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Steel SA, Rolin SN, Davis JJ. Relatively undervalued: Comparing the work relative value units of neuropsychological evaluation to other services. Clin Neuropsychol 2024; 38:907-921. [PMID: 37881944 DOI: 10.1080/13854046.2023.2272788] [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: 07/24/2023] [Accepted: 10/14/2023] [Indexed: 10/27/2023]
Abstract
Objective: We examined work relative value units (wRVUs) and associated revenue of current procedural terminology (CPT) codes for evaluation and management (E&M) services, neuropsychological evaluation (NPE), psychological evaluation (PE), and psychotherapy. Method: CPT code wRVUs were aggregated for E&M (99202-99215), NPE (96116, 96132, 96133, 96136, and 96137), PE (90791, 96130, 96131, 96136, and 96137), and psychotherapy (90791 and 90832-90837 with and without the complexity modifier, 90785). Per minute wRVUs were calculated for each CPT code. The Centers for Medicare and Medicaid Services 2023 conversion factor ($33.8872) was multiplied by wRVUs to examine reimbursement per hour and per prototypical four-hour clinic slot. Results: The wRVUs per minute showed the following ranges: 0.032-0.07 for E&M services, 0.015-0.063 for NPE, 0.015-0.124 for PE, and 0.043-0.135 for psychotherapy. Average hourly revenue ranged from $72 for NPE to $132 for psychotherapy with the complexity modifier. Revenue for prototypical four-hour clinics ranged from $283 for NPE to $493 for psychotherapy with the complexity modifier. PE and psychotherapy services were valued at 124-184% of NPE. Conclusions: E&M code wRVUs increase with case complexity reflecting greater work intensity, and a modifier to PE and psychotherapy captures additional effort needed in complex cases. In contrast, NPE codes lack a complexity modifier, and NPE wRVUs are lower than those of PE and psychotherapy, the latter of which can be billed by master's level providers. NPE is undervalued compared to PE and psychotherapy based on wRVUs currently assigned to the CPT codes used for the respective services.
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Affiliation(s)
- Sarah A Steel
- Department of Rehabilitation Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Summer N Rolin
- Department of Rehabilitation Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Jeremy J Davis
- Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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2
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Considine CM, Rossetti MA, Anderson K, Del Bene VA, Anderson SA, Celka AS, Edmondson MC, Sheese ALN, Piccolino A, Teixeira AL, Stout JC. Huntington study group's neuropsychology working group position on best practice recommendations for the clinical neuropsychological evaluation of patients with Huntington disease. Clin Neuropsychol 2024; 38:984-1006. [PMID: 37849335 DOI: 10.1080/13854046.2023.2267789] [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: 03/10/2023] [Accepted: 10/02/2023] [Indexed: 10/19/2023]
Abstract
Objective: Neuropsychological evaluation is critical to detection and management of cognitive and neuropsychiatric changes associated with Huntington disease (HD). Accurate assessment of non-motor complications of HD is critical given the prominent impact on functional disability, frequently commensurate with or exceeding that of motor symptoms. The increasing emphasis on developing disease-modifying therapies targeting cognitive decline in HD requires consensus on clinical neuropsychological assessment methods. The Neuropsychology Working Group (NPWG) of the Huntington Study Group (HSG) sought to provide evidence and consensus-based, practical guidelines for the evaluation of cognitive and neuropsychiatric symptoms associated with HD. Method: The NPWG recruited a multi-disciplinary group of neuropsychologists, neurologists, and psychiatrists to inform best practices in assessing, diagnosing, and treating the non-motor symptoms in HD. A review was circulated among the NPWG, and in an iterative process informed by reviewed literature, best practices in neuropsychological evaluation of patients with HD were identified. Results: A brief review of the available literature and rational for a clinical consensus battery is offered. Conclusion: Clinical neuropsychologists are uniquely positioned to both detect and characterize the non-motor symptoms in HD, and further, provide neurologists and allied health professions with clinically meaningful information that impacts functional outcomes and quality of life. The NPWG provides guidance on best practices to clinical neuropsychologists in this statement. A companion paper operationalizing clinical application of previous research-based non-motor diagnostic criteria for HD is forthcoming, which also advises on non-motor symptom screening methods for the non-neuropsychologist working with HD.
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Affiliation(s)
- Ciaran M Considine
- Department of Neurology, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - M Agustina Rossetti
- Department of Neurology, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Kendra Anderson
- Department of Neurology, McGovern Medical School UT Health, The University of Texas Health Science Center, Houston, TX, USA
| | - Victor A Del Bene
- Department of Neurology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA
| | - Sharlet A Anderson
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Andrea S Celka
- Department of Neurology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA
| | | | - Amelia L Nelson Sheese
- Department of Neurological Sciences, University of Nebraska Medical Center College of Medicine, Omaha, NE, USA
| | - Adam Piccolino
- Psychology, Piccolino Psychological Services, Burnsville, MN, USA
| | - Antonio L Teixeira
- Department of Neurology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA
| | - Julie C Stout
- Turner Institute for Brain and Mental Health, and School of Psychological Science, Monash University, Melbourne, Australia
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Lunia P, Krishnan K, Irani F, Hundal JS, Arastu S, Vonk JMJ, Sunderaraman P. A scoping review of neuropsychological assessment for Asian Indians in the United States - research and clinical recommendations. Clin Neuropsychol 2024:1-21. [PMID: 38565847 DOI: 10.1080/13854046.2024.2327674] [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: 11/20/2023] [Accepted: 03/01/2024] [Indexed: 04/04/2024]
Abstract
Objective: There is an increasing focus on understanding health disparities among various cultural groups in the United States. The need for heterogeneity in norms and test stimuli across ethnically diverse individuals are being increasingly recognized. However, to date it remains unknown whether and to what extent differences in cognitive norms and tests exist in Asian Indians, a fast-growing population in the U.S. It is essential to understand these differences to improve diagnostic accuracy and provide timely and appropriate clinical care. Method: In this study, we conducted a scoping review of available cognitive tests that were normed, developed, or adapted for Asian Indians living in the U.S. Results: The results suggested a paucity of norms and tests specifically examining cognition in this community. Conclusions: Based on the findings, we provide suggestions for research directions focusing on the development of culturally sensitive neuropsychological tools, normative data representative of this demographic, and interventions addressing healthcare access barriers. Overall, this review provides readers with relevant clinical information to immediately enhance patient care as well as provide actionable items in research to improve the future utility of neuropsychology for Asian Indians in the United States.
