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de Gier M, Oosterman JM, Hughes AM, Moss-Morris R, Hirsch C, Beckerman H, de Groot V, Knoop H. The presence of attentional and interpretation biases in patients with severe MS-related fatigue. Br J Health Psychol 2024. [PMID: 38575519 DOI: 10.1111/bjhp.12723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 03/25/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVE Severe fatigue is a prevalent and disabling symptom in multiple sclerosis (MS). This study tested if a fatigue- and physical activity-related attentional bias (AB) and a somatic interpretation bias (IB) are present in severely fatigued patients with MS. Biases were compared to healthy controls and patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). METHOD Severely fatigued patients with MS or ME/CFS and healthy controls completed a Visual Probe Task (VPT) assessing fatigue- and physical activity-related AB and an IB task that assesses the tendency to interpret ambiguous information in either a somatically threatening way or in a more neutral manner. The VPT was completed by 38 MS patients, 44 ME/CFS patients, and 46 healthy controls; the IB task was completed by 156, 40 and 46 participants respectively. RESULTS ANOVA showed no statistically significant group differences in a fatigue-related AB or physical activity-related AB (omnibus test of interaction between topic × condition: F2,125 = 1.87; p = .159). Both patient groups showed a tendency to interpret ambiguous information in a somatically threatening way compared to healthy controls (F1,2 = 27.61, p < .001). This IB was significantly stronger in MS patients compared to ME/CFS patients. IB was significantly correlated with cognitive responses to symptoms in MS patients. CONCLUSION MS patients tend to interpret ambiguous information in a somatically threatening way. This may feed into unhelpful ways of dealing with symptoms, possibly contributing to the perpetuation of severe fatigue in MS.
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Affiliation(s)
- Marieke de Gier
- Department of Medical Psychology, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience Research Institute, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Mental Health, Amsterdam, The Netherlands
| | - Joukje M Oosterman
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Alicia M Hughes
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Rona Moss-Morris
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Colette Hirsch
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Heleen Beckerman
- Amsterdam Neuroscience Research Institute, Amsterdam, The Netherlands
- Department of Rehabilitation Medicine, MS Center Amsterdam, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Vincent de Groot
- Amsterdam Neuroscience Research Institute, Amsterdam, The Netherlands
- Department of Rehabilitation Medicine, MS Center Amsterdam, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hans Knoop
- Amsterdam Public Health Research Institute, Mental Health, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands
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van der Schaaf ME, Geerligs L, Toni I, Knoop H, Oosterman JM. Disentangling pain and fatigue in chronic fatigue syndrome: a resting state connectivity study before and after cognitive behavioral therapy. Psychol Med 2024:1-14. [PMID: 38193344 DOI: 10.1017/s0033291723003690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
BACKGROUND Fatigue is a central feature of myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS), but many ME/CFS patients also report comorbid pain symptoms. It remains unclear whether these symptoms are related to similar or dissociable brain networks. This study used resting-state fMRI to disentangle networks associated with fatigue and pain symptoms in ME/CFS patients, and to link changes in those networks to clinical improvements following cognitive behavioral therapy (CBT). METHODS Relationships between pain and fatigue symptoms and cortico-cortical connectivity were assessed within ME/CFS patients at baseline (N = 72) and after CBT (N = 33) and waiting list (WL, N = 18) and compared to healthy controls (HC, N = 29). The analyses focused on four networks previously associated with pain and/or fatigue, i.e. the fronto-parietal network (FPN), premotor network (PMN), somatomotor network (SMN), and default mode network (DMN). RESULTS At baseline, variation in pain and fatigue symptoms related to partially dissociable brain networks. Fatigue was associated with higher SMN-PMN connectivity and lower SMN-DMN connectivity. Pain was associated with lower PMN-DMN connectivity. CBT improved SMN-DMN connectivity, compared to WL. Larger clinical improvements were associated with larger increases in frontal SMN-DMN connectivity. No CBT effects were observed for PMN-DMN or SMN-PMN connectivity. CONCLUSIONS These results provide insight into the dissociable neural mechanisms underlying fatigue and pain symptoms in ME/CFS and how they are affected by CBT in successfully treated patients. Further investigation of how and in whom behavioral and biomedical treatments affect these networks is warranted to improve and individualize existing or new treatments for ME/CFS.
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Affiliation(s)
- Marieke E van der Schaaf
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, the Netherlands
- Radboud University, Donders Institute for Brain, Cognition and Behavior, Nijmegen, the Netherlands
- Department of cognitive neuropsychology Tilburg University, Tilburg, The Netherlands
| | - Linda Geerligs
- Radboud University, Donders Institute for Brain, Cognition and Behavior, Nijmegen, the Netherlands
| | - Ivan Toni
- Radboud University, Donders Institute for Brain, Cognition and Behavior, Nijmegen, the Netherlands
| | - Hans Knoop
- Department of Medical Psychology and Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Joukje M Oosterman
- Radboud University, Donders Institute for Brain, Cognition and Behavior, Nijmegen, the Netherlands
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Jansen MG, Oosterman JM, Folkerts AK, Chakraverty D, Kessels RPC, Kalbe E, Roheger M. Classification Of MeMory InTerventions: Rationale and developmental process of the COMMIT tool. Neuropsychol Rehabil 2023:1-22. [PMID: 37523444 DOI: 10.1080/09602011.2023.2236346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 06/29/2023] [Indexed: 08/02/2023]
Abstract
ABSTRACTOver the last decades, numerous memory interventions have been developed to mitigate memory decline in normal ageing. However, there is a large variability in the success of memory interventions, and it remains poorly understood which memory intervention programs are most effective and for whom. This is partially explained by the heterogeneity of memory intervention protocols across studies as well as often poor reporting of the study design. To facilitate a reporting framework that enables researchers to systemize the content and design of memory intervention paradigms, we developed the Classification Of MeMory InTerventions (COMMIT) tool using a 3-stage developmental process. Briefly, COMMIT was based on qualitative content analysis of already existing memory intervention studies published between April 1983 and July 2020, and iteratively validated by both internal and external expert panels. COMMIT provides an easily-applicable interactive tool that enables systematic description of memory intervention studies, together with instructions on how to use this classification tool. Our main goal is to provide a tool that enables the reporting and classification of memory interventions in a transparent, comprehensible, and complete manner, to ensure a better comparability between memory interventions, and, to ultimately contribute to the question which memory intervention shows the greatest benefits.
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Affiliation(s)
- Michelle G Jansen
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Joukje M Oosterman
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Ann-Kristin Folkerts
- Medical Psychology, Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Interventions (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Digo Chakraverty
- Medical Psychology, Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Interventions (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Roy P C Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
- Department of Medical Psychology & Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Elke Kalbe
- Medical Psychology, Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Interventions (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Mandy Roheger
- Department of Psychology, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
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Rensen YCM, Oosterman JM, Eling PATM, Kessels RPC. "Cinderella was attacked by the big bad wolf, but the police saved her": intrusions and confabulations on story recall in Korsakoff's syndrome and alcohol-related cognitive impairments. Cogn Neuropsychiatry 2023; 28:85-101. [PMID: 36472235 DOI: 10.1080/13546805.2022.2153658] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The relation between confabulations and intrusions in patients with Korsakoff's syndrome (KS) and patients with alcohol-related cognitive impairments (ARCI) remains under debate. This study examines (1) differences in the production of confabulations and intrusions between patients with KS and ARCI, (2) whether an altered fairy tale induces more intrusions, and (3) whether different types of intrusions were significantly related to confabulations. METHODS Twenty-three patients with KS and twenty-two patients with ARCI recalled three different types of stories: a novel story, a fairy tale, and a modified fairy tale. Different types of intrusions were correlated with confabulation measures. RESULTS Patients with KS produced more intrusions in the modified fairy tale condition than patients with ARCI, but these were unrelated to confabulations. Only unrelated intrusions were related to provoked confabulations. CONCLUSIONS The results of this study indicate that researchers and clinicians must be aware that in general, intrusions on memory tests should not be interpreted as confabulations. Especially spontaneous confabulations appear to be something completely different from intrusions on any type of story recall. When measuring confabulations it is crucial to use validated instruments.
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Affiliation(s)
- Yvonne C M Rensen
- Vincent van Gogh Institute for Psychiatry, Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Korsakoff Clinic, Venray, The Netherlands
| | - Joukje M Oosterman
- Radboud University, Donders Institute for Brain, Cognition, and Behaviour, Nijmegen, The Netherlands
| | - Paul A T M Eling
- Radboud University, Donders Institute for Brain, Cognition, and Behaviour, Nijmegen, The Netherlands
| | - Roy P C Kessels
- Vincent van Gogh Institute for Psychiatry, Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Korsakoff Clinic, Venray, The Netherlands
- Radboud University, Donders Institute for Brain, Cognition, and Behaviour, Nijmegen, The Netherlands
- Tactus Addiction Care, Deventer, The Netherlands
- Radboud University Medical Center, Department of Medical Psychology, Nijmegen, The Netherlands
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Kessels RPC, de Vent NR, Bruijnen CJWH, Jansen MG, de Jonghe JFM, Dijkstra BAG, Oosterman JM. Regression-Based Normative Data for the Montreal Cognitive Assessment (MoCA) and Its Memory Index Score (MoCA-MIS) for Individuals Aged 18–91. J Clin Med 2022; 11:jcm11144059. [PMID: 35887823 PMCID: PMC9318507 DOI: 10.3390/jcm11144059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/07/2022] [Accepted: 07/12/2022] [Indexed: 01/07/2023] Open
Abstract
(1) Background: There is a need for a brief assessment of cognitive function, both in patient care and scientific research, for which the Montreal Cognitive Assessment (MoCA) is a psychometrically reliable and valid tool. However, fine-grained normative data allowing for adjustment for age, education, and/or sex are lacking, especially for its Memory Index Score (MIS). (2) Methods: A total of 820 healthy individuals aged 18–91 (366 men) completed the Dutch MoCA (version 7.1), of whom 182 also completed the cued recall and recognition memory subtests enabling calculation of the MIS. Regression-based normative data were computed for the MoCA Total Score and MIS, following the data-handling procedure of the Advanced Neuropsychological Diagnostics Infrastructure (ANDI). (3) Results: Age, education level, and sex were significant predictors of the MoCA Total Score (Conditional R2 = 0.4, Marginal R2 = 0.12, restricted maximum likelihood (REML) criterion at convergence: 3470.1) and MIS (Marginal R2 = 0.14, REML criterion at convergence: 682.8). Percentile distributions are presented that allow for age, education and sex adjustment for the MoCA Total Score and the MIS. (4) Conclusions: We present normative data covering the full adult life span that can be used for the screening for overall cognitive deficits and memory impairment, not only in older people with or people at risk of neurodegenerative disease, but also in younger individuals with acquired brain injury, neurological disease, or non-neurological medical conditions.
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Affiliation(s)
- Roy P. C. Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6525 GD Nijmegen, The Netherlands; (M.G.J.); (J.M.O.)
