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Kuo JR, Su BY. Neuropsychological Impairments in Patients With Post-traumatic Epilepsy: A Scoping Review. World Neurosurg 2023; 176:85-97. [PMID: 37127179 DOI: 10.1016/j.wneu.2023.04.101] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 04/24/2023] [Indexed: 05/03/2023]
Abstract
OBJECTIVES To date, the research on the prognosis of the neuropsychological function of patients with post-traumatic seizure (PTE) is sparse. This study aimed to systematically map the literature's extent, range, and characteristics regarding PTE and neuropsychological impairments. METHODS A systematic literature search was conducted in CINAHL, Cochrane, Embase, Medline, PubMed, Scopus, Web of Science, and ScienceDirect databases. The search terms were related to PTE and neuropsychological impairments. RESULTS This scoping review included seven studies, two of which examined the impact of PTE on neuropsychological outcomes. Among the three studies that used neuropsychological assessments, attention/concentration, and memory were the most frequently assessed domains. Only one study reported a significant difference between PTE and non-PTE patients. The cognitive rating scale findings in the other four studies were similar, indicating that patients with PTE performed worse than those without PTE. CONCLUSIONS The results of this review suggest that patients with PTE may have neuropsychological function impairments. More attention needs to be paid to older patients and those with higher brain injury and seizure severity. Additional investigation is necessary to determine the clinical characteristics of TBI and PTE and elucidate the relations between PTE and specific neuropsychological domains.
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Affiliation(s)
- Jinn-Rung Kuo
- Department of Neurosurgery, Medical Research, Chi Mei Medical Center, Tainan, Taiwan; Department of Post-Baccalaureate Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Bei-Yi Su
- Department of Psychology, Chung-Shan Medical University, Taichung, Taiwan; Clinical Psychological Room, Chung Shan Medical University Hospital, Taichung, Taiwan.
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Al-Khalil K, Towe SL, Ikner TP, Meade CS. HIV viremia contributes to neurocognitive impairments in persons who use cocaine. J Neurovirol 2023; 29:331-336. [PMID: 36857016 PMCID: PMC11060036 DOI: 10.1007/s13365-022-01100-4] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 08/30/2022] [Accepted: 09/26/2022] [Indexed: 03/02/2023]
Abstract
Persons with HIV (PWH) who use illicit drugs are at elevated risk for neurocognitive impairment (NCI). This study investigated the effects of HIV disease and HIV viremia on NCI among adults who use cocaine. PWH who were not virologically suppressed showed greater global deficits compared to participants with HIV viral suppression and HIV-negative participants, but no differences emerged between the latter two groups. These findings highlight the adverse effects of poorly controlled HIV disease on NCI, beyond the independent effects of cocaine on cognition, and underscore the importance of strengthening the HIV care continuum for persons who use cocaine.
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Affiliation(s)
- Kareem Al-Khalil
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University, Durham, NC, USA.
| | - Sheri L Towe
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University, Durham, NC, USA
| | - Taylor P Ikner
- College of Liberal and Professional Studies, University of Pennsylvania, Philadelphia, PA, USA
| | - Christina S Meade
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University, Durham, NC, USA
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Diaz-Marsa M, Pemau A, de la Torre-Luque A, Vaz-Leal F, Rojo-Moreno L, Beato-Fernandez L, Graell M, Carrasco-Diaz A, Carrasco JL. Executive dysfunction in eating disorders: Relationship with clinical features. Prog Neuropsychopharmacol Biol Psychiatry 2023; 120:110649. [PMID: 36181959 DOI: 10.1016/j.pnpbp.2022.110649] [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] [Received: 03/22/2022] [Revised: 09/09/2022] [Accepted: 09/25/2022] [Indexed: 10/14/2022]
Abstract
UNLABELLED Eating disorders (ED) are severe mental disorders that may result in significant functional impairment and disability. Neuropsychological studies have consistently found impaired executive function (EF) among ED patients. EF is particularly involved in fundamental skills of daily living and in behavioral and emotional regulation. In this study, impairment of executive functioning is investigated in patients with eating disorders and the associations with clinical features and clinical subtypes are analyzed. METHOD 75 female patients (m = 22.01 years, sd = 9.15) with eating disorder (43 restrictive anorexia, 30 binge-eating anorexia and 13 bulimia nervosa) and 37 healthy controls (m = 18.54 years, sd = 4.21) were included in the study. An extensive assessment of executive function domains (verbal fluency, set shifting, attention span, selective attention, working memory, inhibitory control and processing speed) was carried out in both groups. Clinical scales for food intake restriction, binge-eating/purging, depression, anxiety and impulsivity were also administered and correlated with scores on executive function tests. RESULTS Patients with an ED had significantly lower scores than healthy controls in performance of several executive function tests, particularly in set shifting, interference control and processing speed (p < .01, in all three domains). Executive function impairment was related to anxious, depressive and eating disorder symptoms (p < .05), regardless of clinical subtype. CONCLUSIONS Executive function impairment in eating disorders is associated with greater ED symptomatic severity and might involve a negative treatment outcome. Therefore, cognitive remediation techniques should probably be considered in a number of severe patients with ED.