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Affiliation(s)
- Palak Lunia
- Thomas Jefferson Medical Center, Philadelphia, PA, USA
| | - Kamini Krishnan
- Cleveland Clinic Lou Ruvo Center for Brain Health, Cleveland, OH, USA
| | | | | | - Sana Arastu
- Kaiser Permanente Northern California, Oakland, CA, USA
| | - Jet M J Vonk
- Memory and Aging Center, Department of Neurology, University of California San Francisco (UCSF), San Francisco, CA, USA
| | - Preeti Sunderaraman
- Department of Neurology, Medical Campus, Boston, MA, USA
- The Framingham Heart Study - Brain Aging Program, Framingham, MA, USA
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4
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Aksu S, Soyata AZ, Şeker S, Akkaya G, Yılmaz Y, Kafalı T, Evren C, Umut G. Transcranial direct current stimulation combined with cognitive training improves decision making and executive functions in opioid use disorder: a triple-blind sham-controlled pilot study. J Addict Dis 2024; 42:154-165. [PMID: 36861945 DOI: 10.1080/10550887.2023.2168991] [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] [Indexed: 03/03/2023]
Abstract
Opioid use disorder (OUD) is a chronic disorder with a considerable amount of morbidity and mortality. Despite remarkable improvement achieved by maintenance programs, an array of treatment goals were still unmet. Mounting evidence suggests that transcranial Direct Current Stimulation (tDCS) improves decision making and cognitive functions in addictive disorders. tDCS paired with a decision making task was depicted to diminish impulsivity as well. The present study aimed to assess the effect of tDCS combined with cognitive training (CT) in OUD for the first time. In this triple-blind randomized sham-controlled pilot study, 38 individuals with OUD from the Buprenorphine-Naloxone Maintenance Therapy program were administered 20-minutes of 2 mA active/sham tDCS over the dorsolateral prefrontal cortex with concomitant cognitive training. A selected test battery evaluating decision making under risk and ambiguity as well as executive functions, verbal fluency and working memory was utilized before and after the intervention. Greater improvements were observed in decision making under ambiguity (p = 0.016), set shifting ability and alternating fluency while no improvements were observed in decision making under risk in the active group, compared to sham. Deficits of decision making and executive functions have a pivotal role in the perpetuation and the relapse of the OUD. Alleviation of these impairments brought tDCS/CT forth as an expedient neuroscientifically-grounded treatment option that merits further exploration in OUD, Trial registration: NCT05568251.
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Affiliation(s)
- Serkan Aksu
- Department of Physiology, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Turkey
- Department of Physiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ahmet Zihni Soyata
- Psychiatry Outpatient Clinic, Başakşehir State Hospital, İstanbul, Turkey
| | - Sercan Şeker
- Department of Physiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Gözde Akkaya
- Department of Child Development, Istanbul Topkapı University, Istanbul, Turkey
| | - Yasemin Yılmaz
- Department of Psychology, İstanbul University, Istanbul, Turkey
| | - Tuğba Kafalı
- Department of Psychology, Akdeniz University, Antalya, Turkey
| | - Cüneyt Evren
- Department of Psychology, Istanbul Gelisim University, Istanbul, Turkey
| | - Gökhan Umut
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Turkey, Istanbul
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Bellomo G, Toja A, Paolini Paoletti F, Ma Y, Farris CM, Gaetani L, Salvadori N, Chiasserini D, Wojdaƚa AL, Concha‐Marambio L, Parnetti L. Investigating alpha-synuclein co-pathology in Alzheimer's disease by means of cerebrospinal fluid alpha-synuclein seed amplification assay. Alzheimers Dement 2024; 20:2444-2452. [PMID: 38323747 PMCID: PMC11032521 DOI: 10.1002/alz.13658] [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: 10/10/2023] [Revised: 11/28/2023] [Accepted: 11/30/2023] [Indexed: 02/08/2024]
Abstract
INTRODUCTION Lewy body disease, a frequently observed co-pathology in Alzheimer's disease (AD), can be identified antemortem in cerebrospinal fluid (CSF) by α-synuclein seed amplification assay (αS-SAA). The prevalence and clinical impact of CSF αS-SAA positivity in AD are still unknown. METHODS αS-SAA was performed on CSF samples from 240 AD patients (preclinical, prodromal, and dementia stages), 85 controls, 84 patients with Parkinson's disease (PD), and 21 patients with PD with dementia or dementia with Lewy bodies. In AD patients, associations between αS-SAA positivity and cognitive changes were also evaluated. RESULTS In agreement with available neuropathological studies, αS-SAA positivity was observed in 30% of AD patients (vs 9% in controls), and was associated with cognitive decline, visuospatial impairment, and behavioral disturbances. DISCUSSION αS-SAA positivity in AD patients reflects the prevalence observed in neuropathological series and is associated with a worse clinical outcome. These data confirm the validity of CSF αS-SAA positivity as biomarker of synucleinopathy.
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Affiliation(s)
- Giovanni Bellomo
- Center for Memory DisturbancesLab of Clinical NeurochemistrySection of NeurologyDepartment of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
| | - Andrea Toja
- Center for Memory DisturbancesLab of Clinical NeurochemistrySection of NeurologyDepartment of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
| | - Federico Paolini Paoletti
- Center for Memory DisturbancesLab of Clinical NeurochemistrySection of NeurologyDepartment of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
| | - Yihua Ma
- R&D Unit, Amprion IncSan DiegoCaliforniaUSA
| | | | - Lorenzo Gaetani
- Center for Memory DisturbancesLab of Clinical NeurochemistrySection of NeurologyDepartment of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
| | - Nicola Salvadori
- Center for Memory DisturbancesLab of Clinical NeurochemistrySection of NeurologyDepartment of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
| | - Davide Chiasserini
- Section of Physiology and BiochemistryDepartment of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
| | - Anna Lidia Wojdaƚa
- Center for Memory DisturbancesLab of Clinical NeurochemistrySection of NeurologyDepartment of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
| | | | - Lucilla Parnetti
- Center for Memory DisturbancesLab of Clinical NeurochemistrySection of NeurologyDepartment of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
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Huang F, Huang Y, Huang X, Wang S, Peng Z. Effect of hyperbaric oxygen on symptoms of dementia in patients with delayed encephalopathy after acute carbon monoxide poisoning. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2023; 48:1669-1677. [PMID: 38432857 PMCID: PMC10929946 DOI: 10.11817/j.issn.1672-7347.2023.230240] [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] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Indexed: 03/05/2024]
Abstract
OBJECTIVES Delayed encephalopathy after acute carbon monoxide poisoning (DEACMP) is the most severe complication of carbon monoxide poisoning, which seriously endangers patients' quality of life. This study aims to investigate the efficacy of hyperbaric oxygen (HBO2) on improving dementia symptoms in patients with DEACMP. METHODS A retrospective analysis was performed on DEACMP patients, who visited Xiangya Hospital, Central South University from June 2014 to June 2020. Among them, patients who received conventional drug treatment combined with HBO2 treatment were included in an HBO2 group, while those who only received conventional drug treatment were included in a control group. HBO2 was administered once daily. Patients in the HBO2 group received 6 courses of treatment, with each course consisting of 10 sessions. The Hasegawa Dementia Scale (HDS) was used to diagnose dementia, and the Clinical Dementia Rating (CDR) was used to grade the severity of dementia for DEACMP. The Alzheimer's Disease Assessment Scale-Cognitive Section (ADAS-Cog), the Functional Activities Questionnaire (FAQ), the Neuropsychiatric Inventory (NPI), and the Clinician's Interview-Based Impression of Change-Plus Caregiver Input (CIBIC-Plus) were performed to assess cognitive function, ability to perform activities of daily living (ADL), behavioral and psychological symptoms, and overall function. The study further analyzed the results of objective examinations related to patients' dementia symptoms, including magnetic resonance imaging detection of white matter lesions and abnormal electroencephalogram (EEG). The changes of the above indicators before and after treatment, as well as the differences between the 2 groups after treatment were compared. RESULTS There was no significant difference in the HDS score and CDR grading between the 2 groups before treatment (both P>0.05). After treatment, the score of ADAS-Cog, FAQ, NPI, and CIBIC Plus grading of the 2 groups were significantly improved, and the improvement of the above indicators in the HBO2 group was greater than that in the control group (all P<0.05). The effective rate of the HBO2 group in treating DEACMP was significantly higher than that of the control group (89.47% vs 65.87%, P<0.05). The objective examination results (white matter lesions and abnormal EEG) showed that the recovery of patients in the HBO2 group was better than that in the control group. CONCLUSIONS Hyperbaric oxygen can significantly relieve the symptoms of dementia in patients with DEACMP.