- Vincent van Gogh Institute for Psychiatry, Center of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, 5803 DN Venray, The Netherlands;
- Klimmendaal Rehabilitation Specialists, 6813 GG Arnhem, The Netherlands
- Tactus Addiction Care, 7400 AD Deventer, The Netherlands
- Department of Medical Psychology and Radboudumc Alzheimer Center, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
- Correspondence: ; Tel.: +31-24-3612-541
| | - Nathalie R. de Vent
- Department of Psychology, University of Amsterdam, 1018 WS Amsterdam, The Netherlands;
| | - Carolien J. W. H. Bruijnen
- Vincent van Gogh Institute for Psychiatry, Center of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, 5803 DN Venray, The Netherlands;
- Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Radboud University, 6525 GD Nijmegen, The Netherlands;
| | - Michelle G. Jansen
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6525 GD Nijmegen, The Netherlands; (M.G.J.); (J.M.O.)
| | | | - Boukje A. G. Dijkstra
- Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Radboud University, 6525 GD Nijmegen, The Netherlands;
- Novadic-Kentron, Addiction Care Center, 5261 LX Vught, The Netherlands
| | - Joukje M. Oosterman
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6525 GD Nijmegen, The Netherlands; (M.G.J.); (J.M.O.)
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Lier EJ, van Rijn CM, de Vries M, van Goor H, Oosterman JM. The interaction between pain and cognition: on the roles of task complexity and pain intensity. Scand J Pain 2022; 22:385-395. [PMID: 34727588 DOI: 10.1515/sjpain-2021-0119] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/18/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The interaction between pain and cognition includes a concurrent negative effect of pain on cognitive performance and an analgesic effect of cognitive distraction on pain experience. The purpose of this exploratory study was to investigate the role of pain intensity and task complexity on this interaction. METHODS Two experiments were conducted in healthy volunteers. In both experiments, participants completed 3 conditions: a pain only condition (consisting of the cold pressor test), a cognition only condition (consisting of the cognitive task) and a combined condition (concurrent administration of the cold pressor and cognitive task). In experiment I, participants performed one out of three possible tasks that differed in cognitive load (low, medium, high). In experiment II the parameters of the pain stimulus, induced by a cold pressor test, were adapted and only the high load cognitive task was employed. Pain scores, reaction times, and accuracy rates were recorded. RESULTS In experiment I, cognitive distraction significantly decreased pain scores, irrespective of the cognitive load of the task. Pain did not affect cognitive performance. In experiment II, pain diminished accuracy rates. No effect of cognitive distraction on pain was observed. Individual characteristics did not noticeably influence the interaction between pain and cognition. CONCLUSIONS The results of this study suggest a two-way interaction, however no evidence for a simultaneous bidirectional relationship was found. Cognitive distraction successfully reduces pain, up until a certain point where this relationship is reversed, and pain starts to interfere with cognitive performance. This may imply that priorities shift at a certain pain-threshold, however further research should confirm this hypothesis. This study could contribute to further understanding of cognitive mechanisms related to pain perception.
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Affiliation(s)
- Elisabeth J Lier
- Department of Surgery, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Clementina M van Rijn
- Radboud University, Donders Institute for Brain, Cognition and Behaviour Montessorilaan 3, 6525 HR, Nijmegen, The Netherlands
| | - Marjan de Vries
- Department of Surgery, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Harry van Goor
- Department of Surgery, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Joukje M Oosterman
- Radboud University, Donders Institute for Brain, Cognition and Behaviour Montessorilaan 3, 6525 HR, Nijmegen, The Netherlands
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Brazil IA, Atanassova DV, Oosterman JM. Own Pain Distress Mediates the Link Between the Lifestyle Facet of Psychopathy and Estimates of Pain Distress in Others. Front Behav Neurosci 2022; 16:824697. [PMID: 35283742 PMCID: PMC8908239 DOI: 10.3389/fnbeh.2022.824697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
Psychopathy is a multifaceted personality construct entailing interpersonal-affective disturbances, antisocial traits, and a tendency to lead an erratic lifestyle. Elevated levels of psychopathic traits have been linked to having an altered experience of pain, reduced responsivity to distress in others, and making poor moral choices that bring harm to others. In the context of moral decision-making, it is possible that the capacity to estimate the distress felt by others is linked to a limitation in the first-hand experience of distress, as the presence of psychopathic traits increases. We employed a model-based approach in a non-offender sample (n = 174) to investigate whether pain-related distress mediated the links between facets of psychopathy and estimates of the pain distress potentially experienced by others. Participants judged the permissibility of moral dilemmas and rated how much pain distress they would experience while making such judgements, as well as how much pain distress they believed the “victims” would feel as a result of the moral choice made by the participant. We found that ratings of own pain distress predicted beliefs about the distress others may experience, and elevated scores on the lifestyle facet of psychopathy uniquely predicted lower estimates of own pain distress. Furthermore, own pain distress mediated the relationship between the lifestyle facet and beliefs about others’ distress. Finally, exploratory zero-order correlation analyses revealed that ratings of own pain distress decreased as the scores on multiple psychopathic traits increased. Only the lifestyle facet correlated in the negative direction with beliefs about others’ distress. Taken together, our findings suggest that beliefs about how much pain distress others may experience is indeed mediated by own pain distress, and that the tendency to lead an erratic lifestyle is linked to alterations in this mechanism.
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Affiliation(s)
- Inti A. Brazil
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands
- Forensic Psychiatric Centre Pompestichting, Nijmegen, Netherlands
- *Correspondence: Inti A. Brazil,
| | - Dimana V. Atanassova
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands
| | - Joukje M. Oosterman
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands
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Zwan MD, Deckers K, Claassen JA, Oosterman JM, de Heus RA, van de Rest O, de Groot LC, Smidt N, Broersen LM, Counotte D, Sikkes SA, van Boxtel MP, Aarts E, van der Flier WM, Koehler S. Study design of FINGER‐NL: A multidomain lifestyle intervention in Dutch older adults to prevent cognitive decline. Alzheimers Dement 2021. [DOI: 10.1002/alz.055136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Marissa D. Zwan
- Alzheimer Center & Department of Neurology Neuroscience Campus Amsterdam VU University Medical Center Amsterdam Netherlands
| | - Kay Deckers
- Alzheimer Centrum Limburg Department of Psychiatry and Neuropsychology School for Mental Health and Neuroscience Maastricht University Maastricht Netherlands
| | - Jurgen A.H.R. Claassen
- Department of Geriatrics & Radboud UMC Alzheimer Center Radboud University Medical Center Nijmegen Netherlands
| | - Joukje M. Oosterman
- Donders Institute for Brain Cognition and Behaviour Radboud University Nijmegen Netherlands
| | - Rianne A.A. de Heus
- Department of Geriatrics & Radboud UMC Alzheimer Center Radboud University Medical Center Nijmegen Netherlands
| | - Ondine van de Rest
- Wageningen University Division of Human Nutrition Chair group Nutritional Biology Wageningen Netherlands
| | - Lisette C.P.G.M. de Groot
- Wageningen University Division of Human Nutrition Chair group Nutritional Biology Wageningen Netherlands
| | - Nynke Smidt
- Department of Epidemiology University of Groningen University Medical Center Groningen Groningen Netherlands
| | - Laus M. Broersen
- Danone Nutricia Research Specialized Nutrition Utrecht Netherlands
| | | | - Sietske A.M. Sikkes
- VU University Department of Clinical Neuro and Developmental Psychology Amsterdam Netherlands
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Martin P.J. van Boxtel
- Alzheimer Centrum Limburg Department of Psychiatry and Neuropsychology School for Mental Health and Neuroscience Maastricht University Maastricht Netherlands
| | - Esther Aarts
- Donders Institute for Brain Cognition and Behaviour Radboud University Nijmegen Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center & Department of Neurology Neuroscience Campus Amsterdam VU University Medical Center Amsterdam Netherlands
| | - Sebastian Koehler
- Department of Psychiatry and Neuropsychology Maastricht University Maastricht Netherlands
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Jansen MG, Geerligs L, Claassen JAHR, Overdorp EJ, Brazil IA, Kessels RPC, Oosterman JM. Positive Effects of Education on Cognitive Functioning Depend on Clinical Status and Neuropathological Severity. Front Hum Neurosci 2021; 15:723728. [PMID: 34566608 PMCID: PMC8459869 DOI: 10.3389/fnhum.2021.723728] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/06/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Variability in cognitive functions in healthy and pathological aging is often explained by educational attainment. However, it remains unclear to which extent different disease states alter protective effects of education. We aimed to investigate whether protective effects of education on cognition depend on (1) clinical diagnosis severity, and (2) the neuropathological burden within a diagnosis in a memory clinic setting. Methods: In this cross-sectional study, we included 108 patients with subjective cognitive decline [SCD, median age 71, IQR (66-78), 43% men], 190 with mild cognitive impairment [MCI, median age 78, IQR (73-82), 44% men], and 245 with Alzheimer's disease dementia (AD) [median age 80, IQR (76-84), 35% men]. We combined visual ratings of hippocampal atrophy, global atrophy, and white matter hyperintensities on MRI into a single neuropathology score. To investigate whether the contribution of education to cognitive performance differed across SCD, MCI, and AD, we employed several multiple linear regression models, stratified by diagnosis and adjusted for age, sex, and neurodegeneration. We re-ran each model with an additional interaction term to investigate whether these effects were influenced by neuropathological burden for each diagnostic group separately. False discovery rate (FDR) corrections for multiple comparisons were applied. Results: We observed significant positive associations between education and performance for global cognition and executive functions (all adjusted p-values < 0.05). As diagnosis became more severe, however, the strength of these associations decreased (all adjusted p-values < 0.05). Education related to episodic memory only at relatively lower levels of neuropathology in SCD (β = -0.23, uncorrected p = 0.02), whereas education related to episodic memory in those with higher levels of neuropathology in MCI (β = 0.15, uncorrected p = 0.04). However, these interaction effects did not survive FDR-corrections. Conclusions: Altogether, our results demonstrated that positive effects of education on cognitive functioning reduce with diagnosis severity, but the role of neuropathological burden within a particular diagnosis was small and warrants further investigation. Future studies may further unravel the extent to which different dimensions of an individual's disease severity contribute to the waxing and waning of protective effects in cognitive aging.