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Affiliation(s)
- Marina Diaz-Marsa
- Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; School of Medicine, Universidad Complutense de Madrid, Spain; Hospital Clínico San Carlos, Spain
| | - Andres Pemau
- Faculty of Psychology, Universidad Complutense de Madrid, Spain.
| | - Alejandro de la Torre-Luque
- Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; School of Medicine, Universidad Complutense de Madrid, Spain
| | | | | | | | - Montserrat Graell
- Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; Hospital Universitario Niño Jesus, Spain
| | | | - Jose Luis Carrasco
- Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; School of Medicine, Universidad Complutense de Madrid, Spain; Hospital Clínico San Carlos, Spain
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Azcue N, Gómez-Esteban JC, Acera M, Tijero B, Fernandez T, Ayo-Mentxakatorre N, Pérez-Concha T, Murueta-Goyena A, Lafuente JV, Prada Á, López de Munain A, Ruiz-Irastorza G, Ribacoba L, Gabilondo I, Del Pino R. Brain fog of post-COVID-19 condition and Chronic Fatigue Syndrome, same medical disorder? J Transl Med 2022; 20:569. [PMID: 36474290 PMCID: PMC9724286 DOI: 10.1186/s12967-022-03764-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 11/08/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is characterized by persistent physical and mental fatigue. The post-COVID-19 condition patients refer physical fatigue and cognitive impairment sequelae. Given the similarity between both conditions, could it be the same pathology with a different precipitating factor? OBJECTIVE To describe the cognitive impairment, neuropsychiatric symptoms, and general symptomatology in both groups, to find out if it is the same pathology. As well as verify if the affectation of smell is related to cognitive deterioration in patients with post-COVID-19 condition. METHODS The sample included 42 ME/CFS and 73 post-COVID-19 condition patients. Fatigue, sleep quality, anxiety and depressive symptoms, the frequency and severity of different symptoms, olfactory function and a wide range of cognitive domains were evaluated. RESULTS Both syndromes are characterized by excessive physical fatigue, sleep problems and myalgia. Sustained attention and processing speed were impaired in 83.3% and 52.4% of ME/CFS patients while in post-COVID-19 condition were impaired in 56.2% and 41.4% of patients, respectively. Statistically significant differences were found in sustained attention and visuospatial ability, being the ME/CFS group who presented the worst performance. Physical problems and mood issues were the main variables correlating with cognitive performance in post-COVID-19 patients, while in ME/CFS it was anxiety symptoms and physical fatigue. CONCLUSIONS The symptomatology and cognitive patterns were similar in both groups, with greater impairment in ME/CFS. This disease is characterized by greater physical and neuropsychiatric problems compared to post-COVID-19 condition. Likewise, we also propose the relevance of prolonged hyposmia as a possible marker of cognitive deterioration in patients with post-COVID-19.