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Affiliation(s)
- Fangling Huang
- Department of Hyperbaric Oxygen, Xiangya Hospital, Central South University, Changsha 410008.
| | - Yanqing Huang
- Department of Hyperbaric Oxygen, Xiangya Hospital, Central South University, Changsha 410008
| | - Xu Huang
- Department of Hyperbaric Oxygen, Xiangya Hospital, Central South University, Changsha 410008
| | - Su'e Wang
- Preventive Health Center, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Zhengrong Peng
- Department of Hyperbaric Oxygen, Xiangya Hospital, Central South University, Changsha 410008.
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Pertichetti M, Corbo D, Belotti F, Saviola F, Gasparotti R, Fontanella MM, Panciani PP. Neuropsychological Evaluation and Functional Magnetic Resonance Imaging Tasks in the Preoperative Assessment of Patients with Brain Tumors: A Systematic Review. Brain Sci 2023; 13:1380. [PMID: 37891749 PMCID: PMC10605177 DOI: 10.3390/brainsci13101380] [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: 08/24/2023] [Revised: 09/19/2023] [Accepted: 09/25/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Current surgical treatment of gliomas relies on a function-preserving, maximally safe resection approach. Functional Magnetic Resonance Imaging (fMRI) is a widely employed technology for this purpose. A preoperative neuropsychological evaluation should accompany this exam. However, only a few studies have reported both neuropsychological tests and fMRI tasks for preoperative planning-the current study aimed to systematically review the scientific literature on the topic. METHODS PRISMA guidelines were followed. We included studies that reported both neuropsychological tests and fMRI. Exclusion criteria were: no brain tumors, underage patients, no preoperative assessment, resting-state fMRI only, or healthy sample population/preclinical studies. RESULTS We identified 123 papers, but only 15 articles were included. Eight articles focused on language; three evaluated cognitive performance; single papers studied sensorimotor cortex, prefrontal functions, insular cortex, and cerebellar activation. Two qualitative studies focused on visuomotor function and language. According to some authors, there was a strong correlation between performance in presurgical neuropsychological tests and fMRI. Several papers suggested that selecting well-adjusted and individualized neuropsychological tasks may enable the development of personalized and more efficient protocols. The fMRI findings may also help identify plasticity phenomena to avoid unintentional damage during neurosurgery. CONCLUSIONS Most studies have focused on language, the most commonly evaluated cognitive function. The correlation between neuropsychological and fMRI results suggests that altered functions during the neuropsychological assessment may help identify patients who could benefit from an fMRI and, possibly, functions that should be tested. Neuropsychological evaluation and fMRI have complementary roles in the preoperative assessment.
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Affiliation(s)
- Marta Pertichetti
- Neurosurgery Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia and ASST Spedali Civili Hospital, 25123 Brescia, Italy (M.M.F.); (P.P.P.)
| | - Daniele Corbo
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy; (D.C.); (F.S.); (R.G.)
| | - Francesco Belotti
- Neurosurgery Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia and ASST Spedali Civili Hospital, 25123 Brescia, Italy (M.M.F.); (P.P.P.)
| | - Francesca Saviola
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy; (D.C.); (F.S.); (R.G.)
| | - Roberto Gasparotti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy; (D.C.); (F.S.); (R.G.)
- Neuroradiology Unit, ASST Spedali Civili of Brescia, 25123 Brescia, Italy
| | - Marco Maria Fontanella
- Neurosurgery Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia and ASST Spedali Civili Hospital, 25123 Brescia, Italy (M.M.F.); (P.P.P.)
| | - Pier Paolo Panciani
- Neurosurgery Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia and ASST Spedali Civili Hospital, 25123 Brescia, Italy (M.M.F.); (P.P.P.)
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Moustaka K, Nega C, Beratis IN. Exploring the Impact of Age of Onset of Mild Cognitive Impairment on the Profile of Cognitive and Psychiatric Symptoms. Geriatrics (Basel) 2023; 8:96. [PMID: 37887969 PMCID: PMC10606206 DOI: 10.3390/geriatrics8050096] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/17/2023] [Accepted: 09/22/2023] [Indexed: 10/28/2023] Open
Abstract
The present study aims to explore the differences in the manifestation of cognitive decline and psychiatric symptoms across the different ages of MCI onset: early onset (EOMCI: <65 years old), middle onset (MOMCI: 65-75 years old), and late onset (LOMCI: >75 years old). It was hypothesized that individuals with EOMCI will preserve their cognitive functions to a greater extent as compared to individuals with LOMCI, even after adjusting the cognitive performance for age and education through the use of published Greek norms. The level of cognitive decline concerning MOMCI was evaluated for extracting more precise conclusions regarding the impact of the age of onset on the patterns of MCI symptomatology. The analyses of data were conducted in a Greek population of individuals with MCI, who were consecutive visitors of the Outpatient Memory Clinic of Nestor Alzheimer's Centre in Athens, Greece. The sample consisted of 297 participants who fulfilled the following inclusion criteria: MCI diagnosis based on Petersen's criteria, Greek mother language, and absence of a psychiatric history or chronic and incurable organic disease. The overall results support the presence of a cognitive advantage of the EOMCI group compared to the LOMCI group. In the MOMCI group, cognitive performance displayed a tendency to remain intermediate compared to the other two groups. Nonetheless, significant differences were observed when this group was compared with the LOMCI group. The current findings indicate that the age of onset should be taken under consideration in the neuropsychological assessment of individuals with MCI. The specific parameters could have implications in terms of prognosis as well as the design and implementation of tailored interventions.
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Affiliation(s)
- Kleio Moustaka
- Psychology Department, The American College of Greece, Deree, 6, Gravias Street, 153 42 Athens, Greece; (K.M.); (C.N.)
- Alzheimer’s Center, “Nestor” Greek Psychogeriatric Association, 22, Ioannou Drosopoulou Street, 112 57 Athens, Greece
| | - Chrysanthi Nega
- Psychology Department, The American College of Greece, Deree, 6, Gravias Street, 153 42 Athens, Greece; (K.M.); (C.N.)
| | - Ion N. Beratis
- Psychology Department, The American College of Greece, Deree, 6, Gravias Street, 153 42 Athens, Greece; (K.M.); (C.N.)
