB axis in adulthood (P56), in contrast to the transient deficits seen in adult DSS. This model highlights the unique features of pediatric inflammatory bowel disease.


Assuntos
Encéfalo/fisiopatologia , Microbioma Gastrointestinal , Trato Gastrointestinal/microbiologia , Trato Gastrointestinal/fisiopatologia , Doenças Inflamatórias Intestinais/microbiologia , Doenças Inflamatórias Intestinais/fisiopatologia , Vias Neurais/fisiopatologia , Animais , Ansiedade/psicologia , Comportamento Animal , Transtornos Cognitivos/etiologia , Transtornos Cognitivos/psicologia , Colite/induzido quimicamente , Colite/microbiologia , Colite/fisiopatologia , Sulfato de Dextrana , Modelos Animais de Doenças , Disbiose , Feminino , Hipocampo/metabolismo , Humanos , Doenças Inflamatórias Intestinais/psicologia , Camundongos , Camundongos Endogâmicos C57BL , Neurogênese , Ganho de Peso
12.
Dev Med Child Neurol ; 62(8): 985-992, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32608507

RESUMO

AIM: To determine neurocognitive performance and behavioural problems in children with Panayiotopoulos syndrome. METHOD: All 18 children (10 females, 8 males; mean age 4y 7mo; SD 1y 10mo) diagnosed with Panayiotopoulos syndrome at the Kempenhaeghe Epilepsy Center in the Netherlands between 2010 and 2017 were analysed retrospectively. All underwent a neuropsychological/behavioural assessment, an academic assessment, and a 24-hour electroencephalogram. RESULTS: Mean full-scale IQ (93.5; range 76-123; p=0.04) and performance IQ (93.2; range 76-126; p=0.04) were within the normal range, although significantly lower compared to the normative mean. Verbal IQ (96.3; range 76-118) and processing speed (96.1; range 74-114) were not significantly lower. Simple auditory/visual reaction times, visual attention, visual-motor integration, and verbal memory were significantly lower compared to normative values. On average, patients with Panayiotopoulos syndrome were 8 months behind in arithmetic speed and 11 months behind in reading speed for the number of months in school. Behavioural questionnaires revealed significantly higher scores on reported internalizing behavioural problems. INTERPRETATION: Children with Panayiotopoulos syndrome demonstrated diffuse cognitive dysfunction in full-scale IQ, performance IQ, visual attention, visual-motor integration, and verbal memory. A high incidence of internalizing behavioural problems was reported. This strongly suggests neuropsychological and behavioural comorbidity in children with Panayiotopoulos syndrome. WHAT THIS PAPER ADDS: Children with Panayiotopoulos syndrome are at risk for cognitive deficits in various cognitive domains. Children with Panayiotopoulos syndrome are also prone to internalizing behavioural problems. Mild-to-severe academic underachievement was present in more than half of the children with Panayiotopoulos syndrome.


Assuntos
Transtornos Cognitivos/psicologia , Epilepsias Parciais/psicologia , Comportamento Problema , Criança , Pré-Escolar , Transtornos Cognitivos/complicações , Escolaridade , Epilepsias Parciais/complicações , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Estudos Retrospectivos
13.
Artigo em Inglês | MEDLINE | ID: mdl-32668576

RESUMO

Online poker is a form of gambling where an element of skill may influence the outcome of the game. 'Tilt' in poker describes an episode during which the player can no longer control their game by rational decisions. It leads to a loss of control over the game, a loss of emotional regulation, higher cognitive distortion, and a loss of money. This phenomenon, experienced by most players, could be the gateway to excessive gambling. The aim of this study was to assess the links between the frequency of tilt episodes, cognitive distortion, anxiety, depression, sensation seeking and excessive online poker gambling. Our sample is composed of 291 online poker players, with a mean age of 33.8 years (SD = 10.6). Participants completed an online self-assessment questionnaire, measuring the frequency of tilt episodes, cognitive distortion, anxiety, depression and impulsivity. The findings indicated that the frequency of tilt episodes and cognitive distortion were the only significant predictors of excessive online gambling (respectively, r = 0.49 and r = 0.20). Tilt frequency and cognitive distortion were strongly correlated (GRCS, r = 0.60), moderate to low correlations were found for tilt and anxiety (HADS, r = 0.40), and positive and negative urgency (UPPS, r = 0.27). To date, tilt has seldom been studied, and could improve our understanding of online poker gamblers. It could be a new means of identifying at risk gamblers, and thus facilitating preventive measures specifically adapted to this population.