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Affiliation(s)
- N. Azcue
- grid.452310.1Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - J. C. Gómez-Esteban
- grid.452310.1Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain ,grid.411232.70000 0004 1767 5135Department of Neurology, Cruces University Hospital, Barakaldo, Spain ,grid.11480.3c0000000121671098Department of Neurosciences, University of the Basque Country UPV/EHU, Leioa, Spain
| | - M. Acera
- grid.452310.1Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - B. Tijero
- grid.452310.1Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain ,grid.411232.70000 0004 1767 5135Department of Neurology, Cruces University Hospital, Barakaldo, Spain
| | - T. Fernandez
- grid.452310.1Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain ,grid.411232.70000 0004 1767 5135Department of Neurology, Cruces University Hospital, Barakaldo, Spain
| | - N. Ayo-Mentxakatorre
- grid.452310.1Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - T. Pérez-Concha
- grid.411232.70000 0004 1767 5135Department of Neurology, Cruces University Hospital, Barakaldo, Spain
| | - A. Murueta-Goyena
- grid.452310.1Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain ,grid.11480.3c0000000121671098Department of Neurosciences, University of the Basque Country UPV/EHU, Leioa, Spain
| | - J. V. Lafuente
- grid.11480.3c0000000121671098Department of Neurosciences, University of the Basque Country UPV/EHU, Leioa, Spain
| | - Á. Prada
- grid.414651.30000 0000 9920 5292Department of Immunology, Donostia University Hospital, San Sebastián, Spain ,Spanish Network for the Research in Multiple Sclerosis, Donostia/San Sebastian, Spain
| | - A. López de Munain
- grid.414651.30000 0000 9920 5292Department of Neurology, Donostia University Hospital, San Sebastián, Spain ,grid.432380.eDepartment of Neurosciences, Biodonostia Health Research Institute, San Sebastián, Spain
| | - G. Ruiz-Irastorza
- grid.452310.1Autoimmune Diseases Research Unit, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - L. Ribacoba
- grid.411232.70000 0004 1767 5135Department of Internal Medicine, Cruces University Hospital, Barakaldo, Spain
| | - I. Gabilondo
- grid.452310.1Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain ,grid.411232.70000 0004 1767 5135Department of Neurology, Cruces University Hospital, Barakaldo, Spain ,grid.424810.b0000 0004 0467 2314The Basque Foundation for Science, IKERBASQUE, Bilbao, Spain
| | - R. Del Pino
- grid.452310.1Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
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Bar-On Kalfon T, Gal G, Shorer R, Ablin JN. Cognitive functioning in fibromyalgia: The central role of effort. J Psychosom Res 2016; 87:30-6. [PMID: 27411749 DOI: 10.1016/j.jpsychores.2016.06.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [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] [Received: 02/26/2016] [Revised: 05/29/2016] [Accepted: 06/03/2016] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Fibromyalgia syndrome (FM) patients demonstrate deficits in tests of attention, executive functioning and verbal memory. We assessed the role of effort in the cognitive impairment in FM patients, alongside common symptoms of pain, fatigue and depression. METHOD 50 FM patients underwent a computerized cognitive assessment battery including memory, executive function, attention and information processing speed (NeuroTrax Corp.). Age and education standardized scores were computed. Effort was assessed by the Test of Memory Malingering (TOMM). FM symptoms were assessed by the Fibromyalgia Impact Questionnaire (FIQ), Widespread Pain Index (WPI) and Symptom Severity Scale (SSS), a Visual Analog Scale (VAS) of clinical pain and the Beck Depression Inventory (BDI-2). RESULTS FM patients showed impaired performance on the memory, attention and information processing speed domains. According to the TOMM, sub-optimal effort was shown by 16% of patients. TOMM scores were not associated with pain, fatigue or depression. After controlling for effort, no significant impairment was found in memory scores; however attention and information processing speed scores remained significantly low. Multiple regressions analysis, performed in order to evaluate the contribution of effort, pain, fatigue and depression, found effort to be the only significant variable accounting for variance of cognitive scores on all domains. CONCLUSION The findings confirm impaired attention and processing speed in FM patients, independent of effort level. Nonetheless, the findings point to a general and strong effect of effort on neuropsychological performance in FM patients, especially in the domain of memory, emphasizes the importance of effort testing in this population.
