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Galvez-Sánchez CM, Duschek S, Reyes del Paso GA. A Comparative Analysis of Cognitive Deficits in Rheumatoid Arthritis and Fibromyalgia: Impact of Symptoms Severity and Its Clinical Implications. Psychol Res Behav Manag 2024; 17:1399-1415. [PMID: 38566824 PMCID: PMC10985931 DOI: 10.2147/prbm.s446798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/27/2024] [Indexed: 04/04/2024] Open
Abstract
Purpose Fibromyalgia syndrome (FMS) and rheumatoid arthritis (RA) are chronic pain disorders, with clearly distinct pathogenetic mechanisms, frequently accompanied by symptoms like depression, fatigue, insomnia and cognitive problems. This study compared performance in various cognitive domains between patients with FMS and RA. The role of clinical symptoms severity in determine the differences in cognitive performance was also investigated. Patients and Methods A cross-sectional study was conducted according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement. In total, 64 FMS patients, 34 RA patients and 32 healthy controls participated, all women. Using factor analysis, questionnaire scores were combined to yield a symptom severity factor, which was used as a control variable in the group comparisons. Results Without controlling for symptom severity, both patient groups performed worse than controls in all the cognitive domains assessed (visuospatial memory; verbal memory; strategic planning and self-regulation; processing speed, attention and cognitive flexibility; and planning and organizational abilities); overall deficits were greater in FMS than in RA patients. FMS patients reported more severe clinical symptoms (current pain intensity, total pain, state anxiety, depression, fatigue and insomnia) than RA patients. After controlling for symptom severity, a large proportion of the cognitive test parameters no longer differed between FMS and RA patients. Conclusion The study confirmed significant impairments in attention, memory, and higher cognitive functions in both FMS and RA. The greater deficits seen in FMS patients may at least partly be explained by more severe pain and secondary symptoms. Cognitive screening may facilitate the development of personalized treatment plans to optimize the quality of life of FMS and RA patients.
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Affiliation(s)
- Carmen M Galvez-Sánchez
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology and Speech Therapy, University of Murcia, Murcia, Spain
| | - Stefan Duschek
- Department of Psychology, Institute of Psychology, UMIT TIROL - University for Health Sciences Medical Informatics and Technology, Hall in Tirol, Austria
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Batista AX, Bazán PR, Martin MDGM, Conforto AB, Hoshino M, Simon SS, Hampstead B, Figueiredo EG, Amaro E, Miotto EC. Perilesional and contralesional brain activations related to associative encoding of unfamiliar face-names pairs in adults with left chronic stroke with or without ischemic infarct on left inferior frontal gyrus. Cortex 2023; 168:27-48. [PMID: 37639907 DOI: 10.1016/j.cortex.2023.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 01/31/2023] [Accepted: 04/26/2023] [Indexed: 08/31/2023]
Abstract
The study of an Ischemic stroke infarction allows verifying how the lesion produces alterations in the neuronal networks resulting in cognitive deficits. It also allows the verification of adaptive and maladaptive cerebral reorganization related to the injury. In our previous fMRI study, we found that patients without ischemic vascular lesions in left inferior frontal gyrus showed an efficient compensation mechanism during the associative encoding of face name pairs, by the increased activation of ventrolateral and dorsolateral areas of contralesional hemisphere associated with better memory performance. While patients with ischemic vascular lesions on left inferior frontal gyrus (IFG) demonstrated worse memory performance and no signs of compensation mechanism. The present study explores more of these findings by analyzing perilesional and contralesional activations related to unfamiliar face name associative encoding in adults with chronic ischemic stroke, with or without left IFG lesion, compared to healthy controls. The main results showed that stroke survivors without lesions in IFG demonstrated increased activation in perilesional and contralesional prefrontal regions associated with better associative memory recognition, which are indicative of adaptive compensatory mechanisms. However, they also showed a negative correlation between the activation of right anterior prefrontal and inferior parietal regions and the associative memory performance, which may indicate the presence of maladaptive interhemispheric disinhibition. On the other hand, stroke survivors with IFG lesions demonstrated negative correlations in activations of the ipsilesional inferior parietal cortex and positive correlations in activations of the left middle frontal gyrus and left precentral cortex, which demonstrate the simultaneous occurrence of adaptive and maladaptive brain reorganization mechanisms in this group. However, the increase in perilesional prefrontal regions, associated with bilateral activation of the hippocampus and amygdala, was not enough to compensate for the inefficiency of associative memory performance. Finally, the differences in activation observed in stroke survivors reflect their clinical heterogeneity and demonstrate that adaptive or maladaptive compensatory mechanisms can coexist in the same group of patients. Furthermore, they reinforce the importance of the left IFG in the associative encoding of unfamiliar face name pairs and may suggest a deficit in associative memory related to injury in this region.