Assuntos
Ansiedade/psicologia , Transtornos Cognitivos/psicologia , Depressão/psicologia , Jogo de Azar/psicologia , Comportamento Impulsivo , Internet , Adulto , Ansiedade/complicações , Transtornos de Ansiedade , Transtornos Cognitivos/complicações , Depressão/complicações , Jogo de Azar/complicações , Humanos , Estresse Psicológico/complicações , Estresse Psicológico/psicologia , Inquéritos e Questionários
14.
Internist (Berl) ; 61(9): 929-938, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32666209

RESUMO

Approximately 40% of patients with heart failure show cognitive deficits, such as concentration difficulties, attention deficits, and memory impairment. Affected patients have a higher rate of rehospitalization and an increased mortality. This could be due to low adherence mediated by a lack of disease-specific knowledge and strategies to deal with symptom exacerbation. The pathogenesis of cognitive deficits in heart failure is multifactorial. In this respect the heart failure itself as well as cardiovascular risk factors and comorbidities play a role. Orientating neuropsychological screening tests can show a first indication of the presence of cognitive impairment. When identified, the causes can be specifically treated and care can be optimized through certain measures, such as the involvement of caregivers and healthcare providers.


Assuntos
Transtornos Cognitivos/etiologia , Disfunção Cognitiva/etiologia , Insuficiência Cardíaca/complicações , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/epidemiologia , Transtornos Cognitivos/psicologia , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/epidemiologia , Comorbidade , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/psicologia , Humanos , Adesão à Medicação , Testes Neuropsicológicos
15.
Toxicol Lett ; 332: 192-201, 2020 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-32693020

RESUMO

Fenvalerate, a synthetic pyrethroid insecticide, is an environmental endocrine disruptor and neurodevelopmental toxicant. An early report found that pubertal exposure to high-dose fenvalerate impaired cognitive and behavioral development. Here, we aimed to further investigate the effect of pubertal exposure to low-dose fenvalerate on cognitive and behavioral development. Mice were orally administered with fenvalerate (0.2, 1.0 and 5.0 mg/kg) daily from postnatal day (PND) 28 to PND56. Learning and memory were assessed by Morris water maze. Anxiety-related activities were detected by open-field and elevated plus-maze. Increased anxiety activities were observed only in females exposed to fenvalerate. Spatial learning and memory were damaged only in females exposed to fenvalerate. Histopathology observed numerous scattered shrinking neurons and nuclear pyknosis in hippocampal CA1 region. Neuronal density was reduced in hippocampal CA1 region of fenvalerate-exposed mice. Mechanistically, hippocampal thyroid hormone receptor (TR)ß1 was down-regulated in a dose-dependent manner in females. In addition, TRα1 was declined only in females exposed to 5.0 mg/kg fenvalerate. Taken together, these suggests that pubertal exposure to low-dose fenvalerate impairs cognitive and behavioral development in a gender-dependent manner. Hippocampal TR signaling may be, at least partially, involved in fenvalerate-induced impairment of cognitive and behavioral development.


Assuntos
Transtornos Cognitivos/induzido quimicamente , Hipocampo/metabolismo , Inseticidas/toxicidade , Nitrilos/toxicidade , Piretrinas/toxicidade , Transdução de Sinais/efeitos dos fármacos , Hormônios Tireóideos , Animais , Ansiedade/induzido quimicamente , Ansiedade/psicologia , Peso Corporal/efeitos dos fármacos , Região CA1 Hipocampal/efeitos dos fármacos , Região CA1 Hipocampal/metabolismo , Transtornos Cognitivos/psicologia , Relação Dose-Resposta a Droga , Regulação para Baixo/efeitos dos fármacos , Ingestão de Alimentos/efeitos dos fármacos , Disruptores Endócrinos , Feminino , Hipocampo/efeitos dos fármacos , Masculino , Aprendizagem em Labirinto/efeitos dos fármacos , Camundongos , Camundongos Endogâmicos ICR , Neurônios/patologia , Receptores dos Hormônios Tireóideos/efeitos dos fármacos , Caracteres Sexuais
16.
J Stroke Cerebrovasc Dis ; 29(8): 104923, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32689613