- Alzheimer’s Center, “Nestor” Greek Psychogeriatric Association, 22, Ioannou Drosopoulou Street, 112 57 Athens, Greece
- 1st Department of Neurology, Aiginiteio University Hospital, National and Kapodistrian University of Athens, 115 28, Athens, Greece
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D’Este G, Berra F, Carli G, Leitner C, Marelli S, Zucconi M, Casoni F, Ferini-Strambi L, Galbiati A. Cognitive Reserve in Isolated Rapid Eye-Movement Sleep Behavior Disorder. Brain Sci 2023; 13:brainsci13020176. [PMID: 36831719 PMCID: PMC9954116 DOI: 10.3390/brainsci13020176] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 12/29/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 01/24/2023] Open
Abstract
Isolated rapid-eye-movement sleep behaviour disorder (RBD) is considered the prodromal stage of α-synucleinopathies (e.g., Parkinson's disease and dementia with Lewy bodies); however, iRBD patients show a wide variety in the progression timing (5-15 years). The model of cognitive reserve (CR) might contribute to explaining this phenomenon. Our exploratory study aimed to evaluate, for the first time, the impact of CR level on cognitive performance in polysomnography-confirmed iRBD patients. Fifty-five iRBD patients (mean age ± SD: 66.38 ± 7.51; M/F 44/11) underwent clinical and neuropsychological evaluations at the time of diagnosis. The CR Index questionnaire was part of the clinical assessment. We found that iRBD patients with high levels of CR showed: (i) the lowest percentage of mild cognitive impairment (10%), and (ii) the best performance in visuo-constructive and verbal memory functions (i.e., the recall of the Rey-Osterrieth complex figure test). Our results suggest that CR might help iRBD patients better cope with the cognitive decline related to the neurodegenerative process, providing the first preliminary findings supporting CR as a possible protective factor in this condition. This might pave the way for future longitudinal studies to evaluate the role of CR as a modulating factor in the timing of iRBD conversion and cognitive deterioration development.
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Affiliation(s)
- Giada D’Este
- Department of Psychology, “Vita-Salute” San Raffaele University, 20132 Milan, Italy
- Sleep Disorders Center, Department of Clinical Neurosciences, Neurology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Francesca Berra
- Department of Psychology, “Vita-Salute” San Raffaele University, 20132 Milan, Italy
- Sleep Disorders Center, Department of Clinical Neurosciences, Neurology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Giulia Carli
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
| | - Caterina Leitner
- Department of Psychology, “Vita-Salute” San Raffaele University, 20132 Milan, Italy
- Sleep Disorders Center, Department of Clinical Neurosciences, Neurology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Sara Marelli
- Sleep Disorders Center, Department of Clinical Neurosciences, Neurology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Marco Zucconi
- Sleep Disorders Center, Department of Clinical Neurosciences, Neurology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Francesca Casoni
- Sleep Disorders Center, Department of Clinical Neurosciences, Neurology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Luigi Ferini-Strambi
- Department of Psychology, “Vita-Salute” San Raffaele University, 20132 Milan, Italy
- Sleep Disorders Center, Department of Clinical Neurosciences, Neurology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Andrea Galbiati
- Department of Psychology, “Vita-Salute” San Raffaele University, 20132 Milan, Italy
- Sleep Disorders Center, Department of Clinical Neurosciences, Neurology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
- Correspondence: ; Tel.: +39-022-643-3397
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Kronenburg A, Deckers PT, van den Berg E, van Schooneveld MM, Vonken EJ, van der Zwan A, van Berckel BNM, Yaqub M, Otte W, Klijn CJM, Braun KPJ. The profile of cognitive impairment and hemodynamic compromise in moyamoya: a single-center prospective cohort study. J Neurosurg 2023; 138:173-184. [PMID: 35523260 DOI: 10.3171/2022.3.jns212844] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 12/13/2021] [Accepted: 03/16/2022] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Patients with moyamoya vasculopathy often experience cognitive impairments. In this prospective single-center study, the authors investigated the profile of neurocognitive impairment and its relation with the severity of ischemic brain lesions and hemodynamic compromise. METHODS Patients treated in a Dutch tertiary referral center were prospectively included. All patients underwent standardized neuropsychological evaluation, MRI, digital subtraction angiography, and [15O]H2O-PET (to measure cerebrovascular reactivity [CVR]). The authors determined z-scores for 7 cognitive domains and the proportion of patients with cognitive impairment (z-score < -1.5 SD in at least one domain). The authors explored associations between patient characteristics, imaging and CVR findings, and cognitive scores per domain by using multivariable linear regression and Bayesian regression analysis. RESULTS A total of 40 patients (22 children; 75% females) were included. The median age for children was 9 years (range 1-16 years); for adults it was 39 years (range 19-53 years). Thirty patients (75%) had an infarction, and 31 patients (78%) had impaired CVR (steal phenomenon). Six of 7 cognitive domains scored below the population norm. Twenty-nine patients (73%) had cognitive impairment. Adults performed better than children in the cognitive domain visuospatial functioning (p = 0.033, Bayes factor = 4.0), and children performed better in processing speed (p = 0.041, Bayes factor = 3.5). The authors did not find an association between infarction, white matter disease, or CVR and cognitive domains. CONCLUSIONS In this Western cohort, cognitive functioning in patients with moyamoya vasculopathy was below the population norm, and 73% had cognitive impairment in at least one domain. The cognitive profile differed between adults and children. The authors could not find an association with imaging findings.
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Affiliation(s)
- Annick Kronenburg
- 1Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht
| | - Pieter T Deckers
- 1Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht
| | | | | | | | - Albert van der Zwan
- 1Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht
| | | | - Maqsood Yaqub
- 5Department of Nuclear Medicine & PET Research, Amsterdam UMC, Amsterdam
| | - Willem Otte
- 6Department of Pediatric Neurology, UMC Utrecht Brain Center, Utrecht; and
| | - Catharina J M Klijn
- 1Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht
- 7Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Center for Neuroscience, Radboud UMC, Nijmegen, The Netherlands
| | - Kees P J Braun
- 1Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht
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11
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Barham H, Büyükgök D, Aksu S, Soyata AZ, Bulut G, Eskicioğlu G, Baral Kulaksızoğlu I. Evidence for modulation of planning and working memory capacities by transcranial direct current stimulation in a sample of adults with attention deficit hyperactivity disorder. Neurosci Lett 2022; 790:136883. [PMID: 36152744 DOI: 10.1016/j.neulet.2022.136883] [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: 04/15/2022] [Revised: 09/11/2022] [Accepted: 09/19/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND OBJECTIVE Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that affects up to 2.8% of the adult population. Albeit pharmacological and behavioral therapies alleviate some core symptoms of ADHD, they do not avail cognitive dysfunction adequately. Executive dysfunction has been considered to have a principal role in ADHD and has previously been linked to activity alterations in the prefrontal cortex. Transcranial Direct Current Stimulation (tDCS) is a noninvasive brain stimulation technique that may modulate prefrontal cortex activity and induce neuroplasticity, with preliminary results in ADHD. The aim of the present study is to assess the effect of repeated tDCS on measures of executive functions in adults with ADHD. METHOD In this randomized double-blind sham-controlled study, 22 adults with ADHD were allocated into two groups and were administered five consecutive sessions of 2 mA active/sham tDCS over the dorsolateral prefrontal cortex (right anodal/left cathodal). A neuropsychological test battery was administered before the first session and immediately after the last session. RESULTS The maximum number of digits and the total number of correct trials in the Digit Span Backward test increased in the active group (p = 0.017). The total move score in the Tower of London test decreased (p = 0.033), suggesting better planning ability. However, no significant differences were observed on Stroop Test and Trail Making Test after tDCS. DISCUSSION The present study corroborates the modulating effects of tDCS on planning and working memory in a small group of adults with ADHD. Our results highlighted that cognitive functions are modulable using tDCS in adults with ADHD.