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Affiliation(s)
- Alana X Batista
- Department of Neurology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil; Neuroimagem Funcional (NIF) - Laboratory of Medical Investigations on Magnetic Resonance Imaging (LIM-44), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
| | - Paulo R Bazán
- Neuroimagem Funcional (NIF) - Laboratory of Medical Investigations on Magnetic Resonance Imaging (LIM-44), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Maria da Graça M Martin
- Neuroimagem Funcional (NIF) - Laboratory of Medical Investigations on Magnetic Resonance Imaging (LIM-44), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Adriana B Conforto
- Neuroimagem Funcional (NIF) - Laboratory of Medical Investigations on Magnetic Resonance Imaging (LIM-44), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Maurício Hoshino
- Neuroimagem Funcional (NIF) - Laboratory of Medical Investigations on Magnetic Resonance Imaging (LIM-44), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Sharon S Simon
- Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY, USA
| | - Benjamin Hampstead
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Edson Amaro
- Neuroimagem Funcional (NIF) - Laboratory of Medical Investigations on Magnetic Resonance Imaging (LIM-44), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Eliane C Miotto
- Department of Neurology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil; Neuroimagem Funcional (NIF) - Laboratory of Medical Investigations on Magnetic Resonance Imaging (LIM-44), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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3
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Kirkman MA, Day J, Gehring K, Zienius K, Grosshans D, Taphoorn M, Li J, Brown PD. Interventions for preventing and ameliorating cognitive deficits in adults treated with cranial irradiation. Cochrane Database Syst Rev 2022; 11:CD011335. [PMID: 36427235 PMCID: PMC9697842 DOI: 10.1002/14651858.cd011335.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Cognitive deficits are common in people who have received cranial irradiation and have a serious impact on daily functioning and quality of life. The benefit of pharmacological and non-pharmacological treatment of cognitive deficits in this population is unclear. This is an updated version of the original Cochrane Review published in Issue 12, 2014. OBJECTIVES To assess the effectiveness of interventions for preventing or ameliorating cognitive deficits in adults treated with cranial irradiation. SEARCH METHODS For this review update we searched the Cochrane Register of Controlled Trials (CENTRAL), MEDLINE via Ovid, Embase via Ovid, and PsycInfo via Ovid to 12 September 2022. SELECTION CRITERIA We included randomised controlled (RCTs) trials that evaluated pharmacological or non-pharmacological interventions in cranial irradiated adults, with objective cognitive functioning as a primary or secondary outcome measure. DATA COLLECTION AND ANALYSIS Two review authors (MK, JD) independently extracted data from selected studies and carried out a risk of bias assessment. Cognitive function, fatigue and mood outcomes were reported. No data were pooled. MAIN RESULTS Eight studies met the inclusion criteria and were included in this updated review. Six were from the original version of the review, and two more were added when the search was updated. Nineteen further studies were assessed as part of this update but did not fulfil the inclusion criteria. Of the eight included studies, four studies investigated "prevention" of cognitive problems (during radiotherapy and follow-up) and four studies investigated "amelioration" (interventions to treat cognitive impairment as a late complication of radiotherapy). There were five pharmacological studies (two studies on prevention and three in amelioration) and three non-pharmacological studies (two on prevention and one in amelioration). Due to differences between studies in the interventions being evaluated, a meta-analysis was not possible. Studies in early radiotherapy treatment phase (five studies) Pharmacological studies in the "early radiotherapy treatment phase" were designed to prevent or ameliorate cognitive deficits and included drugs used in dementia (memantine) and fatigue (d-threo-methylphenidate hydrochloride). Non-pharmacological studies in the "early radiotherapy treatment phase" included a ketogenic diet and a two-week cognitive rehabilitation and problem-solving programme. In the memantine study, the primary cognitive outcome of memory at six months did not reach significance, but there was significant improvement in overall cognitive function compared to placebo, with similar adverse events across groups. The d-threo-methylphenidate hydrochloride study found no statistically significant difference between arms, with few adverse events. The study of a calorie-restricted ketogenic diet found no effect, although a lower than expected calorie intake in the control group complicates interpretation of the results. The study investigating the utility of a rehabilitation program did not carry out a statistical comparison of cognitive performance between groups. Studies in delayed radiation or late effect phase (four studies) The "amelioration" pharmacological studies to treat cognitive complications of radiotherapy included drugs used in dementia (donepezil) or psychostimulants (methylphenidate and modafinil). Non-pharmacological measures included cognitive rehabilitation and problem solving (Goal Management Training). These studies included patients with cognitive problems at entry who had "stable" brain cancer. The donepezil study did not find an improvement in the primary cognitive outcome of overall cognitive performance, but did find improvement in an individual test of memory, compared to placebo; adverse events were not reported. A study comparing methylphenidate with modafinil found improvements in cognitive function in both the methylphenidate and modafinil arms; few adverse events were reported. Another study comparing two different doses of modafinil combined treatment arms and found improvements across all cognitive tests, however, a number of adverse events were reported. Both studies were limited by a small sample size. The Goal Management Training study suggested a benefit of the intervention, a behavioural intervention that combined mindfulness and strategy training, on executive function and processing speed. There were a number of limitations across studies and few were without high risks of bias. AUTHORS' CONCLUSIONS In this update, limited additional evidence was found for the treatment or amelioration of cognitive deficits in adults treated with cranial irradiation. As concluded in the original review, there is supportive evidence that memantine may help prevent cognitive deficits for adults with brain metastases receiving cranial irradiation. There is supportive evidence that donepezil, methylphenidate and modafinil may have a role in treating cognitive deficits in adults with brain tumours who have been treated with cranial irradiation; patient withdrawal affected the statistical power of these studies. Further research that tries to minimise the withdrawal of consent, and subsequently reduce the requirement for imputation procedures, may offer a higher certainty of evidence. There is evidence from only a single small study to support non-pharmacological interventions in the amelioration of cognitive deficits. Further research is required.
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Affiliation(s)
- Matthew A Kirkman
- Department of Neurosurgery, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Julia Day
- Community Rehabilitation and Brain Injury Service (CRABIS), Strathbrock Partnership Centre, West Lothian, UK
| | - Karin Gehring
- Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, Netherlands
- Department of Cognitive Neuropsychology, Tilburg University, Tilburg, Netherlands
| | - Karolis Zienius
- Edinburgh Centre for Neuro-Oncology (ECNO), Western General Hospital, Edinburgh, UK
| | - David Grosshans
- Radiation Oncology, MD Anderson Cancer Center, Houston, Texas, USA
| | - Martin Taphoorn
- Department of Neurology, Haaglanden Medical Center, PO Box 432, Netherlands
| | - Jing Li
- Radiation Oncology, MD Anderson Cancer Center, Houston, Texas, USA
| | - Paul D Brown
- Radiation Oncology, Mayo Clinic, Rochester, MN, USA
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Cavendish BA, de Lima MFR, Perícoli L, Buratto LG. Effects of combining retrieval practice and tDCS over long-term memory: A randomized controlled trial. Brain Cogn 2021; 156:105807. [PMID: 34949566 DOI: 10.1016/j.bandc.2021.105807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 07/15/2021] [Accepted: 09/26/2021] [Indexed: 11/30/2022]
Abstract
The ability to retain new information is important in daily life. In particular, two techniques have shown promise for improving long-term retention: retrieval practice (RP), which consists of actively retrieving information from long-term memory to make it more accessible in the future; and transcranial direct current stimulation (tDCS), which consists of non-invasive brain stimulation that modulates cognitive processes by increasing and decreasing neuronal excitability. Previous studies have implicated the left dorsolateral prefrontal cortex (l-dlPFC) in memory encoding and memory organization. We examined whether RP associated with a single 20-min tDCS session over the l-dlPFC could improve long-term memory retention. Participants (N = 119) repeatedly studied a list of related words either via RP or via restudy, while undergoing either anodal or sham stimulation. Participants returned 2 days later for a free-recall test. Results showed that the RP group outperformed the restudy group in all measures, regardless of stimulation type. Also, recall organization was higher in the RP group than in the restudy group. The data support previous findings and indicate that RP may enhance performance by improving the organization of the to-be-remembered list items.