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Affiliation(s)
- Michelle G. Jansen
- Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, Netherlands
| | - Linda Geerligs
- Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, Netherlands
| | - Jurgen A. H. R. Claassen
- Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, Netherlands
- Department of Geriatric Medicine, Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Inti A. Brazil
- Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, Netherlands
| | - Roy P. C. Kessels
- Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, Netherlands
- Department of Medical Psychology, Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, Netherlands
- Vincent van Gogh Institute for Psychiatry, Venray, Netherlands
| | - Joukje M. Oosterman
- Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, Netherlands
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Oosterman JM, Jansen MG, Scherder EJA, Kessels RPC. Cognitive reserve relates to executive functioning in the old-old. Aging Clin Exp Res 2020; 33:2587-2592. [PMID: 33280069 PMCID: PMC8429397 DOI: 10.1007/s40520-020-01758-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 11/11/2020] [Indexed: 01/10/2023]
Abstract
Cognitive reserve (CR) is known to reduce or even protect against the negative effects of aging on cognitive functioning. Nonetheless, little is known about how CR influences the relationship between different cognitive abilities and age in the old–old. The goal of the present study was, therefore, to test the hypothesis whether, in the old–old, CR still modifies the relationship between age and cognitive functioning. Eighty-three adults (aged 71–94) without mild cognitive impairment or dementia residing in residential care facilities completed a detailed neuropsychological test battery. CR was estimated using a combination of educational attainment and an estimation of verbal intelligence. Moderation analyses revealed a significant effect for fluency and a trend for flexibility, showing that the negative relationship between age and cognitive performance is reduced as the level of CR increases. These results demonstrate that CR still influences the relationship between age and executive functions in adults of advanced age.
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11
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Lier EJ, Oosterman JM, Assmann R, de Vries M, van Goor H. The effect of Virtual Reality on evoked potentials following painful electrical stimuli and subjective pain. Sci Rep 2020; 10:9067. [PMID: 32494060 PMCID: PMC7270181 DOI: 10.1038/s41598-020-66035-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 05/13/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Virtual reality (VR) has been shown to reduce pain, however outcome parameters of previous studies have primarily been of a subjective nature and susceptible to bias. This study investigated the effect of VR on cortical processing of evoked potentials (EPs) and subjectively reported pain. Additionally, we explored whether subjects' demographic and personal characteristics modulated the effect of VR analgesia. METHODS Three VR conditions were compared in a randomized cross-over study of 30 healthy volunteers: Passive VR (i.e. no interaction possible with the virtual world), active VR (interactive virtual environment) and no VR (black screen). Subjects received noxious electrical stimuli at random intervals during all conditions. EPs, recorded at Cz, were extracted time locked to stimuli. Pain scores were reported after each condition. RESULTS Active VR significantly decreased pain scores and amplitudes of N1 and P3. Passive VR had no analgesic effect. Age was significantly correlated to pain scores, with older subjects demonstrating larger effects of VR. Gender, game experience, and susceptibility for immersion, did not influence VR analgesia. CONCLUSION Active VR decreases pre-perceptual and perceptual brain activity following painful electrical stimuli, corresponding with reduced pain experience. VR has potential to serve as a non-pharmacologic treatment for pain, particularly in elderly patients.
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Affiliation(s)
- E J Lier
- Department of Surgery, Radboud university medical center Nijmegen, Nijmegen, The Netherlands.
| | - J M Oosterman
- Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - R Assmann
- Department of Surgery, Radboud university medical center Nijmegen, Nijmegen, The Netherlands
| | - M de Vries
- Department of Surgery, Radboud university medical center Nijmegen, Nijmegen, The Netherlands
| | - H van Goor
- Department of Surgery, Radboud university medical center Nijmegen, Nijmegen, The Netherlands
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12
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Janzen G, van Roij CJM, Oosterman JM, Kessels RPC. Egocentric and Allocentric Spatial Memory in Korsakoff's Amnesia. Front Hum Neurosci 2020; 14:121. [PMID: 32296321 PMCID: PMC7136515 DOI: 10.3389/fnhum.2020.00121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 03/16/2020] [Indexed: 11/27/2022] Open
Abstract
The goal of the present study was to investigate spatial memory in a group of patients with amnesia due to Korsakoff’s syndrome (KS). We used a virtual spatial memory task that allowed us to separate the use of egocentric and allocentric spatial reference frames to determine object locations. Research investigating the ability of patients with Korsakoff’s amnesia to use different reference frames is scarce and it remains unclear whether these patients are impaired in using ego- and allocentric reference frames to the same extent. Twenty Korsakoff patients and 24 matched controls watched an animation of a bird flying in one of three trees standing in a virtual environment. After the bird disappeared, the camera turned around, by which the trees were briefly out of sight and then turned back to the center of the environment. Participants were asked in which tree the bird was hiding. In half of the trials, a landmark was shown. Half of the trials required an immediate response whereas in the other half a delay of 10 s was present. Patients performed significantly worse than controls. For all participants trials with a landmark were easier than without a landmark and trials without a delay were easier than with a delay. While controls were above chance on all trials patients were at chance in allocentric trials without a landmark present and with a memory delay. Patients showed no difference in the ego- and the allocentric condition. Together the findings suggest that despite the amnesia, spatial memory and especially the use of ego- and allocentric reference frames in Korsakoff patients are spared.
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Affiliation(s)
- Gabriele Janzen
- Behavioral Science Institute, Radboud University Nijmegen, Nijmegen, Netherlands.,Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, Netherlands
| | - Claudette J M van Roij
- Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, Netherlands
| | - Joukje M Oosterman
- Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, Netherlands
| | - Roy P C Kessels
- Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, Netherlands.,Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, Netherlands.,Department of Medical Psychology, Radboud University Medical Center, Nijmegen, Netherlands
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13
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Rensen YCM, Oudman E, Oosterman JM, Kessels RPC. Confabulations in Alcoholic Korsakoff's Syndrome: A Factor Analysis of the Nijmegen-Venray Confabulation List. Assessment 2020; 28:1545-1555. [PMID: 31928078 PMCID: PMC8392856 DOI: 10.1177/1073191119899476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Confabulations generally refer to the emergence of memories of experiences and events that, in reality, never took place, and which are unintentionally produced. They are frequently observed in alcoholic Korsakoff's syndrome. The aim of the current study was to validate the Nijmegen-Venray Confabulation List (NVCL), an observation scale for quantifying both spontaneous and provoked confabulations. The NVCL was completed for 252 patients with alcoholic Korsakoff's syndrome. Exploratory and confirmatory factor analyses were conducted to test three- and four-factor models of the NVCL structure. A four-factor model (provoked confabulations, spontaneous confabulations, severity of spontaneous confabulations, and distorted sense of reality) fitted the data better than the initially proposed three-factor model (provoked confabulations, spontaneous confabulations, memory, and orientation). The new instrument is therefore referred to as the NVCL-R. We encourage clinicians to include the assessment of confabulations in the neuropsychological examination, and to do so with validated instruments such as the NVCL-R.
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Affiliation(s)
| | - Erik Oudman
- Utrecht University, Utrecht, Netherlands.,Slingedael Korsakoff Center, Rotterdam, Netherlands
| | | | - Roy P C Kessels
- Vincent van Gogh Institute for Psychiatry, Venray, Netherlands.,Radboud University, Nijmegen, Netherlands.,Radboud University Medical Center, Nijmegen, Netherlands
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14
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Vetter NC, Oosterman JM, Mühlbach J, Wolff S, Altgassen M. The impact of emotional congruent and emotional neutral context on recognizing complex emotions in older adults. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2019; 27:677-692. [PMID: 31621481 DOI: 10.1080/13825585.2019.1665164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Adding context information has been shown to attenuate the age-related decline of emotion recognition. Specifically, older adults might benefit from emotional congruent context information due to their greater social knowledge. Contrary, emotional neutral context information might impair older adults' performance more due to their decline of inhibitory abilities. Our aim was to examine the age-related decline of complex emotion recognition across three context conditions (emotional congruent, emotional neutral and no context). We hypothesized that emotional congruent context will help older adults to perform at the same level as younger adults and expected worse performance of older adults in the emotional neutral and no context conditions. Twenty-eight older and 28 younger adults watched film clips with complex emotions preceded by a fixation cross (no context), emotional congruent context or emotional neutral context. Emotional neutral context affected older adults' performance more negatively than young adults', whereas emotional congruent improved performance of both young and older adults to a similar extent. Results suggest that emotional congruent context does not eliminate the overall age-related deficit in complex emotion recognition. In contrast, this deficit might be intensified by emotional neutral context.
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Affiliation(s)
- Nora C Vetter
- Department of Child and Adolescent Psychiatry, Faculty of Medicine Carl Gustav Carus, Technische Universität , Dresden, Germany
| | - Joukje M Oosterman
- Donders Institute for Brain Cognition and Behaviour, Radboud University , Nijmegen, The Netherlands
| | - Jasmin Mühlbach
- Department of Psychology, Technische Universität , Dresden, Germany
| | - Sina Wolff
- Department of Psychology, Technische Universität , Dresden, Germany
| | - Mareike Altgassen
- Donders Institute for Brain Cognition and Behaviour, Radboud University , Nijmegen, The Netherlands
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15
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Ferdek MA, Oosterman JM, Adamczyk AK, van Aken M, Woudsma KJ, Peeters BWMM, Nap A, Wyczesany M, van Rijn CM. Effective Connectivity of Beta Oscillations in Endometriosis-Related Chronic Pain During rest and Pain-Related Mental Imagery. J Pain 2019; 20:1446-1458. [PMID: 31152855 DOI: 10.1016/j.jpain.2019.05.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 04/09/2019] [Accepted: 05/22/2019] [Indexed: 12/22/2022]
Abstract
Using the EEG recordings of patients with endometriosis-related chronic pelvic pain, we have examined the effective connectivity within the cortical pain-related network during rest and during pain-related imagery. During rest, an altered connectivity was hypothesized between cortical somatosensory pain areas and regions involved in emotional and cognitive modulation of pain. During pain-related imagery, alterations in prefrontal-temporal connectivity were expected. The effective connectivity was estimated using the Directed Transfer Function method. Differences between endometriosis patients and controls were found in the beta band (14-25 Hz). During rest, endometriosis was associated with an increased connectivity from the left dorsolateral prefrontal cortex to the left somatosensory cortex and also from the left somatosensory cortex to the orbitofrontal cortex and the right temporal cortex. These results might be related to sustained activation of the somatosensory pain system caused by the ongoing pain. During pain-related imagery, endometriosis patients showed an increased connectivity from the left dorsolateral prefrontal cortex to the right temporal cortex. This finding might point to impaired emotional regulation when processing pain-related stimuli, or it might be related to altered memorization of pain experiences. Results of this study open up new directions in chronic pain research aimed at exploring the beta band connectivity alterations. PERSPECTIVE: This study examined the pain system's dynamics in endometriosis patients with chronic pelvic pain during resting-state and pain-related mental imagery. The results could contribute to the development of new therapies using guided mental imagery.