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Affiliation(s)
- Huzeyfe Barham
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey; Psychiatry Clinic, Moodist Psychiatry and Neurology Hospital, Istanbul, Turkey.
| | - Deniz Büyükgök
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Serkan Aksu
- Department of Physiology, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Turkey; Department of Physiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
| | | | - Gamze Bulut
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Gaye Eskicioğlu
- Department of Psychology, Istanbul University, Istanbul, Turkey
| | - Işın Baral Kulaksızoğlu
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
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12
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Tsiakiri A, Koutzmpi V, Megagianni S, Toumaian M, Geronikola N, Despoti A, Kanellopoulou S, Arampatzi X, Margioti E, Davila A, Zoi P, Kalligerou F, Liozidou A, Tsapanou A, Sakka P. Remote neuropsychological evaluation of older adults. Appl Neuropsychol Adult 2022:1-8. [PMID: 35595233 DOI: 10.1080/23279095.2022.2074850] [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] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The use of technological means in the process of neuropsychological assessment has been proposed as a technique with promising results in the field of detection of neurocognitive disorders for community-dwelling older adults. Especially during the pandemic period due to COVID-19, telemedicine assumed to be vital in the field of early diagnosis of cognitive disorders and highlighted the clinical utility of remote methods of neuropsychological assessmentby video-conference. This descriptive study presents the development of a remote neuropsychological assessment protocol by selecting appropriate validated tests as part of a more comprehensive evaluation for older adults dwelling in the community. We recruited participants from the Athens Alzheimer's Association center in collaboration with the Hellenic Neuropsychological Society, in Athens, Greece, regarding the period between April 2020 and October 2021. 90 individuals, tested for the first time, were categorized into three groups according to their diagnosis which included: (a) Mild Cognitive Impairment (MCI), (b) Alzheimer's disease, (c) cognitively healthy older adults. The presented protocol outlines the main considerations of a framework about remote neuropsychological assessment, which can maximize the effectiveness of interventions and continuity regarding the care of older adults. The recommendations outlined in the presented protocol highlight strengths and limitations that should be taken into account in remote control procedures. Although the protocol was created in response to pandemic restrictions, tele-neuropsychology shows promise as a way to improve access opportunity to neurodiagnostic services for rural aging and underserved populations, which lack specialized healthcare services. Further application to different populations will add validity to the presented descriptive protocol.
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Affiliation(s)
- A Tsiakiri
- Department of Neurology, Medical School, Democritus University of Thrace, Alexandroupoli, Greece
- Hellenic Neuropsychological Society, Athens, Greece
| | - V Koutzmpi
- Hellenic Neuropsychological Society, Athens, Greece
- Athens Alzheimer's Association, Athens, Greece
| | - S Megagianni
- Hellenic Neuropsychological Society, Athens, Greece
- Athens Alzheimer's Association, Athens, Greece
| | - M Toumaian
- Hellenic Neuropsychological Society, Athens, Greece
- Laboratory of Cognitive Neuroscience and Sensorimotor Control, University Mental Health, Neurosciences and Precision Medicine Research Institute "Costas Stefanis," Athens, Greece
| | - N Geronikola
- Hellenic Neuropsychological Society, Athens, Greece
- Athens Alzheimer's Association, Athens, Greece
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - A Despoti
- Hellenic Neuropsychological Society, Athens, Greece
- Clinical Ergospirometry, Exercise and Rehabilitation Laboratory, 1st Critical Care Department, Evangelismos Hospital, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece
| | | | - X Arampatzi
- Athens Alzheimer's Association, Athens, Greece
| | - E Margioti
- Athens Alzheimer's Association, Athens, Greece
| | - A Davila
- Athens Alzheimer's Association, Athens, Greece
| | - P Zoi
- Athens Alzheimer's Association, Athens, Greece
| | - F Kalligerou
- Athens Alzheimer's Association, Athens, Greece
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - A Liozidou
- Hellenic Neuropsychological Society, Athens, Greece
- Laboratory of Cognitive Neuroscience and Clinical Neuropsychology, The Scientific College of Greece. Department of Medicine, School of Health Sciences, National and Kapodistrian University of Athens
| | - A Tsapanou
- Hellenic Neuropsychological Society, Athens, Greece
- Athens Alzheimer's Association, Athens, Greece
- Cognitive Neuroscience Division, Columbia University Irving Medical Center, New York, NY, USA
| | - P Sakka
- Athens Alzheimer's Association, Athens, Greece
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13
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Velasco F, Saucedo-Alvarado PE, Vazquez-Barron D, Trejo D, Velasco AL. Deep Brain Stimulation for Refractory Temporal Lobe Epilepsy. Current Status and Future Trends. Front Neurol 2022; 13:796846. [PMID: 35280275 PMCID: PMC8904383 DOI: 10.3389/fneur.2022.796846] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 01/24/2022] [Indexed: 11/24/2022] Open
Abstract
A comparative analysis of the targets for deep brain stimulation (DBS) to treat refractory temporal lobe epilepsy and the rationale for its use is presented, with an emphasis on the latency to obtain the significant antiepileptic effect and the long-term seizure control. The analysis includes consideration of surgical techniques currently used to optimize antiseizure effects and decrease surgical risks. Seizure control is similar for programed DBS and DBS responsive to abnormal cortical or subcortical electroencephalogram (EEG) activity. There is no difference in the long-term seizure control between programmed and responsive and intermittent or continuous DBS. However, intermittent programed DBS may have a significant antiseizure effect starting in the first month when applied to a non-sclerotic tissue such as the parahippocampal cortex. DBS induces no neuropsychological deterioration.
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Affiliation(s)
| | | | | | | | - Ana Luisa Velasco
- Unit for Stereotactic and Functional Neurosurgery, Epilepsy Clinic, Mexico General Hospital “Dr. Eduardo Liceaga”, Mexico City, Mexico
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14
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Villarreal S, Linnavuo M, Sepponen R, Vuori O, Bonato M, Jokinen H, Hietanen M. Computer-Based Assessment: Dual-Task Outperforms Large-Screen Cancellation Task in Detecting Contralesional Omissions. Front Psychol 2022; 12:790438. [PMID: 35069375 PMCID: PMC8777372 DOI: 10.3389/fpsyg.2021.790438] [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: 10/06/2021] [Accepted: 12/09/2021] [Indexed: 11/18/2022] Open
Abstract
Objective: Traditionally, asymmetric spatial processing (i.e., hemispatial neglect) has been assessed with paper-and-pencil tasks, but growing evidence indicates that computer-based methods are a more sensitive assessment modality. It is not known, however, whether simply converting well-established paper-and-pencil methods into a digital format is the best option. The aim of the present study was to compare sensitivity in detecting contralesional omissions of two different computer-based methods: a "digitally converted" cancellation task was compared with a computer-based Visual and Auditory dual-tasking approach, which has already proved to be very sensitive. Methods: Participants included 40 patients with chronic unilateral stroke in either the right hemisphere (RH patients, N = 20) or the left hemisphere (LH patients, N = 20) and 20 age-matched healthy controls. The cancellation task was implemented on a very large format (173 cm × 277 cm) or in a smaller (A4) paper-and-pencil version. The computer-based dual-tasks were implemented on a 15'' monitor and required the detection of unilateral and bilateral briefly presented lateralized targets. Results: Neither version of the cancellation task was able to show spatial bias in RH patients. In contrast, in the Visual dual-task RH patients missed significantly more left-sided targets than controls in both unilateral and bilateral trials. They also missed significantly more left-sided than right-sided targets only in the bilateral trials of the Auditory dual-task. Conclusion: The dual-task setting outperforms the cancellation task approach even when the latter is implemented on a (large) screen. Attentionally demanding methods are useful for revealing mild forms of contralesional visuospatial deficits.