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Affiliation(s)
- Beatriz Araújo Cavendish
- Department of Basic Psychological Processes, Institute of Psychology, University of Brasília, Brasília 70.910-900, Brazil.
| | | | - Lara Perícoli
- Department of Basic Psychological Processes, Institute of Psychology, University of Brasília, Brasília 70.910-900, Brazil
| | - Luciano Grüdtner Buratto
- Department of Basic Psychological Processes, Institute of Psychology, University of Brasília, Brasília 70.910-900, Brazil
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Weyer-Jamora C, Brie MS, Luks TL, Smith EM, Hervey-Jumper SL, Taylor JW. Postacute Cognitive Rehabilitation for Adult Brain Tumor Patients. Neurosurgery 2021; 89:945-953. [PMID: 33586764 PMCID: PMC8600173 DOI: 10.1093/neuros/nyaa552] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 11/04/2020] [Indexed: 11/14/2022] Open
Abstract
Intrinsic brain tumors often occur within functional neural networks, leading to neurological impairment and disability of varying degrees. Advances in our understanding of tumor-network integration, human cognition and language processing, and multiparametric imaging, combined with refined intraoperative tumor resection techniques, have enhanced surgical management of intrinsic brain tumors within eloquent areas. However, cognitive symptoms impacting health-related quality of life, particularly processing speed, attention, concentration, working memory, and executive function, often persist after the postoperative recovery period and treatment. Multidisciplinary cognitive rehabilitation is the standard of care for addressing cognitive impairments in many neurological diseases. There is promising research to support the use of cognitive rehabilitation in adult brain tumor patients. In this review, we summarize the history and usefulness of postacute cognitive rehabilitation for adult brain tumor patients.
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Affiliation(s)
- Christina Weyer-Jamora
- Department of Neurological Surgery, University of CaliforniaSan Francisco, San Francisco, California
- Department of Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco, California
| | - Melissa S Brie
- Department of Neurological Surgery, University of CaliforniaSan Francisco, San Francisco, California
- Department of Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco, California
| | - Tracy L Luks
- Department of Radiology and Biomedical Imaging, University of CaliforniaSan Francisco, San Francisco, California
| | - Ellen M Smith
- Department of Neurological Surgery, University of CaliforniaSan Francisco, San Francisco, California
| | - Shawn L Hervey-Jumper
- Department of Neurological Surgery, University of CaliforniaSan Francisco, San Francisco, California
| | - Jennie W Taylor
- Department of Neurological Surgery, University of CaliforniaSan Francisco, San Francisco, California
- Department of Neurology, University of California San Francisco, San Francisco, California, USA
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6
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Weyer-Jamora C, Brie MS, Luks TL, Smith EM, Braunstein SE, Villanueva-Meyer JE, Bracci PM, Chang S, Hervey-Jumper SL, Taylor JW. Cognitive impact of lower-grade gliomas and strategies for rehabilitation. Neurooncol Pract 2021; 8:117-128. [PMID: 33898046 PMCID: PMC8049427 DOI: 10.1093/nop/npaa072] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Outcomes for patients with lower-grade gliomas (LrGGs) continue to improve with advances in molecular characterization and treatment. However, cognitive sequela from the tumor and its treatment leave a significant impact on health-related quality of life for these patients. Several factors affect each patient's cognition, such as tumor location, treatment, medication, and comorbidities. However, impairments of processing speed, attention, concentration, working memory, and executive function are common across LrGG patients. Cognitive rehabilitation strategies, well established in traumatic brain injury and stroke populations, are based on neural plasticity and functional reorganization. Adapting these strategies for implementation in patients with brain tumors is an active area of research. This article provides an overview of cognitive domains commonly impaired in LrGG patients and evidence for the use of cognitive rehabilitation strategies to address these impairments with the goal of improving health-related quality of life in this patient population.
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Affiliation(s)
- Christina Weyer-Jamora
- Department of Neurological Surgery, University of California San Francisco
- Department of Psychiatry and Behavioral Sciences, Zuckerberg San Francisco General Hospital, California
| | - Melissa S Brie
- Department of Neurological Surgery, University of California San Francisco
- Department of Psychiatry and Behavioral Sciences, Zuckerberg San Francisco General Hospital, California
| | - Tracy L Luks
- Department of Radiology and Biomedical Imaging, University of California San Francisco
| | - Ellen M Smith
- Department of Neurological Surgery, University of California San Francisco
| | - Steve E Braunstein
- Department of Radiation Oncology, University of California San Francisco
| | | | - Paige M Bracci
- Department of Epidemiology and Biostatistics, University of California San Francisco
| | - Susan Chang
- Department of Neurological Surgery, University of California San Francisco
| | | | - Jennie W Taylor
- Department of Neurological Surgery, University of California San Francisco
- Department of Neurology, University of California San Francisco
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7
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Ereira S, Pujol M, Guitart-Masip M, Dolan RJ, Kurth-Nelson Z. Overcoming Pavlovian bias in semantic space. Sci Rep 2021; 11:3416. [PMID: 33564034 PMCID: PMC7873193 DOI: 10.1038/s41598-021-82889-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 01/25/2021] [Indexed: 01/25/2023] Open
Abstract
Action is invigorated in the presence of reward-predicting stimuli and inhibited in the presence of punishment-predicting stimuli. Although valuable as a heuristic, this Pavlovian bias can also lead to maladaptive behaviour and is implicated in addiction. Here we explore whether Pavlovian bias can be overcome through training. Across five experiments, we find that Pavlovian bias is resistant to unlearning under most task configurations. However, we demonstrate that when subjects engage in instrumental learning in a verbal semantic space, as opposed to a motoric space, not only do they exhibit the typical Pavlovian bias, but this Pavlovian bias diminishes with training. Our results suggest that learning within the semantic space is necessary, but not sufficient, for subjects to unlearn their Pavlovian bias, and that other task features, such as gamification and spaced stimulus presentation may also be necessary. In summary, we show that Pavlovian bias, whilst robust, is susceptible to change with experience, but only under specific environmental conditions.
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Affiliation(s)
- Sam Ereira
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, UCL, London, WC1B 5EH, UK.