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Affiliation(s)
- Magdalena A Ferdek
- Cognition and Behaviour, Donders Institute for Brain, Radboud University, Nijmegen, the Netherlands; Psychophysiology Laboratory, Institute of Psychology, Jagiellonian University, Krakow, Poland.
| | - Joukje M Oosterman
- Cognition and Behaviour, Donders Institute for Brain, Radboud University, Nijmegen, the Netherlands
| | - Agnieszka K Adamczyk
- Psychophysiology Laboratory, Institute of Psychology, Jagiellonian University, Krakow, Poland
| | - Mieke van Aken
- Department of Anatomy, Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Gynaecology and Obstetrics, Arnhem, the Netherlands
| | - Kelly J Woudsma
- Cognition and Behaviour, Donders Institute for Brain, Radboud University, Nijmegen, the Netherlands
| | | | - Annemiek Nap
- Department of Gynaecology and Obstetrics, Arnhem, the Netherlands
| | - Miroslaw Wyczesany
- Psychophysiology Laboratory, Institute of Psychology, Jagiellonian University, Krakow, Poland
| | - Clementina M van Rijn
- Cognition and Behaviour, Donders Institute for Brain, Radboud University, Nijmegen, the Netherlands
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16
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Ferdek MA, Adamczyk AK, van Rijn CM, Oosterman JM, Wyczesany M. Pain catastrophizing is associated with altered EEG effective connectivity during pain‑related mental imagery. Acta Neurobiol Exp (Wars) 2019; 79:53-72. [PMID: 31038485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Pain catastrophizing - defined as a tendency to exaggerate the threat value or seriousness of experienced pain ‑ has been shown to be a risk factor for pain chronification. However, the neural basis of pain catastrophizing remains unclear and requires thorough investigation. This study aimed to explore the relationship between pain catastrophizing and effective connectivity of the pain systems in healthy participants. EEG data were collected during an induced state of pain‑related negative, depressive, positive and neutral mental imagery conditions, and pain catastrophizing tendencies were measured by the Pain Catastrophizing Scale. The Directed Transfer Function, a method based on Granger causality principles, was used to assess the effective connectivity. Linear mixed effects analyses revealed a negative relationship between pain catastrophizing and beta information flow from the right temporal cortex to the frontal regions and a positive relationship between pain catastrophizing and increased beta information flow from the right somatosensory cortices to the right temporal cortices when thinking about pain. These patterns were not found in other imagery conditions. Taken together, this study suggests that individual differences in pain catastrophizing might be related to an altered frontotemporal regulatory loop and increased connectivity between pain and affective systems. Our study reveals connectivity patterns related to pain catastrophizing tendencies that are detectable even in pain‑free, healthy individuals.
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Affiliation(s)
- Magdalena A Ferdek
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, The Netherlands; Psychophysiology Laboratory, Institute of Psychology, Jagiellonian University, Krakow, Poland;
| | | | - Clementina M van Rijn
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, The Netherlands
| | - Joukje M Oosterman
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, The Netherlands
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17
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Affiliation(s)
- Nikita L. Frankenmolen
- Donders Institute for Brain, Cognition and Behaviour, Centre for Cognition, Radboud University, Nijmegen, The Netherlands
- Rehabilitation Centre Klimmendaal, Arnhem, The Netherlands
| | - Luciano Fasotti
- Donders Institute for Brain, Cognition and Behaviour, Centre for Cognition, Radboud University, Nijmegen, The Netherlands
- Rehabilitation Centre Klimmendaal, Arnhem, The Netherlands
| | - Roy P.C. Kessels
- Donders Institute for Brain, Cognition and Behaviour, Centre for Cognition, Radboud University, Nijmegen, The Netherlands
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Joukje M. Oosterman
- Donders Institute for Brain, Cognition and Behaviour, Centre for Cognition, Radboud University, Nijmegen, The Netherlands
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18
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Świder K, Wronka E, Oosterman JM, van Rijn CM, Jongsma MLA. Influence of transient spatial attention on the P3 component and perception of painful and non-painful electric stimuli in crossed and uncrossed hands positions. PLoS One 2017; 12:e0182616. [PMID: 28873414 PMCID: PMC5584947 DOI: 10.1371/journal.pone.0182616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 07/22/2017] [Indexed: 11/19/2022] Open
Abstract
Recent reports show that focusing attention on the location where pain is expected can enhance its perception. Moreover, crossing the hands over the body’s midline is known to impair the ability to localise stimuli and decrease tactile and pain sensations in healthy participants. The present study investigated the role of transient spatial attention on the perception of painful and non-painful electrical stimuli in conditions in which a match or a mismatch was induced between skin-based and external frames of reference (uncrossed and crossed hands positions, respectively). We measured the subjective experience (Numerical Rating Scale scores) and the electrophysiological response elicited by brief electric stimuli by analysing the P3 component of Event-Related Potentials (ERPs). Twenty-two participants underwent eight painful and eight non-painful stimulus blocks. The electrical stimuli were applied to either the left or the right hand, held in either a crossed or uncrossed position. Each stimulus was preceded by a direction cue (leftward or rightward arrow). In 80% of the trials, the arrow correctly pointed to the spatial regions where the stimulus would appear (congruent cueing). Our results indicated that congruent cues resulted in increased pain NRS scores compared to incongruent ones. For non-painful stimuli such an effect was observed only in the uncrossed hands position. For both non-painful and painful stimuli the P3 peak amplitudes were higher and occurred later for incongruently cued stimuli compared to congruent ones. However, we found that crossing the hands substantially reduced the cueing effect of the P3 peak amplitudes elicited by painful stimuli. Taken together, our results showed a strong influence of transient attention manipulations on the NRS ratings and on the brain activity. Our results also suggest that hand position may modulate the strength of the cueing effect, although differences between painful and non-painful stimuli exist.
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Affiliation(s)
- Karolina Świder
- Institute of Psychology, Jagiellonian University, Kraków, Poland
- Donders Institute for Brain, Cognition & Behaviour, Radboud University, Nijmegen, The Netherlands
- * E-mail:
| | - Eligiusz Wronka
- Institute of Psychology, Jagiellonian University, Kraków, Poland
| | - Joukje M. Oosterman
- Donders Institute for Brain, Cognition & Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Clementina M. van Rijn
- Donders Institute for Brain, Cognition & Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Marijtje L. A. Jongsma
- Donders Institute for Brain, Cognition & Behaviour, Radboud University, Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
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19
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Binnekade TT, Scherder EJA, Maier AB, Lobbezoo F, Overdorp EJ, Rhebergen D, Perez RSGM, Oosterman JM. Pain in Patients with Different Dementia Subtypes, Mild Cognitive Impairment, and Subjective Cognitive Impairment. Pain Medicine 2017; 19:920-927. [DOI: 10.1093/pm/pnx162] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Tarik T Binnekade
- Department of Clinical Neuropsychology, VU University, Amsterdam, the Netherlands
| | - Erik J A Scherder
- Department of Clinical Neuropsychology, VU University, Amsterdam, the Netherlands
| | - Andrea B Maier
- Department of Medicine and Aged Care, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia
- Department of Human Movement Sciences, MOVE Research Institute Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Frank Lobbezoo
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Amsterdam, the Netherlands
| | - Eduard J Overdorp
- Department of Medical Psychology, Gelre Medical Centre, Zutphen, the Netherlands
| | - Didi Rhebergen
- GGZ InGeest/Department of Psychiatry and the EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Roberto S G M Perez
- Department of Anesthesiology, VU University Medical Center, Amsterdam, the Netherlands
| | - Joukje M Oosterman
- Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands
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20
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van Heck CH, Oosterman JM, de Kleijn KMA, Jongsma MLA, van Rijn CM. Evidence for a Priori Existence of Attentional Bias Subgroups in Emotional Processing of Aversive Stimuli. Front Behav Neurosci 2017; 11:87. [PMID: 28553210 PMCID: PMC5427543 DOI: 10.3389/fnbeh.2017.00087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 04/25/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Casper H. van Heck
- Donders Institute for Brain, Cognition, and Behaviour, Radboud UniversityNijmegen, Netherlands
- *Correspondence: Clementina M. van Rijn
| | - Joukje M. Oosterman
- Donders Institute for Brain, Cognition, and Behaviour, Radboud UniversityNijmegen, Netherlands
| | - Kim M. A. de Kleijn
- Donders Institute for Brain, Cognition, and Behaviour, Radboud UniversityNijmegen, Netherlands
| | - Marijtje L. A. Jongsma
- Faculty of Social Sciences/Behavioral Science Institute, Radboud UniversityNijmegen, Netherlands
| | - Clementina M. van Rijn
- Donders Institute for Brain, Cognition, and Behaviour, Radboud UniversityNijmegen, Netherlands
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21
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Bjekić J, Živanović M, Purić D, Oosterman JM, Filipović SR. Pain and executive functions: a unique relationship between Stroop task and experimentally induced pain. Psychological Research 2017; 82:580-589. [DOI: 10.1007/s00426-016-0838-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 12/28/2016] [Indexed: 12/21/2022]
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22
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Van Eijk L, Zwijsen SA, Keeser D, Oosterman JM, Pogarell O, Engelbregt HJ. EEG-neurofeedback training and quality of life of institutionalized elderly women (a pilot study). Adv Gerontol 2017; 30:248-254. [PMID: 28575565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This pilot study attempted to study the applicability of neurofeedback for elderly persons living in nursing homes. We hypothesized an improve of cognitive functioning and the independence in daily life (IDL) of elderly people by using low beta (12-15HZ) EEG neurofeedback training (E-NFT). The participants (active E-NFT group, n=10; control group, n=6) were community living elderly women without dementia. Neurofeedback training was adjusted ten times within 9 weeks, with a training duration of 21 minutes by use of a single electrode, which was centrally placed on the skull surface. Executive functioning (measured with the Rey and fluency tasks), memory capacity (measured with the 15 words test), and IDL (measured with the Groningen Activity Restriction Scale) were measured before and after ten E-NFT sessions in nine weeks. No effects were found for IDL nor executive functioning. Interestingly, performance on the memory test improved in the experimental group, indicating a possible positive effect of E-NFT on memory in elderly women. This study demonstrates that E-NFT is applicable to older institutionalized women. The outcome of this pilot-study justifies the investigation of possible memory effects in future studies.
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Affiliation(s)
- L Van Eijk
- Hersencentrum Mental Health Institute, 1016 XW, Marnixstraat 358-366, Amsterdam, The Netherlands;
- Department of Clinical Neuropsychology, VU University, van der Boechorststraat 1,1081 BT Amsterdam, The Netherlands
| | - S A Zwijsen
- Department of General Practice and Elderly Care Medicine and the EMGO⁺ Institute for Health and Care Research, VU Medical Center, Van der Boechorststraat 7,1081 BT Amsterdam, The Netherlands
| | - D Keeser
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University of Munich, Nussbaumstrasse 7, 80336 Munich, Germany
| | - J M Oosterman
- Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, 6525 EN, Kapittelweg 29, Nijmegen, The Netherlands
| | - O Pogarell
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University of Munich, Nussbaumstrasse 7, 80336 Munich, Germany
| | - H J Engelbregt
- Hersencentrum Mental Health Institute, 1016 XW, Marnixstraat 358-366, Amsterdam, The Netherlands;
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University of Munich, Nussbaumstrasse 7, 80336 Munich, Germany
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23
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Frankenmolen NL, Altgassen M, Kessels R, de Waal MM, Hindriksen JA, Verhoeven B, Fasotti L, Scheres A, Kessels RPC, Oosterman JM. Intelligence moderates the benefits of strategy instructions on memory performance: an adult-lifespan examination. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2016; 24:45-61. [PMID: 27141830 DOI: 10.1080/13825585.2016.1171289] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Whether older adults can compensate for their associative memory deficit by using memory strategies efficiently might depend on their general cognitive abilities. This study examined the moderating role of an IQ estimate on the beneficial effects of strategy instructions. A total of 142 participants (aged 18-85 years) received either intentional learning or strategy ("sentence generation") instructions during encoding of word pairs. Whereas young adults with a lower IQ benefited from strategy instructions, those with a higher IQ did not, presumably because they already use strategies spontaneously. Older adults showed the opposite effect: following strategy instructions, older adults with a higher IQ showed a strong increase in memory performance (approximately achieving the level of younger adults), whereas older adults with a lower IQ did not, suggesting that they have difficulties implementing the provided strategies. These results highlight the importance of the role of IQ in compensating for the aging-related memory decline.