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Affiliation(s)
- Sanna Villarreal
- Division of Neuropsychology, HUH Neurocenter, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Matti Linnavuo
- Department of Electrical Engineering and Automation, Aalto University, Espoo, Finland
| | - Raimo Sepponen
- Department of Electrical Engineering and Automation, Aalto University, Espoo, Finland
| | - Outi Vuori
- Division of Neuropsychology, HUH Neurocenter, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Mario Bonato
- Department of General Psychology, University of Padova, Padua, Italy
| | - Hanna Jokinen
- Division of Neuropsychology, HUH Neurocenter, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Marja Hietanen
- Division of Neuropsychology, HUH Neurocenter, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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15
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Sunderaraman P, Irani F, Krishnan K, Hundal JS. A narrative review of the biopsychosocial and health characteristics of Asian Indians in the United States: Clinical and research implications for neuropsychological functioning. Clin Neuropsychol 2021:1-19. [PMID: 34818985 DOI: 10.1080/13854046.2021.1987524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 10/19/2022]
Abstract
Objective: The prevailing scientific literature aggregates Asians living in America into one omnibus category and thus can problematically result in a subpar and at times inaccurate understanding of health, social and cultural factors necessary for competent and informed medical care. Method: A literature search was conducted by cultural experts familiar with Asian Indian culture with a focus on immigrants from this community living in the US. Database using search engines was sought in the following domains: immigration patterns, prevalence for key medical and neurological conditions commonly associated with cognitive dysfunction, psychiatric/psychological needs in the community, some preliminary neuropsychological testing considerations while working with this community, and treatment considerations that could affect adherence and efficacy of outcomes. Articles were selected from 2000 to the most recent date, with emphasis on compiling information from review papers and meta-analysis from the past decade. Conclusions: Asian Indians living in the US are distinct from the larger Asian American community. Immigration trends underscore that Asian Indians have a bimodal distribution of wealth. Regarding medical conditions, a key and highly concerning finding is the higher prevalence of cardiovascular risk factors, especially in young males. The lack of non-existent cognitive data in this community is glaring and should serve as an impetus for conducting high-priority research in this community. Preliminary neuropsychological testing considerations are discussed from a practical perspective with emphasis on multilingualism and region of origin. Finally, treatment considerations include understanding attitudes and beliefs regarding traditional medicine.
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Affiliation(s)
- Preeti Sunderaraman
- Cognitive Neuroscience Division of the Taub Institute for Research on Alzheimer's Disease and the Aging Brain, G.H.Sergeivsky Center, and the Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA.,The Framingham Heart Study - Brain Aging Program, 73 Mount Wayte Avenue, Framingham, MA, USA
| | | | - Kamini Krishnan
- Lou Ruvo Center for Brain Health, Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Jasdeep S Hundal
- Department of Neurosurgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
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16
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Hande VH, Gunasekaran H, Hegde S, Shashidhar A, Arimappamagan A. Role of Clinical Neuropsychologists in Awake-Craniotomy. Neurol India 2021; 69:711-716. [PMID: 34169874 PMCID: PMC7613143 DOI: 10.4103/0028-3886.319237] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Awake craniotomy encompasses surgical resection of focal zone of neurological impairment, using intraoperative functional zone mapping. The strength of the procedure is maximum retention of functionally significant zones to ensure better function and quality of life outcomes in patients. A clinical neuropsychologist plays a vital role in profiling the patient’s cognitive and psychosocial functioning as well as increasing the efficacy of functional zone mapping procedures. Objective Aim of this article is to summarize the literature on the role of clinical neuropsychologists in awake craniotomy and underscoring the need for establishing standardized operating procedures for neuropsychologists in awake craniotomy highlighting experiential anecdotes from a tertiary care facility. Materials and Methods A review of articles that elucidate the role of clinical neuropsychologists was done and summarized to highlight the role of clinical neuropsychologists. An attempt was made to explain the implementation of this role in regular clinical practice at a tertiary care facility. Results The role of a clinical neuropsychologist is highly crucial at pre-/during and postawake craniotomy, and has a significant bearing on the overall psychological outcome of the individual. The need for a standardized protocol to unify practice and increase the efficacy of the awake-craniotomy procedure is put forth. Recommendations for future directions in research to increase the scope of neuropsychologists in awake craniotomy have also been made.
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Affiliation(s)
- Vasudha H Hande
- Clinical Neuropsychology and Cognitive Neuro Science Center, Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Harini Gunasekaran
- Clinical Neuropsychology and Cognitive Neuro Science Center, Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Shantala Hegde
- Clinical Neuropsychology and Cognitive Neuro Science Center, Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Abhinith Shashidhar
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Arivazhagan Arimappamagan
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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17
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Rossi M, Gay L, Conti Nibali M, Sciortino T, Ambrogi F, Leonetti A, Puglisi G, Howells H, Zito P, Villa F, Ciroi G, Riva M, Bello L. Challenging Giant Insular Gliomas With Brain Mapping: Evaluation of Neurosurgical, Neurological, Neuropsychological, and Quality of Life Results in a Large Mono-Institutional Series. Front Oncol 2021; 11:629166. [PMID: 33828981 PMCID: PMC8019925 DOI: 10.3389/fonc.2021.629166] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 03/01/2021] [Indexed: 01/23/2023] Open
Abstract
Objective Giant insular tumors are commonly not amenable to complete resection and are associated with a high postoperative morbidity rate. Transcortical approach and brain mapping techniques allow to identify peri-insular functional networks and, with neurophysiological monitoring, to reduce vascular-associated insults. Cognitive functions to be mapped are still under debate, and the analysis of the functional risk of surgery is currently limited to neurological examination. This work aimed to investigate the neurosurgical outcome (extent of resection, EOR) and functional impact of giant insular gliomas resection, focusing on neuropsychological and Quality of Life (QoL) outcomes. Methods In our retrospective analysis, we included all patients admitted in a five-year period with a radiological diagnosis of giant insular glioma. A transcortical approach was adopted in all cases. Resections were pursued up to functional boundaries defined intraoperatively by brain mapping techniques. We examined clinical, radiological, and intra-operative factors possibly affecting EOR and postoperative neurological, neuropsychological, and Quality of Life (QoL) outcomes. Results We finally enrolled 95 patients in the analysis. Mean EOR was 92.3%. A Gross Total Resection (GTR) was obtained in 70 cases (73.7%). Five patients reported permanent morbidity (aphasia in 3, 3.2%, and superior quadrantanopia in 2, 2.1%). Suboptimal EOR associated with poor seizures control postoperatively. Extensive intraoperative mapping (inclusive of cognitive, visual, and haptic functions) decreased long-term neurological, neuropsychological, and QoL morbidity and increased EOR. Tumor infiltration of deep perforators (vessels arising either medial to lenticulostriate arteries through the anterior perforated substance or from the anterior choroidal artery) associated with a higher chance of postoperative ischemia in consonant areas, with the persistence of new-onset motor deficits 1-month post-op, and with minor EOR. Ischemic insults in eloquent sites represented the leading factor for long-term neurological and neuropsychological morbidity. Conclusion In giant insular gliomas, the use of a transcortical approach with extensive brain mapping under awake anesthesia ensures broad insular exposure and extension of the surgical resection preserving patients’ functional integrity. The relation between tumor mass and deep perforators predicts perioperative ischemic insults, the most relevant risk factor for long-term and permanent postoperative morbidity.