- Wellcome Centre for Human Neuroimaging, UCL, London, WC1N 3BG, UK.
| | - Marine Pujol
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, UCL, London, WC1B 5EH, UK
- Sorbonne Université, Paris, France
| | - Marc Guitart-Masip
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, UCL, London, WC1B 5EH, UK
- Aging Research Centre, Karolinska Institute, 171 65, Stockholm, Sweden
| | - Raymond J Dolan
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, UCL, London, WC1B 5EH, UK
- Wellcome Centre for Human Neuroimaging, UCL, London, WC1N 3BG, UK
| | - Zeb Kurth-Nelson
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, UCL, London, WC1B 5EH, UK
- DeepMind, London, N1C 4AG, UK
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Miotto EC, Bazán PR, Batista AX, Conforto AB, Figueiredo EG, Martin MDGM, Avolio IB, Amaro E, Teixeira MJ. Behavioral and Neural Correlates of Cognitive Training and Transfer Effects in Stroke Patients. Front Neurol 2020; 11:1048. [PMID: 33041987 PMCID: PMC7522394 DOI: 10.3389/fneur.2020.01048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 08/10/2020] [Indexed: 11/13/2022] Open
Abstract
Stroke lesions are frequently followed by cognitive impairments. Cognitive training is a non-pharmacological intervention that can promote neural compensation mechanisms and strategies to remediate cognitive impairments. The aims of this study were: (1) To investigate the cognitive performance, generalization effects, and neural correlates of semantic organization strategy training (SOST) in patients with chronic left frontoparietal stroke and healthy controls (HC); and (2) to compare the behavioral effects and neural correlates of SOST with an active control psychoeducation intervention (PI). In this randomized controlled study, all participants were randomly allocated into two groups, one group received SOST, and the other received PI intervention. Participants underwent two fMRI sessions, one prior and the other, after intervention. In each fMRI session, images were obtained during memory encoding task using a list of semantically related words. We found improved post-intervention memory performance in participants that received SOST (both patients and controls), indicated by number of words recalled, word clustering scores, and performance in a generalization task. The fMRI analysis revealed negative correlation between task performance and regions of the default-mode network. These results suggest that cognitive training using semantic organization strategy can improve episodic memory performance and promote potential functional neuroplasticity in patients with ischemic stroke lesions. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT03644290.
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Affiliation(s)
- Eliane C Miotto
- Department of Neurology, University of São Paulo, São Paulo, Brazil
| | - Paulo R Bazán
- Institute of Radiology, LIM-44, University of São Paulo, São Paulo, Brazil
| | - Alana X Batista
- Department of Neurology, University of São Paulo, São Paulo, Brazil
| | | | | | | | | | - Edson Amaro
- Institute of Radiology, LIM-44, University of São Paulo, São Paulo, Brazil
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9
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Miotto EC, Balardin JB, Martin MDGM, Polanczyk GV, Savage CR, Miguel EC, Batistuzzo MC. Effects of semantic categorization strategy training on episodic memory in children and adolescents. PLoS One 2020; 15:e0228866. [PMID: 32069310 PMCID: PMC7028277 DOI: 10.1371/journal.pone.0228866] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 01/25/2020] [Indexed: 11/18/2022] Open
Abstract
Episodic memory is the ability to learn, store and recall new information. The prefrontal cortex (PFC) is a crucial area engaged in this ability. Cognitive training has been demonstrated to improve episodic memory in adults and older subjects. However, there are no studies examining the effects of cognitive training on episodic memory encoding in typically developing children and adolescents. This study investigated the behavioral effects and neural correlates of semantic categorization strategy training in children and adolescents during verbal episodic memory encoding using functional magnetic resonance imaging (fMRI). Participants with age range: 7-18 years were scanned before and after semantic categorization training during encoding of word lists. Results showed improved memory performance in adolescents, but not in children. Deactivation of the anterior medial PFC/anterior cingulate and higher activation of the right anterior and lateral orbital gyri, right frontal pole and right middle frontal gyrus activation were found after training in adolescents when compared to children. These findings suggest different maturational paths of brain regions, especially in the PFC, and deactivation of default mode network areas, which are involved in successful memory and executive processes in the developing brain.
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Affiliation(s)
- Eliane C. Miotto
- Department of Neurology, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), Sao Paulo, SP, Brazil
- * E-mail:
| | - Joana B. Balardin
- Department of Neurology, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), Sao Paulo, SP, Brazil
- Brain Institute, Hospital Israelita Albert Einstein, Sao Paulo, SP, Brazil
| | | | | | - Cary R. Savage
- Banner Alzheimer’s Institute, Phoenix, AZ, United States of America
| | | | - Marcelo C. Batistuzzo
- Department of Neurology, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), Sao Paulo, SP, Brazil
- Department of Psychiatry, HC-FMUSP, Sao Paulo, SP, Brazil
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10
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Von Ah D, Crouch A. Cognitive Rehabilitation for Cognitive Dysfunction after Cancer and Cancer Treatment: Implications for Nursing Practice. Semin Oncol Nurs 2020; 36:150977. [PMID: 31959511 DOI: 10.1016/j.soncn.2019.150977] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To provide an overview of cognitive rehabilitation approaches for cognitive dysfunction after cancer and cancer treatment. DATA SOURCES Review and synthesis of empirical articles. CONCLUSION Cognitive rehabilitation approaches, including cognitive behavioral therapy and cognitive training, for cognitive dysfunction appear feasible to deliver, satisfactory to participants, and have shown promising results in cancer survivors. Future research is needed to address optimal dose, delivery method, access, cost, and the vulnerable aging cancer survivor population. IMPLICATIONS FOR NURSING PRACTICE Oncology nurses must understand the available evidence and be able to provide information and options to cancer survivors to address cognitive changes after cancer.
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Affiliation(s)
- Diane Von Ah
- Indiana University School of Nursing, Indianapolis, IN.
| | - Adele Crouch
- Indiana University School of Nursing, Indianapolis, IN
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11
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van Lonkhuizen PJC, Klaver KM, Wefel JS, Sitskoorn MM, Schagen SB, Gehring K. Interventions for cognitive problems in adults with brain cancer: A narrative review. Eur J Cancer Care (Engl) 2019; 28:e13088. [PMID: 31090162 PMCID: PMC9285967 DOI: 10.1111/ecc.13088] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 04/17/2019] [Accepted: 04/17/2019] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Many patients with brain cancer experience cognitive problems. In this narrative review, we comprehensively evaluated empirical studies on various intervention approaches for cognitive problems in these patients. METHODS Intervention studies that reported effects on cognitive functioning (either objectively tested or subjectively reported) in adult patients with primary and/or secondary brain tumours were identified through online searches in PubMed (MEDLINE) and Web of Science up to 13 March 2019. RESULTS Of the 364 identified records, 10 pharmacological (including five randomised placebo-controlled trials), 10 cognitive rehabilitation (including five [pilot] RCTs) and two multiple-group exercise studies matched the inclusion criteria. Seventeen of 22 studies had final sample sizes smaller than 40. Several cognitive rehabilitation studies and some pharmacological approaches (donepezil and memantine) showed (at least partial) benefits for cognitive problems in adults with brain cancer. The effects of other pharmacological and exercise interventions were inconclusive and/or preliminary. CONCLUSION Overall, drawing firm conclusions is complicated due to various methodological shortcomings, including the absence of a (placebo) control group and small sample sizes. Promising effects have been reported for cognitive rehabilitation and some pharmacological approaches. Suggestions for more thorough research with respect to the various approaches are provided.