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Affiliation(s)
- Nikita L Frankenmolen
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands.,b Rehabilitation Centre Klimmendaal , Arnhem , The Netherlands
| | - Mareike Altgassen
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands
| | - Renée Kessels
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands
| | - Marleen M de Waal
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands
| | - Julie-Anne Hindriksen
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands
| | - Barbara Verhoeven
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands
| | - Luciano Fasotti
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands.,b Rehabilitation Centre Klimmendaal , Arnhem , The Netherlands
| | - Anouk Scheres
- c Developmental Psychology, Behavioural Science Institute , Radboud University , Nijmegen , The Netherlands
| | - Roy P C Kessels
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands.,d Department of Medical Psychology , Radboud University Medical Center , Nijmegen , The Netherlands
| | - Joukje M Oosterman
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands
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24
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Oosterman JM, Heringa SM, Kessels RPC, Biessels GJ, Koek HL, Maes JHR, van den Berg E. Rule induction performance in amnestic mild cognitive impairment and Alzheimer's dementia: examining the role of simple and biconditional rule learning processes. J Clin Exp Neuropsychol 2016; 39:231-241. [PMID: 27618141 DOI: 10.1080/13803395.2016.1218444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Rule induction tests such as the Wisconsin Card Sorting Test require executive control processes, but also the learning and memorization of simple stimulus-response rules. In this study, we examined the contribution of diminished learning and memorization of simple rules to complex rule induction test performance in patients with amnestic mild cognitive impairment (aMCI) or Alzheimer's dementia (AD). METHOD Twenty-six aMCI patients, 39 AD patients, and 32 control participants were included. A task was used in which the memory load and the complexity of the rules were independently manipulated. This task consisted of three conditions: a simple two-rule learning condition (Condition 1), a simple four-rule learning condition (inducing an increase in memory load, Condition 2), and a complex biconditional four-rule learning condition-inducing an increase in complexity and, hence, executive control load (Condition 3). RESULTS Performance of AD patients declined disproportionately when the number of simple rules that had to be memorized increased (from Condition 1 to 2). An additional increment in complexity (from Condition 2 to 3) did not, however, disproportionately affect performance of the patients. Performance of the aMCI patients did not differ from that of the control participants. In the patient group, correlation analysis showed that memory performance correlated with Condition 1 performance, whereas executive task performance correlated with Condition 2 performance. CONCLUSIONS These results indicate that the reduced learning and memorization of underlying task rules explains a significant part of the diminished complex rule induction performance commonly reported in AD, although results from the correlation analysis suggest involvement of executive control functions as well. Taken together, these findings suggest that care is needed when interpreting rule induction task performance in terms of executive function deficits in these patients.
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Affiliation(s)
- Joukje M Oosterman
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands
| | - Sophie M Heringa
- b Department of Psychiatry, Brain Center Rudolf Magnus , University Medical Center , Utrecht , the Netherlands
| | - Roy P C Kessels
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands.,c Department of Medical Psychology & Radboudumc Alzheimer Center , Radboud University Medical Center , Nijmegen , the Netherlands
| | - Geert Jan Biessels
- d Department of Neurology, Brain Center Rudolf Magnus , University Medical Center , Utrecht , the Netherlands
| | - Huiberdina L Koek
- e Department of Geriatrics , University Medical Center Utrecht , Utrecht , the Netherlands
| | - Joseph H R Maes
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands
| | - Esther van den Berg
- d Department of Neurology, Brain Center Rudolf Magnus , University Medical Center , Utrecht , the Netherlands.,f Experimental Psychology , Utrecht University , Utrecht , The Netherlands.,g Department of Neurology , Erasmus Medical Center , Rotterdam , The Netherlands
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Rensen YCM, Oosterman JM, Walvoort SJW, Eling PATM, Kessels RPC. Intrusions and provoked and spontaneous confabulations on memory tests in Korsakoff's syndrome. J Clin Exp Neuropsychol 2016; 39:101-111. [PMID: 27595167 DOI: 10.1080/13803395.2016.1204991] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Intrusions on verbal memory tests have been used as an index for clinical confabulation. Severe memory impairments in combination with executive dysfunction have been suggested to be the underlying mechanism of confabulation, but to date, this relation is unclear. The aim of this study was (a) to examine the relation between (different types of) intrusions and confabulations in a large sample of confabulating patients with Korsakoff's syndrome (KS) and (b) to investigate whether different measures of executive functioning and memory performance are related to provoked and spontaneous confabulation. METHOD The Dutch version of the California Verbal Learning Test (CVLT) and various executive function and memory tests were administered to a group of 51 confabulating patients with KS. Professional caregivers rated the severity of provoked and spontaneous confabulation behavior of the patients using the Nijmegen-Venray Confabulation List-20 (NVCL-20). RESULTS The total number of intrusions on the CVLT was not related to either provoked or spontaneous confabulation scores. None of the CVLT intrusion scores correlated significantly with any of the confabulation scores, but we did find small-to-medium, positive correlations between unrelated intrusions and both provoked confabulations and spontaneous confabulation. Provoked confabulation behavior was associated with executive dysfunction and poorer memory performances. Spontaneous confabulation was not related to performance on measures of executive function and memory. CONCLUSIONS The total number of intrusions on verbal memory tests and clinical confabulations appear to be different phenomena. Only unrelated intrusions produced on the CVLT might possibly be related to confabulations. The production of provoked, but not spontaneous, confabulation is associated with executive dysfunction and memory deficits.
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Affiliation(s)
- Yvonne C M Rensen
- a Radboud University , Donders Institute for Brain, Cognition, and Behaviour , Nijmegen , The Netherlands.,b Korsakoff Clinic, Vincent van Gogh Institute, Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders , Venray , The Netherlands
| | - Joukje M Oosterman
- a Radboud University , Donders Institute for Brain, Cognition, and Behaviour , Nijmegen , The Netherlands
| | - Serge J W Walvoort
- b Korsakoff Clinic, Vincent van Gogh Institute, Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders , Venray , The Netherlands
| | - Paul A T M Eling
- a Radboud University , Donders Institute for Brain, Cognition, and Behaviour , Nijmegen , The Netherlands
| | - Roy P C Kessels
- a Radboud University , Donders Institute for Brain, Cognition, and Behaviour , Nijmegen , The Netherlands.,b Korsakoff Clinic, Vincent van Gogh Institute, Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders , Venray , The Netherlands.,c Radboud University Medical Center , Department of Medical Psychology , Nijmegen , The Netherlands
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Oosterman JM, Zwakhalen S, Sampson EL, Kunz M. The use of facial expressions for pain assessment purposes in dementia: a narrative review. Neurodegener Dis Manag 2016; 6:119-31. [DOI: 10.2217/nmt-2015-0006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Facial expressions convey reliable nonverbal signals about pain and thus are very useful for assessing pain in patients with limited communicative ability, such as patients with dementia. In this review, we present an overview of the available pain observation tools and how they make use of facial expressions. Utility and reliability of facial expressions to measure pain in dementia are discussed, together with the effect of dementia severity on these facial expressions. Next, we present how behavioral alterations may overlap with facial expressions of pain, and may even influence the extent to which pain is facially expressed. The main focus is on disinhibition, apathy and emotional changes. Finally, an overview of theoretical considerations and practical implications is presented for assessing pain using facial expressions in clinical settings.
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Affiliation(s)
- Joukje M Oosterman
- Radboud University Nijmegen, Donders Institute for Brain, Cognition & Behaviour, Nijmegen, The Netherlands
| | - Sandra Zwakhalen
- Maastricht University, Department of Health Services Research, CAPHRI School for Public Health & Primary Care, Maastricht, The Netherlands
| | - Elizabeth L Sampson
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London Medical School, London, UK
- North Middlesex University Hospital, Barnet Enfield & Haringey Mental Health Trust, London, UK
| | - Miriam Kunz
- University of Groningen, University Medical Center Groningen, Department of General Practice, Section Gerontology, Groningen, The Netherlands
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Overdorp EJ, Kessels RPC, Claassen JA, Oosterman JM. The Combined Effect of Neuropsychological and Neuropathological Deficits on Instrumental Activities of Daily Living in Older Adults: a Systematic Review. Neuropsychol Rev 2016; 26:92-106. [PMID: 26732392 PMCID: PMC4762929 DOI: 10.1007/s11065-015-9312-y] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 12/15/2015] [Indexed: 02/03/2023]
Abstract
To date, studies have consistently demonstrated associations between either neuropsychological deficits or neuroanatomical changes and instrumental activities of daily living (IADL) in aging. Only a limited number of studies have evaluated morphological brain changes and neuropsychological test performance concurrently in relation to IADL in this population. As a result, it remains largely unknown whether these factors independently predict functional outcome. The current systematic review intended to address this lack of information by reviewing the literature on older adults, incorporating studies that examined e.g., normal aging, but also stroke or dementia patients. A comprehensive search of databases (Pubmed, Embase, Medline, Web of Science, PsycINFO) and reference lists was performed, focusing on papers in the English language that examined the combined effect of neuropsychological and neuroanatomical factors on IADL in samples of adults with an average age above 50. In total, 58 potential articles were identified; 20 were included in the review. The results show that especially neuropsychological variables (primarily memory and executive functions) independently predict IADL. Although some unique predictive value of brain morphological changes, such as hippocampal atrophy, was found, support for the importance of white matter changes was limited. However, the results of the studies reviewed are diverse, and appear to be at least partially determined by the variables included. For example, studies were less likely to find an independent effect of cognition if they solely employed a cognitive screening instrument. This indicates that a structured examination of neuroanatomical and neuropsychological correlates of IADL in different patient populations is warranted.
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Affiliation(s)
- Eduard J Overdorp
- Department of Medical Psychology, Gelre Medical Centre, Zutphen, The Netherlands
| | - Roy P C Kessels
- Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Montessorilaan 3, 6500, HE, Nijmegen, The Netherlands.,Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Geriatric Medicine and Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jurgen A Claassen
- Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Montessorilaan 3, 6500, HE, Nijmegen, The Netherlands.,Department of Geriatric Medicine and Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Joukje M Oosterman
- Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Montessorilaan 3, 6500, HE, Nijmegen, The Netherlands.