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Affiliation(s)
- Marco Rossi
- Neurosurgical Oncological Unit, Department of Oncology and Hemato-Oncology, Università Degli Studi di Milano, Milano, Italy
| | - Lorenzo Gay
- Neurosurgical Oncological Unit, Department of Oncology and Hemato-Oncology, Università Degli Studi di Milano, Milano, Italy
| | - Marco Conti Nibali
- Neurosurgical Oncological Unit, Department of Oncology and Hemato-Oncology, Università Degli Studi di Milano, Milano, Italy
| | - Tommaso Sciortino
- Neurosurgical Oncological Unit, Department of Oncology and Hemato-Oncology, Università Degli Studi di Milano, Milano, Italy
| | - Federico Ambrogi
- Laboratory of Medical Statistics, Biometry, and Epidemiology "G.A. Maccararo," Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy
| | - Antonella Leonetti
- Neurosurgical Oncological Unit, Department of Oncology and Hemato-Oncology, Università Degli Studi di Milano, Milano, Italy.,Laboratory of Motor Control, Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Laboratorio Interdisciplinare di Tecnologie Avanzate (LITA), Milano, Italy
| | - Guglielmo Puglisi
- Neurosurgical Oncological Unit, Department of Oncology and Hemato-Oncology, Università Degli Studi di Milano, Milano, Italy.,Laboratory of Motor Control, Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Laboratorio Interdisciplinare di Tecnologie Avanzate (LITA), Milano, Italy
| | - Henrietta Howells
- Laboratory of Motor Control, Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Laboratorio Interdisciplinare di Tecnologie Avanzate (LITA), Milano, Italy
| | - Paola Zito
- Department of Anesthesia and Intensive Care, Humanitas Research Hospital, IRCCS, Milano, Italy
| | - Federico Villa
- Department of Anesthesia and Intensive Care, Humanitas Research Hospital, IRCCS, Milano, Italy
| | - Gjulio Ciroi
- Neurosurgical Oncological Unit, Department of Oncology and Hemato-Oncology, Università Degli Studi di Milano, Milano, Italy
| | - Marco Riva
- Neurosurgical Oncological Unit, Department of Oncology and Hemato-Oncology, Università Degli Studi di Milano, Milano, Italy
| | - Lorenzo Bello
- Neurosurgical Oncological Unit, Department of Oncology and Hemato-Oncology, Università Degli Studi di Milano, Milano, Italy
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18
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Kavé G, Sapir-Yogev S, Bregman N, Shiner T. On the importance of using local tests and local norms in the assessment of memory. Appl Neuropsychol Adult 2021; 29:1492-1498. [PMID: 33691536 DOI: 10.1080/23279095.2021.1892677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The current study compared the assessment of memory with a translated story recall test and its original published norms and an equivalent local test with local norms. Analyses used data from 232 individuals with memory complaints who underwent neuropsychological evaluation at an outpatient memory clinic. One group of participants completed a translated test (N = 126) and another group completed a local test (N = 106). Additionally, participants completed tasks of word list recall, picture naming, and verbal fluency, all having local norms. The results showed that raw scores on the delayed story recall test, and on all other cognitive tasks, did not differ across groups, and the cross-task correlations were significant and similar in size in both groups. Yet, there was an interaction between group and standardized tests scores, whereby the standardized scores on the translated story recall test were equivalent to population mean, whereas all other scores fell below the mean. Conversion of raw scores to the original norms indicated that the performance of individuals with memory complaints was intact, while conversion of scores on a local test to local norms revealed the expected memory impairment. The findings highlight the importance of using local tests and local norms in the assessment of memory.
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Affiliation(s)
- Gitit Kavé
- Department of Education and Psychology, The Open University, Ra'anana, Israel.,Cognitive Neurology Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | | | - Noa Bregman
- Cognitive Neurology Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tamara Shiner
- Cognitive Neurology Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.,Movement Disorders Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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19
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Kiselica AM, Johnson E, Benge JF. How impaired is too impaired? Exploring futile neuropsychological test patterns as a function of dementia severity and cognitive screening scores. J Neuropsychol 2021; 15:410-427. [PMID: 33655681 DOI: 10.1111/jnp.12243] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 11/20/2020] [Revised: 02/04/2021] [Accepted: 02/17/2021] [Indexed: 11/28/2022]
Abstract
Some older adults cannot meaningfully participate in the testing portion of a neuropsychological evaluation due to significant cognitive impairments. There are limited empirical data on this topic. Thus, the current study sought to provide an operational definition for a futile testing profile and examine cognitive severity status and cognitive screening scores as predictors of testing futility at both baseline and first follow-up evaluations. We analysed data from 9,263 older adults from the National Alzheimer's Coordinating Center Uniform Data Set. Futile testing profiles occurred rarely at baseline (7.40%). There was a strong relationship between cognitive severity status and the prevalence of futile testing profiles, χ2 (4) = 3559.77, p < .001. Over 90% of individuals with severe dementia were unable to participate meaningfully in testing. Severity range on the Montreal Cognitive Assessment (MoCA) also demonstrated a strong relationship with testing futility, χ2 (3) = 3962.35, p < .001. The rate of futile testing profiles was similar at follow-up (7.90%). There was a strong association between baseline dementia severity and likelihood of demonstrating a futile testing profile at follow-up, χ2 (4) = 1513.40, p < .001. Over 90% of individuals with severe dementia, who were initially able to participate meaningfully testing, no longer could at follow-up. Similarly, there was a strong relationship between baseline MoCA score band and likelihood of demonstrating a futile testing profile at follow-up, χ2 (3) = 1627.37, p < .001. Results can help to guide decisions about optimizing use of limited neuropsychological assessment resources.
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Affiliation(s)
- Andrew M Kiselica
- Department of Health Psychology, University of Missouri, Columbia, Missouri, USA
| | - Ellen Johnson
- Department of Health Psychology, University of Missouri, Columbia, Missouri, USA.,Department of Psychology, Ohio University, Athens, Ohio, USA
| | - Jared F Benge
- Department of Neurology, University of Texas at Austin, Texas, USA
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20
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Rodrigues TMB, Silva MMDC, Freitas MM, Duarte ZMC, Frutuoso VS, Rodrigues MT, Rubio IGS. Case Report: Functional Analysis and Neuropsychological Evaluation of Dyshormonogenetic Fetal Goiter in Siblings Caused by Novel Compound Hyterozygous TPO Gene Mutations. Front Endocrinol (Lausanne) 2021; 12:671659. [PMID: 34220711 PMCID: PMC8251258 DOI: 10.3389/fendo.2021.671659] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/21/2021] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION It is rare for a euthyroid mother to carry a child with a fetal goiter. However, cases of congenital hypothyroidism (CH) caused by thyroid dyshormonogenesis have been reported. Even though gene mutations associated with fetal goiter have been reported in a few studies, the effects on intellectual development have not been investigated. This study aimed to characterize and investigate the underlying genetic mechanism of CH and neuropsychological development and growth of two siblings with CH-induced fetal goiters. CASE REPORT Two male siblings from a non-consanguineous marriage with CH and fetal goiter were diagnosed by ultrasonography at 32- and 26-weeks of gestation. This condition was confirmed by cordocentesis in the first pregnancy (TSH: 135 μIU/ml). The mother was euthyroid, and no intra-amniotic levothyroxine treatment was performed. Peripheral blood DNA was screened for TPO mutations. The new deletion p.Cys296Alafs*21 and the p.Arg665Trp mutation, inherited from heterozygous parents, were identified in both patients. Functional analysis showed both mutations reduced the TPO enzyme activity and impaired the membrane localization. The p.Cys296Alafs*21 mutation produces a protein product with a drastically reduced molecular weight. Additionally, a complete clinical and neuropsychological evaluation was also performed. The WISC IV test was employed to provide an overall measure of the siblings' cognitive and intellectual abilities. No growth retardation was detected in either child. In general, both children showed normal neuropsychological development; however, they exhibited slight reduction of Processing Speed Index scores, which are sensitive to neurological and attentional factors and motor maturation activity. Notably, the younger sibling obtained significantly low scores in the Operational Memory Index, a measure of attention capacity and psychoneurological immaturity. CONCLUSION We described a new TPO compound heterozygosity that severely impaired the TPO activity and membrane localization leading to severe CH and fetal goiter. This is the first report showing the neuropsychological evaluation in patients with dyshormonogenetic fetal goiter. More studies are needed to understand the neurodevelopmental outcomes of neonates with CH-induced fetal goiters.