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Affiliation(s)
- Tamar Bar-On Kalfon
- School of Behavioral Sciences, Tel Aviv-Jaffa Academic College, Jaffa, Israel
| | - Gilad Gal
- School of Behavioral Sciences, Tel Aviv-Jaffa Academic College, Jaffa, Israel
| | - Ran Shorer
- Institute of Rheumatology, Tel-Aviv Sourasky Medical Center, Israel
| | - Jacob N Ablin
- Institute of Rheumatology, Tel-Aviv Sourasky Medical Center, Israel
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Carvalhal A, Gill MJ, Letendre SL, Rachlis A, Bekele T, Raboud J, Burchell A, Rourke SB. Central nervous system penetration effectiveness of antiretroviral drugs and neuropsychological impairment in the Ontario HIV Treatment Network Cohort Study. J Neurovirol 2016; 22:349-57. [PMID: 26572786 PMCID: PMC10748733 DOI: 10.1007/s13365-015-0404-5] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 10/26/2015] [Accepted: 10/30/2015] [Indexed: 11/29/2022]
Abstract
Since the introduction of combination antiretroviral therapy (cART), the incidence of severe HIV-associated neurocognitive impairment has declined significantly, whereas the prevalence of the milder forms has increased. Studies suggest that better distribution of cART drugs into the CNS may be important in reducing viral replication in the CNS and in reducing HIV-related brain injury. Correlates of neuropsychological (NP) performance were determined in 417 participants of the Ontario HIV Treatment Cohort Study (OCS). All participants were on three cART drugs for at least 90 days prior to assessment. Multiple logistic and linear regression methods were used. Most participants were Caucasian men with mean age of 47 years. About two thirds had a nadir CD4+ T-cell count below 200 cells/μL and 92 % had an undetectable plasma HIV viral load. The median CNS penetration effectiveness (CPE) score was 7. Sixty percent of participants had neuropsychological impairment. Higher CPE values significantly correlated with lower prevalence of impairment in bivariate and multivariate analyses. In this cross-sectional analysis of HIV+ adults who had a low prevalence of comorbidities and were taking three-drug cART regimens, greater estimated distribution of cART drugs into the CNS was associated with better NP performance.
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Affiliation(s)
- Adriana Carvalhal
- Department of Psychiatry, University of Toronto, Toronto, Canada.
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street 17-042, Toronto, ON, Canada, M5B 1W8.
| | - M John Gill
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Scott L Letendre
- HIV Neurobehavioural Research Center and Antiretroviral Research Center, University of California San Diego, San Diego, CA, USA
| | - Anita Rachlis
- Sunnybrook Health Sciences Center, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
| | | | - Janet Raboud
- Toronto General Research Institute, University Health Network, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Ann Burchell
- The Ontario HIV Treatment Network, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Sean B Rourke
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street 17-042, Toronto, ON, Canada, M5B 1W8
- The CIHR Centre for REACH in HIV/AIDS (Research Evidence into Action for Community Health), Toronto, Canada
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Nascimento S, Baierle M, Göethel G, Barth A, Brucker N, Charão M, Sauer E, Gauer B, Arbo MD, Altknecht L, Jager M, Dias ACG, de Salles JF, Saint' Pierre T, Gioda A, Moresco R, Garcia SC. Associations among environmental exposure to manganese, neuropsychological performance, oxidative damage and kidney biomarkers in children. Environ Res 2016; 147:32-43. [PMID: 26844420 DOI: 10.1016/j.envres.2016.01.035] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 01/21/2016] [Accepted: 01/24/2016] [Indexed: 05/06/2023]
Abstract
Environmental exposure to manganese (Mn) results in several toxic effects, mainly neurotoxicity. This study investigated associations among Mn exposure, neuropsychological performance, biomarkers of oxidative damage and early kidney dysfunction in children aged 6-12 years old. Sixty-three children were enrolled in this study, being 43 from a rural area and 20 from an urban area. Manganese was quantified in blood (B-Mn), hair (H-Mn) and drinking water using inductively coupled plasma mass spectrometry (ICP-MS). The neuropsychological functions assessed were attention, perception, working memory, phonological awareness and executive functions - inhibition. The Intelligence quotient (IQ) was also evaluated. The biomarkers malondialdehyde (MDA), protein carbonyls (PCO), δ-aminolevulinate dehydratase (ALA-D), reactivation indexes with dithiothreitol (ALA-RE/DTT) and ZnCl2 (ALA-RE/ZnCl2), non-protein thiol groups, as well as microalbuminuria (mALB) level and N-acetyl-β-D-glucosaminidase (NAG) activity were assessed. The results demonstrated that Mn levels in blood, hair and drinking water were higher in rural children than in urban children (p<0.01). Adjusted for potential confounding factors, IQ, age, gender and parents' education, significant associations were observed mainly between B-Mn and visual attention (β=0.649; p<0.001). Moreover, B-Mn was negatively associated with visual perception and phonological awareness. H-Mn was inversely associated with working memory, and Mn levels from drinking water with written language and executive functions - inhibition. Rural children showed a significant increase in oxidative damage to proteins and lipids, as well as alteration in kidney function biomarkers (p<0.05). Moreover, significant associations were found between B-Mn, H-Mn and Mn levels in drinking water and biomarkers of oxidative damage and kidney function, besides between some oxidative stress biomarkers and neuropsychological tasks (p<0.05). The findings of this study suggest an important association between environmental exposure to Mn and toxic effects on neuropsychological function, oxidative damage and kidney function in children.