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Rensen YCM, Oosterman JM, van Damme JE, Griekspoor SIA, Wester AJ, Kopelman MD, Kessels RPC. Assessment of Confabulation in Patients with Alcohol-Related Cognitive Disorders: The Nijmegen-Venray Confabulation List (NVCL-20). Clin Neuropsychol 2015; 29:804-23. [PMID: 26360957 DOI: 10.1080/13854046.2015.1084377] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Even though the first awareness of confabulations is often based on observations, only questionnaires and structured interviews quantifying provoked confabulations are available. So far, no tools have been developed to measure spontaneous confabulation. This study describes and validates an observation scale for quantifying confabulation behavior, including spontaneous confabulations, in clinical practice. METHOD An observation scale consisting of 20 items was developed, the Nijmegen-Venray Confabulation List-20 (NVCL-20). This scale covers spontaneous confabulation, provoked confabulation, and memory and orientation. Professional caregivers completed the NVCL-20 for 28 Korsakoff (KS) patients and 24 cognitively impaired chronic alcoholics (ALC). Their ratings were related to the Dalla Barba Confabulation Battery (DBCB), Provoked Confabulation Test (PCT), and standard neuropsychological tests. RESULTS The categories of the NVCL-20 have "good" to "excellent" internal consistency and inter-rater agreement. The KS patients confabulated more (both spontaneously and provoked), and more memory and orientation problems were observed. Correlations with neuropsychological test scores showed that confabulations were associated with memory deficits, but not with intrusions or tests of executive dysfunction. CONCLUSIONS The NVCL-20 is the first instrument that includes items addressing spontaneous confabulation. Administration is reliable, valid and feasible in clinical practice, making it a useful addition to existing confabulating measures.
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Affiliation(s)
- Yvonne C M Rensen
- a Radboud University, Donders Institute for Brain, Cognition, and Behavior , Nijmegen , The Netherlands
| | - Joukje M Oosterman
- a Radboud University, Donders Institute for Brain, Cognition, and Behavior , Nijmegen , The Netherlands
| | - Jessica E van Damme
- a Radboud University, Donders Institute for Brain, Cognition, and Behavior , Nijmegen , The Netherlands
| | - Sonja I A Griekspoor
- a Radboud University, Donders Institute for Brain, Cognition, and Behavior , Nijmegen , The Netherlands
| | - Arie J Wester
- b Korsakoff Clinic, Vincent van Gogh Institute, Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders , Venray , The Netherlands
| | - Michael D Kopelman
- c Department of Psychological Medicine, Institute of Psychiatry , King's College London , London , UK
| | - Roy P C Kessels
- a Radboud University, Donders Institute for Brain, Cognition, and Behavior , Nijmegen , The Netherlands.,b Korsakoff Clinic, Vincent van Gogh Institute, Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders , Venray , The Netherlands.,d Department of Medical Psychology , Radboud University Medical Center , Nijmegen , The Netherlands
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Scherder EJA, Plooij B, Achterberg WP, Pieper M, Wiegersma M, Lobbezoo F, Oosterman JM. Chronic pain in "probable" vascular dementia: preliminary findings. Pain Med 2014; 16:442-50. [PMID: 25529977 DOI: 10.1111/pme.12637] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND In a previous study, the levels of pain reported by patients with "possible" vascular dementia (VaD) were higher than those reported by older individuals without dementia. OBJECTIVE To examine experienced pain in patients with "probable" VaD, confirmed by brain imaging. STUDY DESIGN Observational, cross sectional. SETTING Nursing home. METHODS The participants were 20 nursing home residents (14 females, 6 males) who met the NINDS-AIREN criteria for "probable" VaD and 22 nursing home residents with a normal mental status (18 females, 4 males). The patients were in a mild to moderate stage of dementia. All of the participants were suffering from arthritis/arthrosis or osteoporosis. Global cognitive functioning was measured by the Mini-Mental State Examination. Pain was assessed by the Coloured Analogue Scale (CAS: original and modified version) and the Faces Pain Scale. The Geriatric Depression Scale and the Symptom Checklist-90 were used to assess mood. RESULTS The main finding was that, after controlling for mood, the pain levels indicated by patients with "probable" VaD (M = 102.32; standard deviation [SD] = 53.42) were significantly higher than those indicated by the control group (M = 59.17; SD = 38.75), only according to the CAS modified version (F[1,29]) = 5.62, P = 0.01, η2 = 0.16). CONCLUSION As VaD patients may experience greater pain than controls, it is essential for prescribers to be aware of the presence of this neuropathology if these patients are to receive adequate treatment.
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Affiliation(s)
- Erik J A Scherder
- Department of Clinical Neuropsychology, VU University, Amsterdam, The Netherlands
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Overdorp EJ, Kessels RPC, Claassen JA, Oosterman JM. Cognitive impairments associated with medial temporal atrophy and white matter hyperintensities: an MRI study in memory clinic patients. Front Aging Neurosci 2014; 6:98. [PMID: 24904411 PMCID: PMC4034495 DOI: 10.3389/fnagi.2014.00098] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 05/06/2014] [Indexed: 11/13/2022] Open
Abstract
In this retrospective study, we investigated the independent effects of white matter hyperintensities (WMH) and hippocampal atrophy on cognitive functions in a broad sample of patients seen in a memory clinic. To ensure generalizability, these associations were examined irrespective of diagnosis and with minimal exclusion criteria. Next to these independent effects, interactions between WMH and hippocampal atrophy were examined. Between January 2006 and September 2011 a total of 500 patients visited the memory clinic, 397 of whom were included. Magnetic resonance images of 397 patients were visually analyzed for WMH, medial temporal atrophy (MTA), and global atrophy. We evaluated the association of WMH and MTA with the following cognitive domains: global cognition, episodic memory, working memory, executive function and psychomotor speed. Main effects and interaction effects were examined by means of correlation and regression analyses. In the regression analyses, we controlled for potential confounding effects of global atrophy. The correlational results revealed that WMH were associated with global cognition, executive function and psychomotor speed, whereas a trend was found for episodic memory. MTA was associated with all these four cognitive domains; an additional trend was observed for working memory. Hierarchical regression analyses revealed main independent effects of MTA for episodic memory, executive function, psychomotor speed and global cognition; WMH were only associated with global cognition. The interaction between MTA and WMH was significant for episodic memory only. This study demonstrates that predominantly MTA is an independent predictor not only for memory function, with which is it classically associated, but also for global cognition and executive function. Taken together, MTA may be an important correlate of cognitive deficits found in people attending the memory clinic.
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Affiliation(s)
- Eduard J Overdorp
- Department of Psychiatry, Gelre Medical Centre Zutphen, Netherlands ; Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Nijmegen, Netherlands
| | - Roy P C Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Nijmegen, Netherlands ; Department of Medical Psychology, Radboud University Medical Center-Radboud Alzheimer Center Nijmegen, Netherlands
| | - Jurgen A Claassen
- Department of Medical Psychology, Radboud University Medical Center-Radboud Alzheimer Center Nijmegen, Netherlands ; Department of Geriatric Medicine, Radboud University Medical Center-Radboud Alzheimer Center Nijmegen, Netherlands
| | - Joukje M Oosterman
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Nijmegen, Netherlands
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Oosterman JM, Hendriks H, Scott S, Lord K, White N, Sampson EL. When pain memories are lost: a pilot study of semantic knowledge of pain in dementia. Pain Med 2014; 15:751-7. [PMID: 24401151 DOI: 10.1111/pme.12336] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE It has been documented that pain in people with dementia is often under-reported and poorly detected. The reasons for this are not clearly defined. This project aimed to explore semantic concepts of pain in people with dementia and whether this is associated with clinical pain report. DESIGN Cohort study with nested cross-sectional analysis. SETTING Acute general hospital medical wards for older people. SUBJECTS People with dementia (N = 26) and control participants (N = 13). METHODS Two subtests of semantic memory for pain: (1) Identifying painful situations from a standardized range of pictures; (2) Describing the concept of pain. Participants also indicated whether they were in pain or not, were observed for pain (PAINAD scale) and completed the Wong-Baker FACES scale to indicate pain severity. RESULTS Compared with the control group, people with dementia were less able to identify painful situations and used fewer categories to define their concept of pain. In turn, the performance on these two measures was related to the reported presence and, albeit less strongly, to the reported severity of pain, indicating that a reduction in semantic memory for pain is associated with a decline in reported pain. CONCLUSIONS This study is the first to show that semantic memory for pain is diminished in dementia patients. When using clinical pain tools, clinicians should consider these effects which may bias clinical pain ratings when they evaluate and manage pain in these patients. This might improve the recognition and management of pain in people with dementia.
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Affiliation(s)
- Joukje M Oosterman
- Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
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Oosterman JM, Wijers M, Kessels RPC. Planning or something else? Examining neuropsychological predictors of Zoo Map performance. Appl Neuropsychol Adult 2012; 20:103-9. [PMID: 23397996 DOI: 10.1080/09084282.2012.670150] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The Zoo Map Test of the Behavioral Assessment of the Dysexecutive Syndrome battery is often applied to measure planning ability as part of executive function. Successful performance on this test is, however, dependent on various cognitive functions, and deficient Zoo Map performance does therefore not necessarily imply selectively disrupted planning abilities. To address this important issue, we examined whether planning is still the most important predictor of Zoo Map performance in a heterogeneous sample of neurologic and psychiatric outpatients (N = 71). In addition to the Zoo Map Test, the patients completed other neuropsychological tests of planning, inhibition, processing speed, and episodic memory. Planning was the strongest predictor of the total raw score and inappropriate places visited, and no additional contribution of other cognitive scores was found. One exception to this was the total time, which was associated with processing speed. Overall, our findings indicate that the Zoo Map Test is a valid indicator of planning ability in a heterogeneous patient sample.
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Affiliation(s)
- Joukje M Oosterman
- Donders Institute for Brain, Cognition, and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands.
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Veldhuijzen DS, Sondaal SF, Oosterman JM. Intact Cognitive Inhibition in Patients With Fibromyalgia but Evidence of Declined Processing Speed. The Journal of Pain 2012; 13:507-15. [DOI: 10.1016/j.jpain.2012.02.011] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Revised: 01/27/2012] [Accepted: 02/29/2012] [Indexed: 01/12/2023]
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Oosterman JM, Dijkerman HC, Kessels RP, Scherder EJ. A unique association between cognitive inhibition and pain sensitivity in healthy participants. Eur J Pain 2012; 14:1046-50. [DOI: 10.1016/j.ejpain.2010.04.004] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2009] [Revised: 03/22/2010] [Accepted: 04/06/2010] [Indexed: 11/24/2022]
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Oosterman JM, de Goede M, Wester AJ, van Zandvoort MJE, Kessels RPC. Perspective taking in Korsakoff's syndrome: the role of executive functioning and task complexity. Acta Neuropsychiatr 2011; 23:302-8. [PMID: 25380042 DOI: 10.1111/j.1601-5215.2011.00552.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Oosterman JM, de Goede M, Wester AJ, van Zandvoort MJE, Kessels RPC. Perspective taking in Korsakoff's syndrome: the role of executive functioning and task complexity.Objective: The ability to make inferences about knowledge, thoughts and feelings of others, i.e. perspective taking, is a key element of social cognition. Clinical observations indicate that Korsakoff patients may have impairments in social cognition, but studies are scarce. Also, executive dysfunction is present in Korsakoff patients, which may hamper perspective taking directly.Methods: Twenty-three patients with Korsakoff's syndrome and 15 healthy matched controls were examined on a story comprehension task, in which inferences had to be made that either relied on perspective taking or not. The effects of task complexity were taken into account and executive function was assessed using an extensive neuropsychological test battery.Results: The performance of Korsakoff patients declined with increasing complexity, but the pattern of decline for perspective-taking and non-perspective-taking stories was similar compared to that of the control group. Furthermore, the performance decline with increasing task complexity was directly related to the overall decline in executive functioning.Conclusion: Executive dysfunction, not deficits in perspective taking per se, appears to underlie difficulties in story comprehension in patients with Korsakoff's syndrome.
