Associations of depression,anxiety and PTSD with neurological disability and cognitive impairment in survivors of moyamoya disease

Depression, anxiety and posttraumatic stress disorder (PTSD) are common complications of cerebrovascular diseases. However, they were seldom explored in Moyamoya Disease (MMD) survivors. In this study, we measured the prevalence of depression, anxiety and PTSD in MMD survivors. We evaluated the association of mental disorders with neurological disability and cognitive impairment, and further find out the independent protective and risk factors of neurological disability and cognitive impairment. In MMD survivors, the prevalence of these three mental disorders is high, 46.7% for depression, 50% for anxiety and 47.5% for PTSD. Anxiety and PTSD were significantly associated with more severe neurological disability (p = 0.039 and < 0.001); depression and anxiety were significantly associated with greater cognitive deficiency (p = 0.004 and 0.002). We further found PTSD was the only risk factor associated with neurological disability, and the corresponding odds ratio (OR) and 95% confidence interval (CI) was 81.74 (9.91–674.17); depression and anxiety were risk factors associated with cognitive impairment, and the corresponding OR and 95%CI were 2.73 (1.10–6.81) and 3.37 (1.29–8.78). Therefore, these three mental disorders were associated with more severe neurological disability and greater cognitive deficiency in MMD survivors.     

Correlation between functional mobility and cognitive performance in older adults with cognitive impairment

Association between cognitive impairment and gait performance occurs in mild cognitive impairment (MCI) and Alzheimer‘s disease (AD), particularly under “divided attention” conditions, leading to a greater risk of falls. We studied 36 controls, 42 MCI, and 26 mild AD patients, using the Timed Up-and-Go test (TUG) under four conditions: TUG single – TUG1; TUG cognitive – TUG2; TUG manual –TUG3; TUG cognitive and manual – TUG4. Cognition was assessed using the MMSE, SKT, Exit25, and TMT (A and B). We found significant correlations between cognitive scores and TUG2 [r values (MMSE: –0.383, TMT-A: 0.430, TMT-B: 0.386, Exit25: 0.455, SKT: 0.563)] and TUG4 [(MMSE: –0.398, TMT-A: 0.384, TMT-B: 0.352,Exit25: 0.466, SKT: 0.525)] in the AD group, and between all TUG modalities and SKT in MCI and AD. Our results revealed that functional mobility impairment in cognitive dual tasks correlated to cognitive decline in AD patients and to attention and memory impairment in MCI.     

fMRI and cognitive dysfunction in schizophrenia

Despite being one of the most prevalent psychiatric conditions, SCHIZOPHRENIA is still poorly understood, with no clear objective biological marker. The advent of neuroimaging has enabled in vivo investigations to complement older techniques, and has revealed important insights. fMRI provides a means to assess the neurobiological theory that schizophrenia is caused by abnormal fronto-temporal lobe connections. In studies of language abnormalities, fMRI can explicitly assess the hypothesis that the normal lateralization of language is reversed in schizophrenia. Longitudinal fMRI studies, and studies examining the effects of medication, suggest that the technique has further potential to advance our understanding of this complex disorder.     

Patterns of cognitive ageing

Neuroanatomical evidence suggests that normal ageing affects some brain areas, and the “local” functions they support, earlier and more severely than others. Changes appear to be especially marked in the hippocampus, temporal association and prefrontal cortex. Evidence from classical neuropsychological studies suggests that these brain areas are associated with memory and “executive” functions, respectively. We may, therefore, expect that tests purported to measure these functions may be disproportionately affected in old age and that there may be evidence for some separation of these functions even within neurologically normal populations. What we also know, however, is that measures reflecting general fluid ability also decline with increasing age, so any hypothesis relating to specific “local” deficits must acknowledge and account for any “globar” changes in performance. Volunteers (n=162) aged between 60–80 years who had completed the Cattell and Cattell Culture Fair Intelligence Test (CCF) completed the Cambridge Automated Neuropsychological Test Battery (CANTAB). The CANTAB has been administered to several patient populations and tests from the battery have been shown to be sensitive to damage in both temporal and prefrontal areas (Owen et al., 1996). Results from the test battery showed that both the Paired Associate Learning and Spatial Recognition tests were the most sensitive to normal ageing even when CCF is accounted for. In contrast, this performance on the “executive” tests, shown to be sensitive to frontal lobe damage, was not related to age, and CCF scores predicted performance on these tests. These results are discussed in relation to theories of cognitive ageing and patterns of change and in relation to several important methodological and theoretical considerations for the study of executive function. Received: 31 March 1999 / Accepted: 23 July 1999     

Patterns of cognitive appraisal in emotion

There has long been interest in describing emotional experience in terms of underlying dimensions, but traditionally only two dimensions, pleasantness and arousal, have been reliably found. The reasons for these findings are reviewed, and integrating this review with two recent theories of emotions (Roseman, 1984; Scherer, 1982), we propose eight cognitive appraisal dimensions to differentiate emotional experience. In an investigation of this model, subjects recalled past experiences associated with each of 15 emotions, and rated them along the proposed dimensions. Six orthogonal dimensions, pleasantness, anticipated effort, certainty, attentional activity, self-other responsibility/control, and situational control, were recovered, and the emotions varied systematically along each of these dimensions, indicating a strong relation between the appraisal of one's circumstances and one's emotional state. The patterns of appraisal for the different emotions, and the role of each of the dimensions in differentiating emotional experience are discussed.     