RESUMO

OBJECTIVE: In this prospective study, we aimed to investigate the presence and evolution of cerebellar cognitive affective syndrome in a cohort of isolated cerebellar stroke with no known cognitive or psychiatric impairment. We tried to distinguish the unconfounded effect of cerebellar lesions on neuropsychological processing. METHODS: After a meticulous exclusion procedure based on possible confounders, we recruited 14 patients and 13 age-matched healthy controls to the study, prospectively. All of the patients had a detailed initial neuropsychological assessment at the first week and a follow-up assessment at the 4th month after stroke. RESULTS: The prevalence of cognitive or behavioral-affective abnormalities in our cohort were 86% and 64% respectively. The patients exhibited mild and transient affective-behavioral abnormalities except for depressive symptoms that persisted in the subacute stage. They scored lower in general cognitive performance as revealed by mini mental test (p=0.001). Memory, executive functions, attention and working memory, central processing speed, and linguistic abilities were impaired (p<0.001; p=0.001; p=0.007; p=0.05; p<0.001 respectively). Improvement was evident only in memory domain of the cognitive functions in the subacute stage. Cognitive impairment was more likely with a medial or posterolateral infarct (p=0.014). Behavioral-affective abnormalities were not associated with a specific location in our cohort. Age seemed to negatively correlate with the recovery in general cognitive performance on the follow-up. CONCLUSIONS: These findings show that acute denervation of cerebellocortical projections leads to mild affective-behavioral abnormalities, and full-blown cerebellar cognitive affective syndrome is rare. However, cognition was significantly affected after an acute cerebellar infarct even in a previously healthy, non-demented pure population.


Assuntos
Afeto , Infartos do Tronco Encefálico/psicologia , Doenças Cerebelares/psicologia , Cerebelo/irrigação sanguínea , Transtornos Cognitivos/psicologia , Cognição , Transtornos do Humor/fisiopatologia , Doença Aguda , Atenção , Infartos do Tronco Encefálico/diagnóstico , Infartos do Tronco Encefálico/epidemiologia , Infartos do Tronco Encefálico/fisiopatologia , Estudos de Casos e Controles , Doenças Cerebelares/diagnóstico , Doenças Cerebelares/epidemiologia , Doenças Cerebelares/fisiopatologia , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/epidemiologia , Transtornos Cognitivos/fisiopatologia , Função Executiva , Feminino , Humanos , Idioma , Masculino , Memória , Pessoa de Meia-Idade , Transtornos do Humor/diagnóstico , Transtornos do Humor/epidemiologia , Transtornos do Humor/psicologia , Prevalência , Estudos Prospectivos , Fatores de Risco , Fatores de Tempo , Turquia/epidemiologia
17.
Epidemiol Psychiatr Sci ; 29: e144, 2020 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-32684190

RESUMO

AIMS: Establishing the minimum clinically important difference (MCID) in functioning and cognition is essential to the interpretation of the research and clinical work conducted in bipolar disorders (BD). The present study aimed to estimate the MCID for the Functioning Assessment Short Test (FAST) and a battery of neuropsychological tests in BD. METHODS: Anchor-based and distributive methods were used to estimate the MCID for the FAST and cognition using data from a large, multicentre, observational cohort of individuals with BD. The FAST and cognition were linked with the Clinical Global Impressions Scale-Severity (CGI-S) and Global Assessment of Functioning (GAF) using an equipercentile method. The magnitude of the standard error measurement (s.e.m.) provided another estimate of the MCID. RESULTS: In total, 570 participants were followed for 2 years. Cross-sectional CGI-S and GAF scores were linked to a threshold ⩽7 on the FAST for functional remission. The MCID for the FAST equalled 8- or 9-points change from baseline using the CGI-S and GAF. One s.e.m. on the FAST corresponded to 7.6-points change from baseline. Cognitive variables insufficiently correlated with anchor variables (all ρ <0.3). One s.e.m. for cognitive variables corresponded to a range of 0.45 to 0.93-s.d. change from baseline. CONCLUSIONS: These findings support the value of the estimated MCID for the FAST and cognition and may be a useful tool to evaluate cognitive and functional remediation effects and improve patient functional outcomes in BD. The CGI-S and GAF were inappropriate anchors for cognition. Further studies may use performance-based measures of functioning instead.


Assuntos
Transtorno Bipolar/diagnóstico , Transtornos Cognitivos/diagnóstico , Cognição/fisiologia , Testes Neuropsicológicos/estatística & dados numéricos , Transtorno Bipolar/psicologia , Transtornos Cognitivos/psicologia , Estudos Transversais , Função Executiva , Feminino , Humanos , Masculino , Memória de Curto Prazo , Avaliação de Resultados em Cuidados de Saúde , Tempo de Reação , Comportamento Social
18.
Geriatr Psychol Neuropsychiatr Vieil ; 18(2): 151-156, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: covidwho-611800

RESUMO

At the beginning of the Covid-19 epidemic, National forum for ethical reflection on Alzheimer's disease and neurodegenerative diseases conducted a national survey to identify the difficulties encountered by professionals working in the field of old age and autonomy, families and volunteers, and the initiatives they have implemented. Seven major difficulties were identified: the isolation induced by the prohibition of visits, the lack of protective equipment and tests, the difficulties of people with cognitive difficulties in understanding measures to avoid the spread of the epidemic, the sustainability of overwork for professionals, the concern of the families of residents, complex situations at home and difficulties in accessing care. Four initiatives are being implemented: information and training for teams, compensation for interrupted visits, consultations and exchanges between professionals, actions to benefit people living at home. The Covid-19 epidemic hit the elderly sector at a very special moment in its history, several years of effort by the sector to reinvent itself around strong values. They have been a resource during this period of crisis. An ambitious law on old age and autonomy therefore appears to be a necessity.