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Affiliation(s)
- Pearl J C van Lonkhuizen
- Department of Cognitive Neuropsychology, Tilburg University, Tilburg, The Netherlands.,Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Kete M Klaver
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Jeffrey S Wefel
- Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Margriet M Sitskoorn
- Department of Cognitive Neuropsychology, Tilburg University, Tilburg, The Netherlands
| | - Sanne B Schagen
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Brain and Cognition, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Karin Gehring
- Department of Cognitive Neuropsychology, Tilburg University, Tilburg, The Netherlands.,Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
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12
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Cognitive rehabilitation for executive dysfunction in brain tumor patients: a pilot randomized controlled trial. J Neurooncol 2019; 142:565-575. [DOI: 10.1007/s11060-019-03130-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 02/21/2019] [Indexed: 11/25/2022]
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13
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Batista AX, Bazán PR, Conforto AB, Martins MDGM, Hoshino M, Simon SS, Hampstead B, Figueiredo EG, Castro MP, Michelan D, Amaro E, Miotto EC. Resting state functional connectivity and neural correlates of face-name encoding in patients with ischemic vascular lesions with and without the involvement of the left inferior frontal gyrus. Cortex 2018; 113:15-28. [PMID: 30557760 DOI: 10.1016/j.cortex.2018.11.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Revised: 08/31/2018] [Accepted: 11/12/2018] [Indexed: 11/28/2022]
Abstract
Face-name association is a relevant ability for social interactions and involves the ventral and dorsolateral prefrontal cortices, particularly in the left hemisphere, bilateral hippocampal, fusiform gyrus and occipital regions. Previous studies demonstrated the primary role of the hippocampus for this ability in healthy subjects. However, no study has examined the participation of the left inferior frontal area, specially the left inferior frontal gyrus (LIFG) in patients with ischemic vascular lesions. In the present study we addressed this issue and investigated the neural correlates and resting state functional connectivity of face-name memory encoding in ischemic patients with LIFG or without lesions in the left IFG (nLIFG) and healthy controls (HC) using fMRI. The main results showed that the nLIFG group demonstrated efficient compensation related to encoding and performance on face-name learning and recognition memory task, in addition to similar brain areas activated during task performance compared to healthy controls. Some of these areas were more activated in nLIFG group, indicating a compensation mechanism. In contrast, the LIFG group showed worse behavior performance, and no signs of an efficient compensation mechanism. Functional connectivity analysis suggested that the left IFG region seems to be important for maintaining the connectivity of the right fusiform gyrus or, perhaps, lesion in this area is associated to maladaptive reorganization. Our findings highlight the relevant role of the left IFG in face-name learning and encoding, possibly as a primary region in addition to the bilateral hippocampal formation and fusiform gyrus.
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Affiliation(s)
- Alana X Batista
- Department of Neurology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Paulo R Bazán
- Department of Radiology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Adriana B Conforto
- Department of Neurology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Maria da Graça M Martins
- Department of Radiology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Maurício Hoshino
- Department of Neurology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Sharon S Simon
- Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Benjamin Hampstead
- Department of Psychiatry and Michigan Alzheimer's Disease Center, University of Michigan, Ann Arbor, MI, USA
| | - Eberval G Figueiredo
- Department of Neurology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Marcia P Castro
- Department of Neurology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Debora Michelan
- Department of Neurology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Edson Amaro
- Department of Radiology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Eliane C Miotto
- Department of Neurology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
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14
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Allen DH, Myers JS, Jansen CE, Merriman JD, Von Ah D. Assessment and Management of Cancer- and Cancer Treatment-Related Cognitive Impairment. J Nurse Pract 2018; 14:217-224.e5. [PMID: 30906237 DOI: 10.1016/j.nurpra.2017.11.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Deborah H Allen
- Duke University Health System, DUMC Box 3543, Durham NC 27710
| | - Jamie S Myers
- Research Assistant Professor, Kansas Univeristy School of Nursing, Mail Stop 2029, Kansas City, KS 66160,
| | - Catherine E Jansen
- Oncology Clinical Nurse Specialist, Kaiser Permanente, 4141 Geary Blvd., San Francisco, CA 94118,
| | - John D Merriman
- Assistant Professor, New York University Meyers College of Nursing, 433 1st Avenue, New York, NY 10010,
| | - Diane Von Ah
- Associate Professor & Chair, Dept. of Community Health Systems, Indiana University School of Nursing, 749 Chestnut St, Terre Haute, IN 47809,
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15
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Gallagher K, Azuma T. Analysis of Story Recall in Military Veterans With and Without Mild Traumatic Brain Injury: Preliminary Results. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 27:485-494. [PMID: 29497758 DOI: 10.1044/2017_ajslp-16-0208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 11/21/2017] [Indexed: 06/08/2023]
Abstract
PURPOSE The purpose of this study was to determine whether detailed analysis of story recall performance reveals significant differences between veterans with and without history of mild traumatic brain injury (mTBI). METHOD Twenty-one military veterans participated, with 7 reporting history of mTBI. All participants were administered the Logical Memory I and II subtests from the Wechsler Memory Scale-Fourth Edition (Wechsler, 2009). Responses were scored for total correct ideas (TCI) and total words produced (TWP). RESULTS Although the groups did not differ in scaled scores, other measures did reveal significant differences. After a delay, the mTBI group showed a greater drop in TCI relative to the control group. Additionally, the control group showed an increase in TWP when the recall was delayed versus immediate; a pattern not observed for the mTBI group. CONCLUSIONS The mTBI and control groups did not significantly differ in scaled scores. However, group differences were observed in TCI and TWP. The findings suggest that, relative to the control group, the mTBI group were less successful in retrieving episodic information and eliciting self-cueing. Small sample size limited data interpretation, and larger sample sizes are needed to confirm the findings. The results indicate that veterans with mTBI may present with symptoms persisting beyond the acute state of the injury.