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Affiliation(s)
- Joukje M Oosterman
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Maartje de Goede
- TNO Defence, Security and Safety, Business Unit Human Factors, Soesterberg, The Netherlands
| | - Arie J Wester
- Korsakoff Clinic, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
| | - Martine J E van Zandvoort
- Department of Experimental Psychology, Helmholtz Instituut, Utrecht University, Utrecht, The Netherlands
| | - Roy P C Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
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Oosterman JM, Morel S, Meijer L, Buvens C, Kessels RPC, Postma A. Differential Age Effects on Spatial and Visual Working Memory. Int J Aging Hum Dev 2011; 73:195-208. [DOI: 10.2190/ag.73.3.a] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The present study was intended to compare age effects on visual and spatial working memory by using two versions of the same task that differed only in presentation mode. The working memory task contained both a simultaneous and a sequential presentation mode condition, reflecting, respectively, visual and spatial working memory processes. Young and older participants had to remember the locations of five equal objects under three different conditions: a baseline (immediate recall), a maintenance (including a delay of 5 seconds), and a manipulation (e.g., relocate all objects one column to the right) condition. Only older adults performed worse on the sequential compared to the simultaneous baseline condition and only this group revealed lower performance on the sequential delay compared to the simultaneous delay condition. However, in both groups the manipulation condition affected performance on the simultaneous and sequential presentation modes to the same extent. The findings of this study therefore partially support an age-related differentiation between visual and spatial working memory, with a stronger age effect on spatial than on visual working memory.
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Affiliation(s)
| | | | - Lisette Meijer
- Rehabilitation Center De Hoogstraat, Utrecht, The Netherlands
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Pulles WLJA, Oosterman JM. The role of neuropsychological performance in the relationship between chronic pain and functional physical impairment. Pain Med 2011; 12:1769-76. [PMID: 22054175 DOI: 10.1111/j.1526-4637.2011.01266.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE In this study, the relationship between pain intensity, neuropsychological, and physical function in adult chronic pain patients was examined. DESIGN Thirty participants with chronic pain completed neuropsychological tests tapping mental processing speed, memory, and executive function. Pain intensity was measured with three visual analog scales and the Pain Rating Index of the McGill Pain Questionnaire. A grip strength test, the 6-minute walk test, the Unipedal Stance Test and the Lifting Low Test were administered in order to obtain a performance-based measure of physical capacity. Self-reported physical ability was assessed with the Disability Rating Index and the Short Form-36 Physical Functioning, and Role Physical scales. Psychosocial function was examined using the Mental Health and Role Emotional subscales of the Short Form-36. SETTING The study was set in two outpatient physical therapy clinics in The Netherlands. RESULTS The analysis showed that a lower mental processing speed was related to a higher level of pain, as well as to a lower performance-based and self-reported physical functioning. In addition, both performance-based and self-reported physical function revealed an inverse correlation with pain intensity. Psychosocial function turned out to be an important mediator of the relationship between pain and self-reported, but not performance-based, physical function. Mental processing speed, on the other hand, was found to mediate the relationship between pain and performance-based physical functioning. CONCLUSION The results suggest that in chronic pain patients, mental processing speed mediates the relationship between pain and physical function.
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Affiliation(s)
- Wiesje L J A Pulles
- Physical Therapy, Avans University of Applied Sciences, Hogeschoollaan 1, Breda, The Netherlands.
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Kessels RPC, Molleman PW, Oosterman JM. Assessment of working-memory deficits in patients with mild cognitive impairment and Alzheimer's dementia using Wechsler's Working Memory Index. Aging Clin Exp Res 2011; 23:487-90. [PMID: 22526081 DOI: 10.1007/bf03325245] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS Although episodic memory deficits are a hallmark in mild cognitive impairment (MCI) and Alzheimer's dementia (AD), little attention has been paid so far to the ability to maintain and manipulate information during a brief period of time, i.e. working memory. In this study, we examine verbal working memory in both cognitively unimpaired older people and MCI and AD patients. METHODS Seventy- five participants were examined with either no cognitive impairment (n=25), MCI (n=25) or AD (n=25). Working memory was investigated with Wechsler's Working Memory Index tests (Digit Span, Letter-Number Sequencing and Arithmetic). RESULTS Both MCI and AD patients performed worse on all three working-memory tests compared with controls, the subtest Letter-Number Sequencing also revealing worse performance in AD compared with MCI patients. CONCLUSIONS Workingmemory deficits are already present in MCI patients and worsen in AD patients, suggesting that working memory should be assessed as part of neuropsychological testing.
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Affiliation(s)
- Roy P C Kessels
- Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Montessorilaan 3, 6525 HR Nijmegen, The Netherlands.
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Abstract
BACKGROUND Executive function deficits are commonly observed in many clinical populations, highlighting the importance of appropriate diagnostic tools to screen for these deficits. Most neuropsychological tests of executive function, however, are time-consuming and difficult to administer in the case of moderate to severe cognitive decline. The aim of the present study was to examine whether the Key Search Test, a short and easy to administer test, is a useful indicator of executive function deficits in a study sample with a diagnosis of cognitive impairment. METHODS Participants consisted of elderly people visiting the memory clinic at the department of geriatrics of a university medical center (n= 140) and of elderly controls (n= 37). Next to the Key Search Test, other executive function tests and a memory test were administered. RESULTS Low to moderate correlations were found between the Key Search Test and other executive function tests. Furthermore, although the Key Search Test discriminated significantly between intact and impaired executive function (AUC = 0.677, P < 0.001), sensitivity and specificity were low and no optimal cut-off point could be determined. CONCLUSION The Key Search test might not be an appropriate measure of executive functions in cognitively impaired individuals.
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Affiliation(s)
- Joukje M Oosterman
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands.
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Oosterman JM, Vogels RLC, van Harten B, Gouw AA, Poggesi A, Scheltens P, Kessels RPC, Scherder EJA. Assessing mental flexibility: neuroanatomical and neuropsychological correlates of the Trail Making Test in elderly people. Clin Neuropsychol 2010; 24:203-19. [PMID: 20162494 DOI: 10.1080/13854040903482848] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The Trail Making Test part B (TMT-B) is highly sensitive to age-related changes in the brain and cognitive function. However, the precise contribution of periventricular hyperintensities (PVH), deep white matter hyperintensities (DWMH), and medial temporal lobe atrophy (MTA) to task performance remains unspecified. Similarly, diminished performance may be due to deficient flexibility functions, but also to other age-related cognitive decline (e.g., mental slowing). The aim of the present study was to determine neuroanatomical (PVH, DWMH, MTA) and neuropsychological (working memory, executive function, speed and attention, episodic memory) predictors of TMT-B performance in elderly people. Results showed that MTA was the strongest predictor of TMT-B performance. The predictive value of the neuropsychological scores differed among the various TMT-B variables. For example, all neuropsychological domains predicted the TMT-B total completion time, whereas only executive function predicted the ratio score (TMT-B/A). We conclude that MTA is a very important predictor of TMT-B performance in elderly people. Furthermore, multiple cognitive functions are involved in TMT-B performance and a mild decline in any of these functions may result in diminished TMT-B performance. Therefore it is crucial to use the ratio score when one wishes to examine executive function ability.
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Affiliation(s)
- Joukje M Oosterman
- Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, 6500 HE Nijmegen, The Netherlands.
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Oosterman JM, van Someren EJW, Vogels RLC, Van Harten B, Scherder EJA. Fragmentation of the rest-activity rhythm correlates with age-related cognitive deficits. J Sleep Res 2009; 18:129-35. [PMID: 19250179 DOI: 10.1111/j.1365-2869.2008.00704.x] [Citation(s) in RCA: 122] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Aging affects both cognitive performance and the sleep-wake rhythm. The recent surge of studies that support a role of sleep for cognitive performance in healthy young adults suggests that disturbed sleep-wake rhythms may contribute to 'age-related' cognitive decline. This relationship has however not previously been extensively investigated. The present correlational study integrated a battery of standardized cognitive tests to investigate the association of mental speed, memory, and executive function with actigraphically recorded sleep-wake rhythms in 144 home-dwelling elderly participants aged 69.5 +/- 8.5 (mean +/- SD). Multiple regression analyses showed that the partial correlations of the fragmentation of the sleep-wake rhythm with each of the three cognitive domains (r = -0.16, -0.19, and -0.16 respectively) were significant. These associations were independent from main effects of age, implying that a unique relationship between the rest-activity rhythm and cognitive performance is present in elderly people.
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Affiliation(s)
- Joukje M Oosterman
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands.
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Oosterman JM, Van Harten B, Weinstein HC, Scheltens P, Sergeant JA, Scherder EJA. White matter hyperintensities and working memory: an explorative study. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2009; 15:384-99. [PMID: 18421629 DOI: 10.1080/13825580701879998] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
White matter hyperintensities (WMH) are commonly observed in elderly people and may have the most profound effect on executive functions, including working memory. Surprisingly, the Digit Span backward, a frequently employed working memory task, reveals no association with WMH. In the present study, it was investigated whether more detailed analyses of WMH variables and study sample selection are important when establishing a possible relationship between the Digit Span backward and WMH. To accomplish this, the Digit Span backward and additional working memory tests, WMH subscores, and cardiovascular risk factors were examined. The results revealed that performance on the Digit Span backward test is unrelated to WMH, whereas a relationship between other working memory tests and WMH was confirmed. Furthermore, a division between several white matter regions seems important; hyperintensities in the frontal deep white matter regions were the strongest predictor of working memory performance.
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Affiliation(s)
- Joukje M Oosterman
- Department of Clinical Neuropsychology, Vrije Universiteit, Van der Boechorststraat 1, Amsterdam, The Netherlands.