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Affiliation(s)
- Sabrina Nascimento
- Laboratory of Toxicology (LATOX), Department of Analyses, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Post-graduate Program in Pharmaceutical Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Marília Baierle
- Laboratory of Toxicology (LATOX), Department of Analyses, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Gabriela Göethel
- Laboratory of Toxicology (LATOX), Department of Analyses, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Post-graduate Program in Pharmaceutical Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Anelise Barth
- Laboratory of Toxicology (LATOX), Department of Analyses, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Natália Brucker
- Laboratory of Toxicology (LATOX), Department of Analyses, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Mariele Charão
- Laboratory of Toxicology (LATOX), Department of Analyses, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Institute of Health Sciences, Feevale University, Novo Hamburgo, RS, Brazil
| | - Elisa Sauer
- Laboratory of Toxicology (LATOX), Department of Analyses, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Post-graduate Program in Pharmaceutical Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Bruna Gauer
- Laboratory of Toxicology (LATOX), Department of Analyses, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Post-graduate Program in Pharmaceutical Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Marcelo Dutra Arbo
- Laboratory of Toxicology (LATOX), Department of Analyses, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Louise Altknecht
- Laboratory of Toxicology (LATOX), Department of Analyses, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Institute of Cardiology, University Cardiology Foundation (FUC), Porto Alegre, RS, Brazil
| | - Márcia Jager
- Post-graduate Program in Psychology, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil
| | - Ana Cristina Garcia Dias
- Post-graduate Program in Psychology, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil
| | - Jerusa Fumagalli de Salles
- Post-graduate Program in Psychology, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Tatiana Saint' Pierre
- Department of Chemistry, Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro, RJ, Brazil
| | - Adriana Gioda
- Department of Chemistry, Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro, RJ, Brazil
| | - Rafael Moresco
- Laboratory of Clinical Biochemistry, Department of Clinical and Toxicological Analyses, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil
| | - Solange Cristina Garcia
- Laboratory of Toxicology (LATOX), Department of Analyses, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Post-graduate Program in Pharmaceutical Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Institute of Cardiology, University Cardiology Foundation (FUC), Porto Alegre, RS, Brazil.
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Baldanzi S, Bevilacqua F, Lorio R, Volpi L, Simoncini C, Petrucci A, Cosottini M, Massimetti G, Tognoni G, Ricci G, Angelini C, Siciliano G. Disease awareness in myotonic dystrophy type 1: an observational cross-sectional study. Orphanet J Rare Dis 2016; 11:34. [PMID: 27044540 PMCID: PMC4820880 DOI: 10.1186/s13023-016-0417-z] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [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] [Received: 08/08/2015] [Accepted: 03/30/2016] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Myotonic dystrophy type 1 (Steinert's disease or DM1), the most common form of autosomal dominant muscular dystrophy in adults, is a multisystem disorder, affecting skeletal muscle as well as eyes, heart, gastrointestinal tract, endocrine system, and central nervous system, finally responsible of increasing disabilities and secondary social consequences. To date, DM1-related brain involvement represents a challenging field of research. It is well known that DM1 patients frequently present neuropsychological disturbances and psychiatric comorbidities among which reduced awareness of disease burden and its progression, also defined as anosognosia, is common in clinical practice, this leading to secondary misattribution of symptoms, delay in timely diagnostic procedures and low compliance to treatment. METHODS Here we present an observational cross sectional study in which disease-related cognitive dysfunctions and quality of life were assessed by a protocol finally designed to estimate the prevalence of disease awareness in a sample of 65 adult-onset DM1 patients. RESULTS Our analysis showed that in DM1 patients several cognitive functions, including executive and mnesic domains with visuo-spatial involvement, were affected. The assessment of anosognosia revealed that a high percentage (51.6%) of DM1 subjects was disease unaware. The reduced illness awareness occurs across different physical and life domains, and it appears more prominent in Activities and Independence domains investigated by the Individualized Neuromuscular Quality Of Life (INQoL) questionnaire. Moreover, the unawareness resulted significantly related (at p <0.05 and p < 0.01) to the performance failure in cognitive tests, specifically in the domains of visuo-spatial memory, cognitive flexibility and conceptualization. CONCLUSIONS The obtained data confirm, by a systematic analysis, what's the common clinical perceiving of disease unawareness in Steinert's disease, this related to the already known cognitive-behavioural impairment of frontal type in affected patients. We believe that a deep knowledge of this aspect will be useful for medical practice in the management of patients with DM1, also for guidance in occupational and social interventions, definition of outcome measures and in preparation of trial readiness.