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Affiliation(s)
- Karen Gallagher
- Department of Speech and Hearing Science, Arizona State University, Tempe
| | - Tamiko Azuma
- Department of Speech and Hearing Science, Arizona State University, Tempe
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16
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Guimond S, Béland S, Lepage M. Strategy for Semantic Association Memory (SESAME) training: Effects on brain functioning in schizophrenia. Psychiatry Res Neuroimaging 2018; 271:50-58. [PMID: 29102504 DOI: 10.1016/j.pscychresns.2017.10.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 09/05/2017] [Accepted: 10/23/2017] [Indexed: 12/17/2022]
Abstract
Self-initiation of semantic encoding strategies is impoverished in schizophrenia and contributes to memory impairments. Recently, we observed that following a brief training, schizophrenia patients had the potential to increase the self-initiation of these strategies. In this study, we investigated the neural correlates underlying such memory improvements. Fifteen schizophrenia patients with deficits in self-initiation of semantic encoding strategies were enrolled in a Strategy for Semantic Association Memory (SESAME) training. Patients underwent a memory task in an fMRI scanner. Memory performance and brain activity during the task were measured pre- and post- training, and changes following training were assessed. We also investigated if structural preservation measured by the cortical thickness of the left dorsolateral prefrontal cortex (DLPFC) predicted memory improvement post-training. Memory training led to significant improvements in memory performance that were associated with increased activity in the left DLPFC, during a task in which patients needed to self-initiate semantic encoding strategies. Furthermore, patients with more cortical reserve in their left DLPFC showed greater memory improvement. Our findings provide evidence of neural malleability in the left DLPFC in schizophrenia using cognitive strategies training. Moreover, the brain-behavioural changes observed in schizophrenia provide hope that memory performance can be improved with a brief intervention.
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Affiliation(s)
- Synthia Guimond
- Department of psychology, McGill University, Montréal, Canada; Douglas Mental Health University Institute, Montréal, Canada; Department of psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| | - Sophie Béland
- Douglas Mental Health University Institute, Montréal, Canada; Integrated Program in Neuroscience, McGill University, Montréal, Canada
| | - Martin Lepage
- Douglas Mental Health University Institute, Montréal, Canada; Department of psychiatry, McGill University, Montréal, Canada.
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17
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O'Neil-Pirozzi TM, Doruk D, Thomson JM, Fregni F. Immediate memory and electrophysiologic effects of prefrontal cortex transcranial direct current stimulation on neurotypical individuals and individuals with chronic traumatic brain injury: a pilot study. Int J Neurosci 2016; 127:592-600. [DOI: 10.1080/00207454.2016.1216415] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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18
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Fang S, Wang Y, Jiang T. The Influence of Frontal Lobe Tumors and Surgical Treatment on Advanced Cognitive Functions. World Neurosurg 2016; 91:340-6. [PMID: 27072331 DOI: 10.1016/j.wneu.2016.04.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 04/01/2016] [Accepted: 04/02/2016] [Indexed: 11/25/2022]
Abstract
Brain cognitive functions affect patient quality of life. The frontal lobe plays a crucial role in advanced cognitive functions, including executive function, meta-cognition, decision-making, memory, emotion, and language. Therefore, frontal tumors can lead to serious cognitive impairments. Currently, neurosurgical treatment is the primary method to treat brain tumors; however, the effects of the surgical treatments are difficult to predict or control. The treatment may both resolve the effects of the tumor to improve cognitive function or cause permanent disabilities resulting from damage to healthy functional brain tissue. Previous studies have focused on the influence of frontal lesions and surgical treatments on patient cognitive function. Here, we review cognitive impairment caused by frontal lobe brain tumors.
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Affiliation(s)
- Shengyu Fang
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Yinyan Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Tao Jiang
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Beijing Institute for Brain Disorders, Brain Tumor Center, Beijing, China.
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19
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Batistuzzo MC, Balardin JB, Martin MDGM, Hoexter MQ, Bernardes ET, Borcato S, Souza MDME, Querido CN, Morais RM, de Alvarenga PG, Lopes AC, Shavitt RG, Savage CR, Amaro E, Miguel EC, Polanczyk GV, Miotto EC. Reduced prefrontal activation in pediatric patients with obsessive-compulsive disorder during verbal episodic memory encoding. J Am Acad Child Adolesc Psychiatry 2015; 54:849-58. [PMID: 26407495 DOI: 10.1016/j.jaac.2015.06.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 06/02/2015] [Accepted: 07/17/2015] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Patients with obsessive-compulsive disorder (OCD) often present with deficits in episodic memory, and there is evidence that these difficulties may be secondary to executive dysfunction, that is, impaired selection and/or application of memory-encoding strategies (mediation hypothesis). Semantic clustering is an effective strategy to enhance encoding of verbal episodic memory (VEM) when word lists are semantically related. Self-initiated mobilization of this strategy has been associated with increased activity in the prefrontal cortex, particularly the orbitofrontal cortex, a key region in the pathophysiology of OCD. We therefore studied children and adolescents with OCD during uncued semantic clustering strategy application in a VEM functional magnetic resonance imaging (fMRI)-encoding paradigm. METHOD A total of 25 pediatric patients with OCD (aged 8.1-17.5 years) and 25 healthy controls (HC, aged 8.1-16.9) matched for age, gender, handedness, and IQ were evaluated using a block design VEM paradigm that manipulated semantically related and unrelated words. RESULTS The semantic clustering strategy score (SCS) predicted VEM performance in HC (p < .001, R(2) = 0.635), but not in patients (p = .099). Children with OCD also presented hypoactivation in the dorsomedial prefrontal cortex (cluster-corrected p < .001). Within-group analysis revealed a negative correlation between Yale-Brown Obsessive Compulsive Scale scores and activation of orbitofrontal cortex in the group with OCD. Finally, a positive correlation between age and SCS was found in HC (p = .001, r = 0.635), but not in patients with OCD (p = .936, r = 0.017). CONCLUSION Children with OCD presented altered brain activation during the VEM paradigm and absence of expected correlation between SCS and age, and between SCS and total words recalled. These results suggest that different neural mechanisms underlie self-initiated semantic clustering in OCD.
