Protective factors and behavioral adjustment in preschool children of Iranian Martyrs

Out of 228 Iranian preschool Martyrs' children whose behaviour adjustment in the nursery settings was screened using the Preschool Behaviour Checklist, 12 well adjusted, zero scorers were compared with 8 poorly adjusted, high scorers. Using the parent's Behaviour Checklist, high scorers showed significantly more problems at home than zero scorers. On the Malaise Inventory, mothers of high scorers showed poorer mental health than mothers of zero scorers. Home observations showed that mother-child interaction was more aversive in high scorers than in zero scorers. More mothers of zero scorers had remarried.     

The validity of the hospital anxiety and depression scale and the geriatric depression scale in Parkinson's disease

We assessed the concurrent validity of the Hospital Anxiety and Depression Scale (HADS) and the Geriatric Depression Scale (GDS) against the Hamilton Rating Scale for Depression (Ham-D) in patients with Parkinson's disease (PD). Forty-six non-demented PD patients were assessed by a neurologist on the Ham-D. Patients also completed four mood rating scales: the HADS, the GDS, the VAS and the Face Scale. For the HADS and the GDS, Receiver Operating Characteristics (ROC) curves were obtained and the positive and negative predictive values (PPV, NPV) were calculated for different cut-off scores. Maximum discrimination between depressed and non-depressed PD patients was reached at a cut-off score of 10/11 for both the HADS and the GDS. At the same cut-off score of 10/11 for both the HADS and the GDS, the high sensitivity and NPV make these scales appropriate screening instruments for depression in PD. A high specificity and PPV, which is necessary for a diagnostic test, was reached at a cut-off score of 12/13 for the GDS and at a cut-off score of 11/12 for the HADS. The results indicate the validity of using the HADS and the GDS to screen for depressive symptoms and to diagnose depressive illness in PD.     

Procedural memory and neurological disease

Abstract

Dissociations between different aspects of learning and memory in patients with amnesic syndromes and various neurodegenerative diseases has led to a fundamental revision of the taxonomy of human memory, and a greater understanding of its neurobiological basis. It has been suggested that, while lesions to temporal and diencephalic structures leave procedural learning intact, neurological disorders involving the striatum lead to deficits in this aspect of learning. However, as comparative evidence has accumulated on a variety of procedural tasks, it has become clear that different neurological diseases lead to varying patterns of impaired and intact performance. This has led to a revision of the concept of a unified procedural system in favour of parallel, independent systems, only some of which involve the striatum. There is a danger, however, that the effort to fit the patterns of functional association and dissociation into a neuroanatomical framework may be premature, It is suggested that the way forward lies in more comparative studies, but ones which (1) adopt a broader perspective, assessing other patient groups or single cases, (2) tackle the question of inter-subject variability, (3) adopt a more analytic approach to the assessment of individual performance, and which utilise theory-driven methods to assess the processes of learning at different stages, and (4) which employ complementary methods such as pharmacological manipulations in normal subjects to assess the neurochemical basis of procedural knowledge.     

Dopaminergic medication alters auditory distractor processing in Parkinson's disease

Parkinson's disease (PD) patients show signs of cognitive impairment, such as executive dysfunction, working memory problems and attentional disturbances, even in the early stages of the disease. Though motor symptoms of the disease are often successfully addressed by dopaminergic medication, it still remains unclear, how dopaminergic therapy affects cognitive function. The main objective of this study was to assess the effect of dopaminergic medication on visual and auditory attentional processing. 14 PD patients and 13 matched healthy controls performed a three-stimulus auditory and visual oddball task while their EEG was recorded. The patients performed the task twice, once on- and once off-medication. While the results showed no significant differences between PD patients and controls, they did reveal a significant increase in P3 amplitude on- vs. off-medication specific to processing of auditory distractors and no other stimuli. These results indicate significant effect of dopaminergic therapy on processing of distracting auditory stimuli. With a lack of between group differences the effect could reflect either 1) improved recruitment of attentional resources to auditory distractors; 2) reduced ability for cognitive inhibition of auditory distractors; 3) increased response to distractor stimuli resulting in impaired cognitive performance; or 4) hindered ability to discriminate between auditory distractors and targets. Further studies are needed to differentiate between these possibilities.     

The Potential of Anamnestic Comparative Self-Assessment (ACSA) to Reduce Bias in the Measurement of Subjective Well-Being

Background: The conventional question (CQ) on subjective well-being (SWB) is e.g. “How is life?”, with ratings between e.g. ‘Best’ and ‘Worst possible’. Disadvantages may be casualness of responses and biases of proximate, peer or cultural relativity. Alternatively, with Anamnestic Comparative Self-Assessment (ACSA), the scale anchors are the respondents’ self-defined memories of their best and worst periods in life. Thus ACSA uses life review and experiential scale anchors. Objective: To compare the validity, sensitivity and responsiveness of the CQ and ACSA. Method: ACSA and the CQ were administered in parallel to 2584 university-hospital patients suffering from a wide range of psychiatric and somatic diseases. Results: ACSA and CQ did not measure the same construct (r = 0.50). CQ ratings were almost normally distributed, whereas ACSA ratings were overall lower, and clearly positively skewed, suggesting greater sensitivity to the respondents’ diseased state. Contrary to CQ, ACSA ratings of critically ill patients with end-stage liver disease were very low. After life-saving liver transplantation, ACSA ratings increased significantly more than CQ ratings, suggesting better responsiveness of ACSA to objective change. Trait-like socio-demographic variables such as sex, age, and marital status influenced CQ, but not ACSA ratings. Conclusion: In between-subject studies, depending on one’s study objectives, ACSA should be considered as a complement or an alternative to conventional SWB instruments. The CQ is probably preferable when socio-demographic variables are study endpoints. In longitudinal or intervention studies and for intercultural comparisons, ACSA, which reduces the need for correction of several biases or confounders, seems more useful.     