Assuntos
Infecções por Coronavirus/terapia , Geriatria/ética , Geriatria/tendências , Pneumonia Viral/terapia , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Técnicas de Laboratório Clínico/estatística & dados numéricos , Transtornos Cognitivos/complicações , Transtornos Cognitivos/psicologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Família , Feminino , França/epidemiologia , Acesso aos Serviços de Saúde , Humanos , Masculino , Pandemias , Educação de Pacientes como Assunto , Isolamento de Pacientes/psicologia , Autonomia Pessoal , Equipamento de Proteção Individual , Pneumonia Viral/epidemiologia , Inquéritos e Questionários
19.
Geriatr Psychol Neuropsychiatr Vieil ; 18(2): 151-156, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: covidwho-607701

RESUMO

At the beginning of the Covid-19 epidemic, National forum for ethical reflection on Alzheimer's disease and neurodegenerative diseases conducted a national survey to identify the difficulties encountered by professionals working in the field of old age and autonomy, families and volunteers, and the initiatives they have implemented. Seven major difficulties were identified: the isolation induced by the prohibition of visits, the lack of protective equipment and tests, the difficulties of people with cognitive difficulties in understanding measures to avoid the spread of the epidemic, the sustainability of overwork for professionals, the concern of the families of residents, complex situations at home and difficulties in accessing care. Four initiatives are being implemented: information and training for teams, compensation for interrupted visits, consultations and exchanges between professionals, actions to benefit people living at home. The Covid-19 epidemic hit the elderly sector at a very special moment in its history, several years of effort by the sector to reinvent itself around strong values. They have been a resource during this period of crisis. An ambitious law on old age and autonomy therefore appears to be a necessity.


Assuntos
Infecções por Coronavirus/terapia , Geriatria/ética , Geriatria/tendências , Pneumonia Viral/terapia , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Técnicas de Laboratório Clínico/estatística & dados numéricos , Transtornos Cognitivos/complicações , Transtornos Cognitivos/psicologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Família , Feminino , França/epidemiologia , Acesso aos Serviços de Saúde , Humanos , Masculino , Pandemias , Educação de Pacientes como Assunto , Isolamento de Pacientes/psicologia , Autonomia Pessoal , Equipamento de Proteção Individual , Pneumonia Viral/epidemiologia , Inquéritos e Questionários
20.
Geriatr Psychol Neuropsychiatr Vieil ; 18(2): 151-156, 2020 06 01.
Artigo em Francês | MEDLINE | ID: mdl-32554346

RESUMO

At the beginning of the Covid-19 epidemic, National forum for ethical reflection on Alzheimer's disease and neurodegenerative diseases conducted a national survey to identify the difficulties encountered by professionals working in the field of old age and autonomy, families and volunteers, and the initiatives they have implemented. Seven major difficulties were identified: the isolation induced by the prohibition of visits, the lack of protective equipment and tests, the difficulties of people with cognitive difficulties in understanding measures to avoid the spread of the epidemic, the sustainability of overwork for professionals, the concern of the families of residents, complex situations at home and difficulties in accessing care. Four initiatives are being implemented: information and training for teams, compensation for interrupted visits, consultations and exchanges between professionals, actions to benefit people living at home. The Covid-19 epidemic hit the elderly sector at a very special moment in its history, several years of effort by the sector to reinvent itself around strong values. They have been a resource during this period of crisis. An ambitious law on old age and autonomy therefore appears to be a necessity.


Assuntos
Infecções por Coronavirus/terapia , Geriatria/ética , Geriatria/tendências , Pneumonia Viral/terapia , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Técnicas de Laboratório Clínico/estatística & dados numéricos , Transtornos Cognitivos/complicações , Transtornos Cognitivos/psicologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Família , Feminino , França/epidemiologia , Acesso aos Serviços de Saúde , Humanos , Masculino , Pandemias , Educação de Pacientes como Assunto , Isolamento de Pacientes/psicologia , Autonomia Pessoal , Equipamento de Proteção Individual , Pneumonia Viral/epidemiologia , Inquéritos e Questionários
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