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Affiliation(s)
| | | | | | - Marcelo Queiroz Hoexter
- National Institute of Developmental Psychiatry for Children and Adolescents, Obsessive-Compulsive Spectrum Disorders Program (PROTOC) at FMUSP
| | - Elisa Teixeira Bernardes
- National Institute of Developmental Psychiatry for Children and Adolescents, Obsessive-Compulsive Spectrum Disorders Program (PROTOC) at FMUSP
| | - Sonia Borcato
- National Institute of Developmental Psychiatry for Children and Adolescents, Obsessive-Compulsive Spectrum Disorders Program (PROTOC) at FMUSP
| | - Marina de Marco E Souza
- National Institute of Developmental Psychiatry for Children and Adolescents, Obsessive-Compulsive Spectrum Disorders Program (PROTOC) at FMUSP
| | - Cicero Nardini Querido
- National Institute of Developmental Psychiatry for Children and Adolescents, Obsessive-Compulsive Spectrum Disorders Program (PROTOC) at FMUSP
| | - Rosa Magaly Morais
- National Institute of Developmental Psychiatry for Children and Adolescents, Obsessive-Compulsive Spectrum Disorders Program (PROTOC) at FMUSP
| | - Pedro Gomes de Alvarenga
- National Institute of Developmental Psychiatry for Children and Adolescents, Obsessive-Compulsive Spectrum Disorders Program (PROTOC) at FMUSP
| | - Antonio Carlos Lopes
- National Institute of Developmental Psychiatry for Children and Adolescents, Obsessive-Compulsive Spectrum Disorders Program (PROTOC) at FMUSP
| | - Roseli Gedanke Shavitt
- National Institute of Developmental Psychiatry for Children and Adolescents, Obsessive-Compulsive Spectrum Disorders Program (PROTOC) at FMUSP
| | - Cary R Savage
- Center for Health Behavior Neuroscience, Kansas University Medical Center, Kansas City, KA
| | - Edson Amaro
- Departamento de Radiologia, Faculdade de Medicina, Hospital das Clínicas, Universidade de São Paulo
| | - Euripedes C Miguel
- National Institute of Developmental Psychiatry for Children and Adolescents, Obsessive-Compulsive Spectrum Disorders Program (PROTOC) at FMUSP
| | - Guilherme V Polanczyk
- National Institute of Developmental Psychiatry for Children and Adolescents, Obsessive-Compulsive Spectrum Disorders Program (PROTOC) at FMUSP
| | - Eliane C Miotto
- University of São Paulo Medical School (FMUSP), São Paulo, Brazil
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20
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Miotto EC, Balardin JB, Savage CR, Martin MDGM, Batistuzzo MC, Amaro Junior E, Nitrini R. Brain regions supporting verbal memory improvement in healthy older subjects. ARQUIVOS DE NEURO-PSIQUIATRIA 2015; 72:663-70. [PMID: 25252229 DOI: 10.1590/0004-282x20140120] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Accepted: 07/07/2014] [Indexed: 11/22/2022]
Abstract
UNLABELLED Despite growing interest in developing cognitive training interventions to minimize the aging cognitive decline process, no studies have attempted to explore which brain regions support the application of semantic strategies during verbal memory encoding. Our aim was to investigate the behavioral performance and brain correlates of these strategies in elderly individuals using fMRI in healthy older subjects. METHOD Subjects were scanned twice on the same day, before and after, directed instructions to apply semantic strategies during the encoding of word lists. RESULTS Improved memory performance associated to increased semantic strategy application and brain activity in the left inferior and middle and right medial superior prefrontal cortex were found after the directed instructions. There was also reduced activation in areas related to strategy mobilization. CONCLUSION Improved memory performance in older subjects after the application of semantic strategies was associated with functional brain reorganization involving regions inside and outside the typical memory network.
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Affiliation(s)
- Eliane C Miotto
- Departamento de Neurologia, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | - Joana B Balardin
- Departamento de Neurologia, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | - Cary R Savage
- Center for Health Behavior Neuroscience, Kansas University, Kansas, EUA
| | - Maria da Graça M Martin
- Departamento de Radiologia, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | - Marcelo C Batistuzzo
- Departamento de Neurologia, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | - Edson Amaro Junior
- Departamento de Radiologia, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | - Ricardo Nitrini
- Departamento de Neurologia, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, Brazil
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21
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Lepping RJ, Brooks WM, Kirchhoff BA, Martin LE, Kurylo M, Ladesich L, Lierman JA, Varghese G, Savage CR. Effectiveness of Semantic Encoding Strategy Training after Traumatic Brain Injury is Correlated with Frontal Brain Activation Change. INTERNATIONAL JOURNAL OF PHYSICAL MEDICINE & REHABILITATION 2015; 3. [PMID: 32832578 PMCID: PMC7440179 DOI: 10.4172/2329-9096.1000254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Background Traumatic Brain Injury (TBI) is frequently associated with chronic, treatment-resistant memory problems, and is one of the leading causes of disability in otherwise healthy adults. Cognitive rehabilitation therapies are used with the goal of improving memory functioning; however, not all patients benefit. Prefrontal cortex (PFC) is critical for employing effective memory strategies. We hypothesized that memory improvement after a brief cognitive intervention would be associated with increases in PFC activation during a memory task. Methods The current study used behavioral analyses and functional magnetic resonance imaging (fMRI) to examine the effects of two days of intensive semantic encoding strategy training on memory performance and brain activation patterns in patients in the post-acute stage of TBI. fMRI data were collected before and after training while participants learned word lists. Results Post-training vs. pre-training changes in total recall and semantic clustering during recall were positively correlated with post-training vs. pre-training changes in neural activation in PFC. Conclusions These results suggest that variability in treatment response to cognitive training after TBI may be due in part to variability in PFC function, and that some survivors of TBIs may benefit from treatments specifically targeting the PFC.