Treatment of cognitive impairment in multiple sclerosis

Cognitive impairment in multiple sclerosis is an increasingly recognized entity. This article reviews the cognitive impairment of multiple sclerosis, its prevalence, its relationship to different types of multiple sclerosis, and its contribution to long-term functional prognosis. The discussion also focuses on the key elements of cognitive dysfunction in multiple sclerosis which distinguish it from other forms of cognitive impairment. Therapeutic interventions potentially effective for the cognitive impairment of multiple sclerosis are reviewed including the effects of disease modifying therapies and the use of physical and cognitive interventions.     

Peri-ictal and ictal cognitive dysfunction in epilepsy

Disturbances in cognitive function, particularly memory, are a common complaint of patients with epilepsy. Factors contributing to cognitive dysfunction are the type of epilepsy, type and frequency of seizures, anti-epileptic drugs and the location of underlying brain lesions. Whilst a great deal of attention has been paid to permanent cognitive impairment, the nature and underlying mechanisms of ictal and peri-ictal cognitive changes are poorly understood. In-depth investigation of seizure related cognitive dysfunction is of great clinical relevance, as these changes are potentially reversible and treatable, thus reducing the cumulative effect of frequent seizures. Greater knowledge of peri-ictal and ictal cognitive dysfunction would improve seizure prediction, localization of seizure focus and assessment of treatment effectiveness, greatly reducing distress and disability. This paper will review current understanding of peri-ictal and ictal cognitive dysfunction and discuss future directions for research.     

Focused attention deficits in patients with Alzheimer's disease and mild cognitive impairment

Reaction time (RT) tasks take various forms, and can assess psychomotor speed, (i.e., simple reaction time task), and focused attention (i.e., choice reaction time (CRT) task). If cues are provided before stimulus presentation (i.e., cued choice reaction time (CCRT) task), then a cueing effect can also be assessed. A limited number of studies have addressed the nature of focused attention impairments in Alzheimer's disease (AD). Additionally, it is unknown whether similar impairments occur in Mild Cognitive Impairment (MCI). The current study used three RT tasks to address the nature of focused attention impairments in AD and MCI subjects. The results suggest that there were significant CRT and CCRT differences in AD subjects when compared to NECs. Furthermore, slowed RTs were also present in the MCI group, which provides evidence for impaired focussed attention and the inability to benefit from a cue in both the MCI and AD groups. The implications of the impairments related to the MCI group could potentially prove useful in early diagnosis of cognitive impairments in the elderly.     

Passive smoking is associated with cognitive and emotional impairment in adolescent girls

It is well established that smoking is associated with impaired mental health and sleep problems. However, the possible effects of passive smoking on cognitive and emotional characteristics have not previously been evaluated in adolescents. We investigated the association between passive smoking and cognitive and emotional function, and sleep patterns in 940 adolescent girls. The girls were divided into two groups [305 exposed subjects and 635 non-exposed subjects (the controls)]. The passive smokers had a significantly lower cognitive function and higher depression, aggression, and insomnia scores compared to the control group (P?<?0.05). No significant difference was detected with respect to day-time sleepiness and sleep apnea. Logistic regression analyses showed that the passive smokers were more likely than the controls to have cognitive impairments, depressive mood, aggressive behavior, and insomnia. Adolescent passive smokers had significant differences in their cognitive abilities and emotional function.     

Patterns of discourse production among neurological patients with fluent language disorders

Dissociations between impairments in microlinguistic and macrolinguistic abilities were examined in brain-damaged patients to assess whether these abilities are psychologically and neurologically distinct. The discourse productions of three groups of patients with equally severe fluent language disorders, but varying neuropathology and varying profiles of associated nonlinguistic cognitive impairments, were analyzed. Patients with fluent aphasia secondary to a single left-hemisphere CVA showed the greatest impairment on syntactic and lexical error measures taken to reflect microlinguistic abilities, but normal performance on measures of macrolinguistic organization (i.e., thematic coherence). Patients with probable Alzheimer's Disease were impaired on thematic coherence measures, but not on measures reflecting microlinguistic syntactic and phonological processes. Closed head injury patients whose primary clinical symptom was a fluent language disorder were impaired on both microlinguistic and macrolinguistic measures, which appears to parallel their deficits both in language-specific and in nonspecific, higher-order, diffusely organized cognitive processes.     