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Affiliation(s)
- Sigrid Baldanzi
- Department of Clinical and Experimental Medicine, Neurological Unit, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | | | - Rita Lorio
- IRCCS San Camillo Venezia, Via Alberoni 70, Venezia, 30126, Italy
| | - Leda Volpi
- Department of Clinical and Experimental Medicine, Neurological Unit, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - Costanza Simoncini
- Department of Clinical and Experimental Medicine, Neurological Unit, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - Antonio Petrucci
- Neurology and Neurophysiopathology Unit, San Camillo Forlanini Hospital, Piazza Carlo Forlanini 1, 00151, Rome, Italy
| | - Mirco Cosottini
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Via Paradisa 2, 56126, Pisa, Italy
| | - Gabriele Massimetti
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - Gloria Tognoni
- Department of Clinical and Experimental Medicine, Neurological Unit, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - Giulia Ricci
- Department of Clinical and Experimental Medicine, Neurological Unit, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - Corrado Angelini
- IRCCS San Camillo Venezia, Via Alberoni 70, Venezia, 30126, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, Neurological Unit, University of Pisa, Via Roma 67, 56126, Pisa, Italy.
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Lewin AB, Larson MJ, Park JM, McGuire JF, Murphy TK, Storch EA. Neuropsychological functioning in youth with obsessive compulsive disorder: an examination of executive function and memory impairment. Psychiatry Res 2014; 216:108-15. [PMID: 24508366 DOI: 10.1016/j.psychres.2014.01.014] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 01/07/2014] [Accepted: 01/09/2014] [Indexed: 11/22/2022]
Abstract
Preliminary research suggests neuropsychological deficits in youth with obsessive-compulsive disorder (OCD) similar to those in adults; however, small samples and methodological confounds limit interpretation. We aimed to examine the rates and clinical correlates of cognitive sequelae in youth with OCD, focusing on executive functioning and memory abilities. Youth ages 7-17 years with OCD (N=96) completed a hypothesis-driven neuropsychological battery (including the Rey-Osterreith Complex Figure, California Verbal Learning Test, and subtests of the Delis-Kaplan Executive Function System and Wide Range Assessment of Memory and Learning) that primarily assessed executive functioning, memory and processing speed. Cognitive sequelae were identified in 65% of youth (37% using a more stringent definition of impairment). Magnitude of cognitive sequelae was not associated with OCD severity or age; however, greater neuropsychological impairments were found amongst youth prescribed atypical neuroleptics and those diagnosed with comorbid tic disorders. Comorbidity burden was associated with presence of neuropsychological impairment, but was not specific to any single test. Findings suggest that the presence of cognitive sequelae is prevalent amongst treatment-seeking youth with OCD. Deficits were found in executive functioning and non-verbal memory performance but these impairments were not associated with OCD severity.
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Ownsworth T, Dwan T, Chambers S, Walker DG, Shum DHK. The moderating effect of estimated pre-morbid IQ on the relationship between neuropsychological status and subjective well-being after brain tumour. J Psychosom Res 2014; 76:257-60. [PMID: 24529047 DOI: 10.1016/j.jpsychores.2013.12.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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] [Received: 10/16/2013] [Revised: 12/19/2013] [Accepted: 12/21/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVE People with brain tumour experience complex and distressing symptoms. Neuropsychological impairment is proposed to have a negative impact on subjective well-being; however, research is yet to examine the influence of estimated premorbid IQ on this relationship. This preliminary study investigated the moderating effect of estimated premorbid IQ on the relationship between global neuropsychological status (GNF) and depression and quality of life. METHODS 73 adults (51% male) aged 21-65 years with primary brain tumour (52% benign) were administered a test battery assessing estimated premorbid IQ, GNF, depression (Depression Anxiety Stress Scales) and quality of life (Functional Assessment of Cancer Therapy, FACT). RESULTS A series of two-way analysis of covariance (ANCOVA) controlling for education found a significant interaction between estimated premorbid IQ (low average to average vs high average) and GNF (low vs high) on levels of depression (p < .05) and FACT emotional well-being (p < .05). For these outcomes, individuals with high average estimated premorbid IQ and low GNF reported better well-being than those with low-average to average estimated premorbid IQ and low GNF. Higher GNF was related to greater functional well-being (p < .01) irrespective of estimated premorbid IQ. CONCLUSION The finding that higher premorbid cognitive ability buffers the effect of neuropsychological impairment on emotional well-being after brain tumour advances understanding of the role of cognitive reserve in adjustment to neurological disorders.