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Affiliation(s)
- Rebecca J Lepping
- Hoglund Brain Imaging Center, University of Kansas Medical Center, Kansas city, USA
| | - William M Brooks
- Hoglund Brain Imaging Center, University of Kansas Medical Center, Kansas city, USA.,Department of Neurology, University of Kansas Medical Center, Kansas city, USA
| | | | - Laura E Martin
- Hoglund Brain Imaging Center, University of Kansas Medical Center, Kansas city, USA.,Department of Preventive Medicine, University of Kansas Medical Center, Kansas city, USA
| | - Monica Kurylo
- Department of Psychiatry, University of Kansas Medical Center, Kansas city, USA.,Department of Physical Medicine and Rehabilitation, University of Kansas Medical Center, Kansas city, USA
| | - Linda Ladesich
- Meadowbrook Rehabilitation Hospital, Gardner, Kansas city, USA
| | - Jo Ann Lierman
- Hoglund Brain Imaging Center, University of Kansas Medical Center, Kansas city, USA
| | - George Varghese
- Department of Physical Medicine and Rehabilitation, University of Kansas Medical Center, Kansas city, USA
| | - Cary R Savage
- Department of Psychiatry, University of Kansas Medical Center, Kansas city, USA.,Center for Health Behavior Neuroscience, University of Kansas Medical Center, Kansas city, USA
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22
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Day J, Zienius K, Gehring K, Grosshans D, Taphoorn M, Grant R, Li J, Brown PD. Interventions for preventing and ameliorating cognitive deficits in adults treated with cranial irradiation. Cochrane Database Syst Rev 2014; 2014:CD011335. [PMID: 25519950 PMCID: PMC6457828 DOI: 10.1002/14651858.cd011335.pub2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Cognitive deficits are common in people who have received cranial irradiation and have a serious impact on daily functioning and quality of life. The benefit of pharmacological and non-pharmacological treatment of cognitive deficits in this population is unclear. OBJECTIVES To assess the effectiveness of interventions for preventing or ameliorating cognitive deficits in adult patients treated with cranial irradiation. SEARCH METHODS In August 2014. we searched the Cochrane Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and PsycINFO and checked the reference lists of included studies. We also searched for ongoing trials via ClinicalTrials.gov, the Physicians Data Query and the Meta Register of Controlled Trials. SELECTION CRITERIA We included randomised controlled trials (RCTs) that evaluated pharmacological or non-pharmacological interventions in cranial irradiated adults, with objective cognitive functioning as a primary or secondary outcome measure. DATA COLLECTION AND ANALYSIS Two review authors (JD, KZ) independently extracted data from selected studies and carried out a 'Risk of bias' assessment. Cognitive function, fatigue and mood outcomes were reported. No data were pooled. MAIN RESULTS Sixteen studies were identified for possible inclusion in the review, six of which were included. Three studies investigated prevention and three studies investigated amelioration. Due to differences between studies in the interventions being evaluated, a meta-analysis was not possible. Two studies investigated a pharmacological intervention for the prevention of cognitive deficits; memantine compared with placebo, and d-threo-methylphenidate HCL compared with placebo. In the first study the primary cognitive outcome of memory at six months did not reach significance, but there was significant improvement in overall cognitive function compared to placebo, with similar adverse events across groups. The second study found no statistically significant difference between arms, with few adverse events. The third study investigated a rehabilitation program for the prevention of cognitive deficits but did not carry out a statistical comparison of cognitive performance between groups.Three studies investigated the use of a pharmacological intervention for the treatment of cognitive deficits; methylphenidate compared with modafinil, two different doses of modafinil, and donepezil compared with placebo. The first study found improvements in cognitive function in both the methylphenidate and modafinil arms; few adverse events were reported. The second study combined treatment arms and found improvements across all cognitive tests, however, a number of adverse events were reported. Both studies were limited by a small sample size. The third study did not find an improvement in the primary cognitive outcome of overall performance, but did find improvement in an individual test of memory, compared to placebo; adverse events were not reported. No non-pharmacological studies for the amelioration of cognitive deficits were eligible. There were a number of limitations across studies but few without high risks of bias. AUTHORS' CONCLUSIONS There is supportive evidence that memantine may help prevent cognitive deficits for adults with brain metastases receiving cranial irradiation. There is supportive evidence that donepezil may have a role in treating cognitive deficits in adults with primary or metastatic brain tumours who have been treated with cranial irradiation. Patient withdrawal affected the statistical power of both studies. Further research that tries to minimise the withdrawal of consent, and subsequently reduce the requirement for imputation procedures, may offer a higher quality of evidence.There is no strong evidence to support any non-pharmacological interventions (medical or cognitive/behavioural) in the prevention or amelioration of cognitive deficits. Non-randomised studies appear promising but are as yet to be conclusive via translation into high quality evidence. Further research is required.
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Affiliation(s)
- Julia Day
- Edinburgh Centre for Neuro-Oncology (ECNO),Western General Hospital,Crewe Road South, Edinburgh, Scotland, EH4 2XU, UK. .
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23
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Miotto EC, Balardin JB, Vieira G, Sato JR, Martin MDGM, Scaff M, Teixeira MJ, Junior EA. Right inferior frontal gyrus activation is associated with memory improvement in patients with left frontal low-grade glioma resection. PLoS One 2014; 9:e105987. [PMID: 25157573 PMCID: PMC4144959 DOI: 10.1371/journal.pone.0105987] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 07/31/2014] [Indexed: 11/30/2022] Open
Abstract
Patients with low-grade glioma (LGG) have been studied as a model of functional brain reorganization due to their slow-growing nature. However, there is no information regarding which brain areas are involved during verbal memory encoding after extensive left frontal LGG resection. In addition, it remains unknown whether these patients can improve their memory performance after instructions to apply efficient strategies. The neural correlates of verbal memory encoding were investigated in patients who had undergone extensive left frontal lobe (LFL) LGG resections and healthy controls using fMRI both before and after directed instructions were given for semantic organizational strategies. Participants were scanned during the encoding of word lists under three different conditions before and after a brief period of practice. The conditions included semantically unrelated (UR), related-non-structured (RNS), and related-structured words (RS), allowing for different levels of semantic organization. All participants improved on memory recall and semantic strategy application after the instructions for the RNS condition. Healthy subjects showed increased activation in the left inferior frontal gyrus (IFG) and middle frontal gyrus (MFG) during encoding for the RNS condition after the instructions. Patients with LFL excisions demonstrated increased activation in the right IFG for the RNS condition after instructions were given for the semantic strategies. Despite extensive damage in relevant areas that support verbal memory encoding and semantic strategy applications, patients that had undergone resections for LFL tumor could recruit the right-sided contralateral homologous areas after instructions were given and semantic strategies were practiced. These results provide insights into changes in brain activation areas typically implicated in verbal memory encoding and semantic processing.
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Affiliation(s)
- Eliane C. Miotto
- Department of Neurology, University of São Paulo, São Paulo, Brazil
- * E-mail:
| | | | - Gilson Vieira
- Department of Radiology, University of São Paulo, São Paulo, Brazil
| | - Joao R. Sato
- Centre of Mathematics, Computation and Cognition, Universidade Federal ABC, Santo Andre, Brazil
| | | | - Milberto Scaff
- Department of Neurology, University of São Paulo, São Paulo, Brazil
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24
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Declarative memory disorders in patients with brain tumors can improve after cognitive training intervention: evidence from functional MRI. J Neurooncol 2012; 110:301-2. [DOI: 10.1007/s11060-012-0952-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Accepted: 07/28/2012] [Indexed: 10/28/2022]
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