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Oosterman JM, Vogels RLC, van Harten B, Gouw AA, Scheltens P, Poggesi A, Weinstein HC, Scherder EJA. The role of white matter hyperintensities and medial temporal lobe atrophy in age-related executive dysfunctioning. Brain Cogn 2008; 68:128-33. [PMID: 18450353 DOI: 10.1016/j.bandc.2008.03.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2007] [Revised: 01/31/2008] [Accepted: 03/13/2008] [Indexed: 11/16/2022]
Abstract
Various studies support an association between white matter hyperintensities (WMH) and deficits in executive function in nondemented ageing. Studies examining executive functions and WMH have generally adopted executive function as a phrase including various functions such as flexibility, inhibition, and working memory. However, these functions include distinctive cognitive processes and not all may be affected as a result of WMH. Furthermore, atrophy of the medial temporal lobe (MTA) is frequently observed in ageing. Nevertheless, in previous studies of nondemented ageing MTA was not considered when examining a relationship between white matter and executive function. The goal of the present study was to examine how WMH and MTA relate to a variety of executive functions, including flexibility, fluency, inhibition, planning, set shifting, and working memory. Strong correlations were observed between WMH and MTA and most of the executive functions. However, only MTA was related to flexibility and set shifting performance. Regression analysis furthermore showed that MTA was the strongest predictor of working memory, after which no further significant association with WMH was noted. Alternatively, both MTA and periventricular hyperintensities independently predicted inhibition performance. These findings emphasize the importance of MTA when examining age-related decline in executive functioning.
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Affiliation(s)
- Joukje M Oosterman
- Experimental Psychology, Helmholtz Institute, Utrecht University, Heidelberglaan 2, 3584 CS, Utrecht, The Netherlands.
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Vogels RLC, Oosterman JM, Laman DM, Gouw AA, Schroeder-Tanka JM, Scheltens P, van der Flier WM, Weinstein HC. Transcranial Doppler Blood Flow Assessment in Patients With Mild Heart Failure: Correlates With Neuroimaging and Cognitive Performance. ACTA ACUST UNITED AC 2008; 14:61-5. [DOI: 10.1111/j.1751-7133.2008.07365.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Vogels RLC, Oosterman JM, van Harten B, Gouw AA, Schroeder-Tanka JM, Scheltens P, van der Flier WM, Weinstein HC. Neuroimaging and correlates of cognitive function among patients with heart failure. Dement Geriatr Cogn Disord 2008; 24:418-23. [PMID: 17938570 DOI: 10.1159/000109811] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/03/2007] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS We purposed to investigate the relationship between cerebral abnormalities detected by magnetic resonance imaging (MRI) and cognitive performance in nondemented outpatients with heart failure (HF). METHODS In 58 patients with HF neuropsychological assessment was performed including tests of mental speed, executive functions, memory, language and visuospatial functions. Deep, periventricular and total white matter hyperintensities (WMH), lacunar and cortical infarcts, global and medial temporal lobe atrophy (MTA) were investigated on MRI of the brain. Correlations between MRI findings and the cognitive measures were calculated. RESULTS MTA correlated with memory (r = -0.353, p < 0.01), with executive functions (r = -0.383, p < 0.01) and the Mini Mental State Examination (r = -0.343, p < 0.05). Total WMH and deep WMH were found to correlate with depression and anxiety scores, but not with cognitive measures. Age, estimated premorbid intelligence and MTA were independent predictors of diminished cognitive performance. CONCLUSIONS In HF patients, MTA was related to cognitive dysfunction, involving memory impairment and executive dysfunction, whereas WMH was related to depression and anxiety.
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Affiliation(s)
- Raymond L C Vogels
- Department of Neurology, Sint Lucas-Andreas Hospital, Amsterdam, The Netherlands.
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Vogels RLC, Oosterman JM, van Harten B, Scheltens P, van der Flier WM, Schroeder-Tanka JM, Weinstein HC. Profile of Cognitive Impairment in Chronic Heart Failure. J Am Geriatr Soc 2007; 55:1764-70. [PMID: 17727641 DOI: 10.1111/j.1532-5415.2007.01395.x] [Citation(s) in RCA: 139] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To determine the frequency and pattern of cognitive dysfunction in outpatients with chronic congestive heart failure (CHF) and to identify the corresponding demographic and clinical correlates. DESIGN Case-control study. SETTING Outpatient clinic in a community hospital. PARTICIPANTS Sixty-two outpatients with CHF, 53 controls diagnosed with cardiovascular disease uncomplicated by CHF (cardiac controls), and 42 healthy controls were investigated. MEASUREMENTS Neuropsychological assessment included tests of mental speed, executive function, memory, language, and visuospatial function. Composite z-scores for five cognitive domains and mean z-score for overall cognitive performance were computed. The cutoff score to indicate cognitive impairment was defined as the overall healthy participants' cognitive z-score minus 2 standard deviations. Independent demographic and clinical predictors of cognitive impairment were identified using linear regression analysis. RESULTS Patients with CHF showed a pattern of general cognitive impairment, including impairment of executive function, memory, language, mental speed, and attention. Twenty-five percent (P=.04) of patients with CHF were classified as cognitively impaired, compared with 15% of the cardiac controls and 4% of the healthy controls. Independent predictors of cognitive impairment in patients with CHF were estimated intelligence, New York Heart Association class, and presence of the apolipoprotein (Apo)E epsilon4 allele. CONCLUSION Cognitive dysfunction is relatively common in patients with CHF, with deficits being most prominent in the domains of executive function, memory, language, and mental speed. Disease severity and ApoE genotype are likely to be important determinants for cognitive impairment in patients with chronic CHF.
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Affiliation(s)
- Raymond L C Vogels
- Department of Neurology, Sint Lucas-Andreas Hospital, Amsterdam, The Netherlands
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Oosterman JM, de Vries K, Scherder EJA. Executive ability in relation to blood pressure in residents of homes for the elderly. Arch Clin Neuropsychol 2007; 22:731-8. [PMID: 17643953 DOI: 10.1016/j.acn.2007.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2006] [Revised: 03/29/2007] [Accepted: 06/06/2007] [Indexed: 11/30/2022] Open
Abstract
The objective of the present study was to examine whether blood pressure (BP) relates to various executive functions in residents of homes for the elderly. Several cognitive tests measuring flexibility, fluency, inhibition, planning, and working memory were administered. Associations between these executive functions and systolic and diastolic BP (SBP and DBP) were examined. The results revealed that normal SBP (<120 mmHg) related to better fluency and flexibility performance, whereas no significant effects of DBP were noted. The present study indicates that specifically SBP might be important with regard to executive ability in residents of homes for the elderly.
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Affiliation(s)
- Joukje M Oosterman
- Department of Clinical Neuropsychology, Vrije Universiteit, Amsterdam, The Netherlands.
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Abstract
This study was intended to, meta-analytically, review whether the subtests of the Wechsler Adult Intelligence Scale are useful in differentiating between vascular dementia and Alzheimer's disease. We expected the Alzheimer's disease group to outperform the vascular dementia group on those subtests that require executive functions, whereas inferior performance of the Alzheimer's disease patients was expected on memory tests. Two steps in the analysis were undertaken in an attempt to clarify this issue. The first step consisted of including all studies examining Wechsler Adult Intelligence Scale subtest performance in vascular dementia and Alzheimer's disease patients. Secondly, a subcortical vascular dementia subgroup was distinguished and performance of this subgroup was compared to that of the Alzheimer's disease group.Overall, the analyses showed that both the vascular dementia and, more strongly, the subcortical vascular dementia group revealed decreased executive functions on several subtests compared to the Alzheimer's disease group. The Alzheimer's disease group showed inferior performance on a single semantic memory test only compared to both the vascular dementia and the subcortical vascular dementia groups. These results indicate that several subtests of the Wechsler Adult Intelligence Scale can differentiate between these two clinical groups, and that most of these tests reveal more impaired performance in the vascular dementia group.
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Affiliation(s)
- Joukje M Oosterman
- Department of Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
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van Harten B, Oosterman JM, Potter van Loon BJ, Scheltens P, Weinstein HC. Brain Lesions on MRI in Elderly Patients with Type 2 Diabetes Mellitus. Eur Neurol 2006; 57:70-4. [PMID: 17179707 DOI: 10.1159/000098054] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2006] [Accepted: 08/23/2006] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND PURPOSE Diabetes mellitus (DM) type 2 has been associated with poor cognitive performance and dementia, particularly in elderly patients. The exact mechanisms underlying the cognitive dysfunction in DM remain unclear. Imaging studies of the brain could be helpful to give more insight into possible structural brain lesions underlying these cognitive dysfunctions. Therefore, we performed a study in independently living patients with DM type 2 in order to investigate the association between DM and brain imaging abnormalities. METHODS The study population consisted of 45 patients with DM type 2 without hypertension (mean age 73.4 +/- 5.1 years, mean duration 16.5 +/- 11.5 years), 45 patients with DM type 2 and hypertension (mean age 73.5 +/- 6.1 years, mean duration 11.9 +/- 9.2 years) and 44 control subjects (mean age 73.1 +/- 5.4 years). All patients and control subjects underwent an MRI of the brain. White matter lesions (WML), cerebral atrophy and medial temporal lobe atrophy were rated by a standardized visual rating scale. Lacunar infarcts were defined as focal hypo-intensities on fluid-attenuated inversion recovery sequences with a hyperintense rim around it. RESULTS WML occurred more frequently in diabetic patients with hypertension as well as without hypertension. Significantly more deep WML were found in DM patients with and without hypertension when compared to control subjects, whereas no difference was found in the occurrence of periventricular hyperintensities. In all 3 groups, lacunar infarcts occurred sporadically. A trend towards higher atrophy scores was seen in patients with DM compared to control subjects. CONCLUSIONS The data of this cross-sectional study suggest that type 2 DM is an independent risk factor for deep WML in the independently living elderly patients.
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Affiliation(s)
- Barbera van Harten
- Department of Neurology, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands.
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Oosterman JM, van Harten B, Weinstein HC, Scheltens P, Scherder EJA. Pain intensity and pain affect in relation to white matter changes. Pain 2006; 125:74-81. [PMID: 16750299 DOI: 10.1016/j.pain.2006.04.030] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2005] [Revised: 02/23/2006] [Accepted: 04/27/2006] [Indexed: 10/24/2022]
Abstract
Since aging is a risk factor for both dementia and the occurrence of painful conditions, with the number of aged people increasing in the next decades, an increase in the number of elderly people suffering from both conditions can be anticipated. Reliable pain assessment in this population is restricted by reduced communicative and cognitive capacity, with serious consequences for effective pain treatment. White matter changes are frequently observed in the various subtypes of dementia as well as in normal aging, and may play a crucial role in pain processing. In healthy elderly people, reliable pain assessment can be accomplished, which enables examining the relationship between pain experience and white matter changes. A normal structure and function of the white matter is extremely important for dorsolateral prefrontal cortex (DLPFC) functioning, which has recently been linked to pain inhibition. The present study focused on the relation between white matter changes and both pain intensity and pain affect in elderly people without dementia. The Coloured Analogue Scale (CAS) and the Number of Words Chosen-Affective (NWC-A) were applied to measure pain intensity and pain affect, respectively. The presence of white matter changes was significantly related to a higher score on the NWC-A but not the CAS score. These results suggest that pain experience may change as a result of aging and that white matter changes might be indicative for these alterations.
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Affiliation(s)
- Joukje M Oosterman
- Department of Clinical Neuropsychology, Vrije Universiteit, Amsterdam, The Netherlands.
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