Semantic and phonemic verbal fluency in Parkinson's disease: Influence of clinical and demographic variables

Changes of cognitive function in PD have been extensively documented and defined as a 'frontal' type executive dysfunction. One of the main components of this executive dysfunction is the impairment of verbal fluency. The aim of the present study was to assess semantic and phonemic fluency in a large sample of PD patients and to investigate the effect of clinical and sociodemographic variables on verbal fluency in this patient group. Three hundred patients with idiopathic Parkinson's disease who were consecutive referrals to our clinic and 50 age and education matched healthy controls completed the phonemic and semantic verbal fluency tasks. Both phonemic and semantic verbal fluency were significantly impaired in PD patients relative to matched controls. Stage of illness, presence of depression, education and age influenced verbal fluency measures. Regression analyses established that global measures of cognitive ability (MMSE) and executive function (FAB) and side of onset of motor symptoms predicted 36-37% of variance of phonemic or semantic verbal fluency measures. Thus, future studies aimed at assessing cognitive functioning in PD patients treated by deep brain stimulation (DBS) should adequately take into account several factors (stage of illness, depression, executive functioning) which may potentially influence performance on verbal fluency tasks.     

Involvement of dorsal hippocampal α-adrenergic receptors in the effect of scopolamine on memory retrieval in inhibitory avoidance task

The present study evaluated the possible role of α-adrenergic receptors of the dorsal hippocampus on scopolamine-induced amnesia and scopolamine state-dependent memory in adult male Wistar rats. The animals were bilaterally implanted with chronic cannulae in the CA1 regions of the dorsal hippocampus, trained in a step-through type inhibitory avoidance task, and tested 24 h after training to measure step-through latency. Results indicate that post-training or pre-test intra-CA1 administration of scopolamine (1 and 2 μg/rat) dose-dependently reduced the step-through latency, showing an amnestic response. Amnesia produced by post-training scopolamine (2 μg/rat) was reversed by pre-test administration of the scopolamine that is due to a state-dependent effect. Interestingly, pre-test intra-CA1 microinjection of α1-adrenergic agonist, phenylephrine (1 and 2 μg/rat) or α2-adrenergic agonist, clonidine improved post-training scopolamine (2 μg/rat)-induced retrieval impairment. Furthermore, pre-test intra-CA1 microinjection of phenylephrine (0.25, 0.5 and 1 μg/rat) or clonidine (0.25, 0.5 and 1 μg/rat) with an ineffective dose of scopolamine (0.25 μg/rat), synergistically improved memory performance impaired by post-training scopolamine. On the other hand, pre-test injection of α1-receptors antagonist prazosin (1 and 2 μg/rat) or α2-receptors antagonist yohimbine (1 and 2 μg/rat) prevented the restoration of memory by pre-test scopolamine. It is important to note that pre-test intra-CA1 administration of the same doses of prazosin or yohimbine, alone did not affect memory retrieval. These results suggest that α1- and α2-adrenergic receptors of the dorsal hippocampal CA1 regions may play an important role in scopolamine-induced amnesia and scopolamine state-dependent memory.     

Basal ganglia, dopamine and temporal processing: performance on three timing tasks on and off medication in Parkinson's disease

A pervasive hypothesis in the timing literature is that temporal processing in the milliseconds and seconds range engages the basal ganglia and is modulated by dopamine. This hypothesis was investigated by testing 12 patients with Parkinson's disease (PD), both 'on' and 'off' dopaminergic medication, and 20 healthy controls on three timing tasks. In a seconds range (30-120 s) time production task, patients tested 'on' medication showed a significantly different accuracy profile compared to controls and when tested 'off' medication. However, no group or on vs off medication differences in accuracy were found on a time reproduction task and a warned reaction time task requiring temporal processing within the 250-2000 ms range. Variability was measured using the coefficient of variation, with the performance of the patient group on the time reproduction task violating the scalar property, suggesting atypical temporal processing mechanisms. The data suggest that the integrity of the basal ganglia is necessary for 'typical' time production in the seconds range as well as for time reproduction at shorter intervals. Exploratory factor analysis suggested that the time production task uses neural mechanisms distinct from those used in the other two timing tasks. The dissociation of the effects of dopaminergic medication and nature of task on performance in PD raises interesting questions about the pharmacological mediation and task-specificity of deficits in temporal processing.     

The factors that induce or overcome freezing of gait in Parkinson's disease

Freezing of gait (FoG), a transient halt in walking, is a major mobility problem for patients with Parkinson's disease (PD). This study examined the factors that induce FoG, and identified the cues and strategies that help overcome it through a postal survey of 130 PD patients. 72% reported FoG. The factors that commonly induced FoG were turning, fatigue, confined spaces and stressful situations, in addition to emotional factors. FoG was also ameliorated by various attentional and external cueing strategies. The concept of paradoxical kinesis, the potential neural substrates of such external cueing effects, and their importance for rehabilitation in PD are discussed.