Recognition memory deficits in mild cognitive impairment

ABSTRACT There is no agreement on the pattern of recognition memory deficits characteristic of patients diagnosed with mild cognitive impairment (MCI). Whereas lower performance in recollection is the hallmark of MCI, there is a strong controversy about possible deficits in familiarity estimates when using recognition memory tasks. The aim of this research is to shed light on the pattern of responding in recollection and familiarity in MCI. Five groups of participants were tested. The main participant samples were those formed by two MCI groups differing in age and an Alzheimer's disease group (AD), which were compared with two control groups. Whereas one of the control groups served to assess the performance of the MCI and AD people, the other one, composed of young healthy participants, served the purpose of evaluating the adequacy of the experimental tasks used in the evaluation of the different components of recognition memory. We used an associative recognition task as a direct index of recollection and a choice task on a pair of stimuli, one of which was perceptually similar to those studied in the associative recognition phase, as an index of familiarity. Our results indicate that recollection decreases with age and neurological status, and familiarity remains stable in the elderly control sample but it is deficient in MCI. This research shows that a unique encoding situation generated deficits in recollective and familiarity mechanisms in mild cognitive impaired individuals, providing evidence for the existence of deficits in both retrieval processes in recognition memory in a MCI stage.     

Threat-based cognitive biases in anxious children: comparison with non-anxious children before and after cognitive behavioural treatment

Attention and interpretation biases for threat stimuli were assessed in 19 anxious (ANX) children before and after cognitive behavioural therapy (CBT), and compared with responses from 19 non-anxious (NA) control children collected over the same period. Attentional bias was assessed using a picture version of the visual probe task with threat, neutral and pleasant pictures. Threat interpretation bias was assessed using both a homographs task in which children used homograph words in a sentence and their neutral or threatening meaning was assessed, and a stories task in which children rated their negative emotion, danger judgments, and influencing ability in ambiguous situations. ANX children showed attention biases towards threat on the visual probe task and threat interpretation biases on the stories task but not the homographs task at pre-treatment in comparison with NA children. Following treatment, ANX children's threat interpretation biases as assessed on the stories task reduced significantly to within levels comparable to NA children. However, ANX children continued to show larger attentional biases towards threat than pleasant pictures on the visual probe task at post-treatment, whereas NA children did not show attentional biases. Moreover, a residual threat interpretation style on the stories task at post-treatment was associated with higher anxiety symptoms in both ANX and NA children.     

Recognition memory deficits in mild cognitive impairment

ABSTRACT

There is no agreement on the pattern of recognition memory deficits characteristic of patients diagnosed with mild cognitive impairment (MCI). Whereas lower performance in recollection is the hallmark of MCI, there is a strong controversy about possible deficits in familiarity estimates when using recognition memory tasks. The aim of this research is to shed light on the pattern of responding in recollection and familiarity in MCI. Five groups of participants were tested. The main participant samples were those formed by two MCI groups differing in age and an Alzheimer's disease group (AD), which were compared with two control groups. Whereas one of the control groups served to assess the performance of the MCI and AD people, the other one, composed of young healthy participants, served the purpose of evaluating the adequacy of the experimental tasks used in the evaluation of the different components of recognition memory. We used an associative recognition task as a direct index of recollection and a choice task on a pair of stimuli, one of which was perceptually similar to those studied in the associative recognition phase, as an index of familiarity. Our results indicate that recollection decreases with age and neurological status, and familiarity remains stable in the elderly control sample but it is deficient in MCI. This research shows that a unique encoding situation generated deficits in recollective and familiarity mechanisms in mild cognitive impaired individuals, providing evidence for the existence of deficits in both retrieval processes in recognition memory in a MCI stage.     

儿童行为抑制性与心理障碍关联的认知神经过程

行为抑制型儿童相较于普通儿童更容易在童年中期和青春期出现心理障碍, 具有更高的发展风险性。此类儿童比非抑制型儿童表现出更多的退缩动机、更长的预期过程与前注意过程、更少的注意控制、对负性信息更多的注意偏向、异常活跃的反应监控过程和更慢的习惯化过程。这些与心理障碍患者相似的认知神经过程是儿童行为抑制性与心理障碍间的重要联系途径, 并能作为预测指标筛选有更高发展风险性的个体。除儿童本身的特质外, 环境因素也能通过塑造认知神经过程, 进而影响儿童的发展结果。因此在未来的研究中, 可以考虑不同文化背景下的儿童行为抑制性与心理障碍关联的认知神经过程差异。进而从个体特质和环境因素两方面寻找行为抑制型儿童发展的保护性因素。     

Neurocognitive dysfunction in children with sleep disorders

It is well known that adults with sleep disturbances frequently exhibit a wide range of neurocognitive decrements, and that these deficits are potentially reversible with effective treatment. However, the consequences of respiratory sleep disturbances on neurocognitive function in children have only recently been evaluated, and suggest a strong causal association between the episodic hypoxia and sleep fragmentation that characterize the disease and the emergence of reduced memory, attention and intelligence as well as a link to problematic and hyperactive behaviours and mood disturbances. This article takes a critical look at the current literature on these issues, reviews the major findings and discusses such findings in conjunction with those derived from pertinent animal models.