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Affiliation(s)
- Tamara Ownsworth
- School of Applied Psychology and Griffith Health Institute, Griffith University, Brisbane, Australia.
| | - Toni Dwan
- School of Applied Psychology and Griffith Health Institute, Griffith University, Brisbane, Australia
| | - Suzanne Chambers
- School of Applied Psychology and Griffith Health Institute, Griffith University, Brisbane, Australia; Cancer Council Queensland, Australia; Health and Wellness Institute, Edith Cowan University, Australia; Centre for Clinical Research, University of Queensland, Australia
| | - David G Walker
- Newro Foundation and Briz Brain & Spine, Brisbane, Australia
| | - David H K Shum
- School of Applied Psychology and Griffith Health Institute, Griffith University, Brisbane, Australia
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Hsu KJ, Young-Wolff KC, Kendler KS, Halberstadt LJ, Prescott CA. Neuropsychological deficits in major depression reflect genetic/familial risk more than clinical history: a monozygotic discordant twin-pair study. Psychiatry Res 2014; 215:87-94. [PMID: 24262663 PMCID: PMC3955732 DOI: 10.1016/j.psychres.2013.10.037] [Citation(s) in RCA: 14] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Revised: 08/26/2013] [Accepted: 10/20/2013] [Indexed: 01/21/2023]
Abstract
Neuropsychological deficits have been associated with major depression (MD) and persist in some individuals even after symptom remission. However, it is unclear if the deficits are a consequence of MD or are pre-existing and reflect MD vulnerability. We addressed this issue by studying 117 twins from monozygotic (MZ) pairs discordant for lifetime history of DSM-III-R defined MD and 41 twins from MZ pairs in which neither twin had experienced MD. Our assessment included a structured clinical interview and measures from the WMS-III and WAIS-III. The "unaffected" twins from discordant pairs showed the same pattern of performance as their affected cotwins on measures of attention, working memory, verbal memory, and visuo-spatial processing. Compared to twins from pairs with no MD history, twins in discordant pairs had lower performance in the domains of attention, memory, visuo-spatial processing, and general knowledge. However, after adjusting for sex and age, the groups differed only on attention and general knowledge. The similar performance of twins in pairs discordant for MD suggests that familial risk for MD has a greater influence on neuropsychological functioning than individual MD history. Findings of impairment in individuals euthymic for MD are more consistent with pre-existing deficits than scarring effects of MD.
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Affiliation(s)
- Kean J. Hsu
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Kelly C. Young-Wolff
- Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Kenneth S. Kendler
- Department of Psychiatry and Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, Richmond, VA
| | - Lisa J. Halberstadt
- Department of Psychiatry and Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, Richmond, VA
| | - Carol A. Prescott
- Department of Psychology, University of Southern California, Los Angeles, CA, USA,Correspondence concerning this article should be addressed to Carol Prescott, Department of Psychology, SGM 501, University of Southern California, Los Angeles, CA 90089-1061. Contact:
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Abstract
Traumatic Brain Injury (TBI) is the most common cause of death and disability in young people. The patients with TBI often suffer impairments in psycho motor speed, memory, attention, speed of information processing, executive functioning, fluid intelligence, language and visuo-spatial skills. These impairments need to be addressed as these have a significant impact on their social and occupational functioning. Neuropsychological rehabilitation has been found to be useful in improving cognitive and day to day functioning. It focuses on the improvement of basic abilities which in turn enhance cognitive functioning. The aim of the present study was to develop a home based neuropsychological rehabilitation programme and examine its usefulness in severe TBI. A single case study method was adopted. A detailed assessment was done at 1½ months (pre-assessment) and 9 months (post-intervention) to evaluate the changes. Post-intervention improvement was observed in her cognitive functions and day to day functioning. She had resumed her previous job also. Home based neuropsychological rehabilitation emerged to be useful in brain damaged patients.
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