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Affiliation(s)
| | - Marlon Messias da Conceição Silva
- Thyroid Molecular Science Laboratory, Department of Biological Sciences, Federal University of São Paulo, Federal University of São Paulo (UNIFESP), Diadema, Brazil
- Structural and Functional Biology Program, Federal University of São Paulo, UNIFESP, São Paulo, Brazil
| | - Magali Maciel Freitas
- Thyroid Molecular Science Laboratory, Department of Biological Sciences, Federal University of São Paulo, Federal University of São Paulo (UNIFESP), Diadema, Brazil
| | - Zélia Maria Costa Duarte
- Thyroid Molecular Science Laboratory, Department of Biological Sciences, Federal University of São Paulo, Federal University of São Paulo (UNIFESP), Diadema, Brazil
| | - Vitória Sousa Frutuoso
- Thyroid Molecular Science Laboratory, Department of Biological Sciences, Federal University of São Paulo, Federal University of São Paulo (UNIFESP), Diadema, Brazil
| | - Mariana Teixeira Rodrigues
- Thyroid Molecular Science Laboratory, Department of Biological Sciences, Federal University of São Paulo, Federal University of São Paulo (UNIFESP), Diadema, Brazil
- Structural and Functional Biology Program, Federal University of São Paulo, UNIFESP, São Paulo, Brazil
| | - Ileana Gabriela Sanchez Rubio
- Thyroid Molecular Science Laboratory, Department of Biological Sciences, Federal University of São Paulo, Federal University of São Paulo (UNIFESP), Diadema, Brazil
- Structural and Functional Biology Program, Federal University of São Paulo, UNIFESP, São Paulo, Brazil
- *Correspondence: Ileana Gabriela Sanchez Rubio,
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21
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Vonk JMJ, Arce Rentería M, Medina VM, Pericak-Vance MA, Byrd GS, Haines J, Brickman AM, Manly JJ. Education Moderates the Relation Between APOE ɛ4 and Memory in Nondemented Non-Hispanic Black Older Adults. J Alzheimers Dis 2020; 72:495-506. [PMID: 31594222 DOI: 10.3233/jad-190415] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 01/06/2023]
Abstract
BACKGROUND The APOEɛ4 allele is a well-known risk factor for Alzheimer's disease (AD). Previous research argues that higher education helps to preserve cognition in older adults with AD pathology because of its key role in cognitive reserve and resilience. OBJECTIVE To test if higher educational level buffers the effect of APOEɛ4 on cognition among older non-Hispanic Blacks. METHODS Participants were 849 non-demented older non-Hispanic Blacks (38.3% APOEɛ4+), who underwent a comprehensive neuropsychological evaluation. Multiple linear regression models tested the relationship between APOEɛ4 status and twelve cognitive measures with education (up to high school and beyond high school) as a moderator. RESULTS Education buffered the effects of the APOEɛ4 allele, such that there was no impact of APOEɛ4 status on word-list memory retention and working memory among participants with more than a high school degree. This pattern was not observed for ten other cognitive measures of verbal and visual episodic memory, semantic memory, executive function, and processing speed-although a similar trend was observed for switching ability in executive functioning. The buffering effect of education was stronger among women than men. CONCLUSION Our findings suggest that genetic effects on late-life cognition may be modified by environmental factors such as educational attainment. These results are consistent with the framework of cognitive reserve such that engaging in cognitively enriching activities and acquiring skills and knowledge with more years of education may increase the capacity to maintain cognitive function despite high genetic risk for impairment.
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Affiliation(s)
- Jet M J Vonk
- Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Miguel Arce Rentería
- Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Valerie M Medina
- Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Margaret A Pericak-Vance
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Goldie S Byrd
- North Carolina Agricultural and Technical State University, Dean, College of Arts and Sciences, Greensboro, NC, USA
| | - Jonathan Haines
- Center for Human Genetics Research, Vanderbilt University, Nashville, TN, USA
| | - Adam M Brickman
- Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Jennifer J Manly
- Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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22
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Manera U, Peotta L, Iazzolino B, Canosa A, Vasta R, Palumbo F, Torrieri MC, Solero L, Daviddi M, Grassano M, Moglia C, Pagani M, Chiò A, Cavallo M. The Characteristics of Cognitive Impairment in ALS Patients Depend on the Lateralization of Motor Damage. Brain Sci 2020; 10:E650. [PMID: 32961718 DOI: 10.3390/brainsci10090650] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 07/15/2020] [Revised: 09/15/2020] [Accepted: 09/17/2020] [Indexed: 01/30/2023] Open
Abstract
(1) Background: Cognitive features of patients with amyotrophic lateral sclerosis (ALS) have never been specifically analyzed according to the lateralization of motor impairment. In the present study we investigated the cognitive performances of ALS patients to describe the relationship between motor and cognitive dysfunction, according to site and side of disease onset. (2) Methods: Six-hundred and nine ALS patients underwent a comprehensive neuropsychological evaluation at diagnosis in Turin ALS Centre Tests included—mini-mental state examination (MMSE), frontal assessment battery (FAB), trail-making test A/B (TMT A-B), digit span forward and backward (digit span FW/digit span BW), letter fluency test (FAS), category fluency test (CAT), Rey auditory verbal learning test (RAVLT), Babcock story recall test (BSRT), Rey-Osterrieth complex figure test (ROCFT), Wisconsin card sorting test (WCST), Raven’s coloured progressive matrices (CPM47). Cognitive performances of patients, grouped by side and site of onset, were statistically compared using z-scores, as appropriate. (3) Results: Bulbar patients and bilateral spinal onset patients (Sbil) were generally characterized by lower cognitive performances in most neuropsychological tests, when compared to patients with lateralized onset (right-side spinal onset, Sri and left-side spinal onset, Sle). Digit span backward and visual memory task (ROCFT) median z-scores were significantly higher, reflecting a better cognitive performance, in Sri patients when compared to bulbar/Sbil patients, while verbal memory tasks (RAVLT and BRST) resulted in significantly higher scores in Sle patients. Our results are in keeping with hemispheric functional lateralization of language and visuospatial abilities. (4) Conclusions: In ALS patients, as in other neurodegenerative diseases, we found a direct relationship between lateralized motor and cognitive features.
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Abstract
Cognistat is a cognitive screening test that is widely used in English-speaking countries. Its French adaptation is now available. The present study aims to establish norms for a population aged 60 and over. One hundred and fifty-one participants aged between 60 and 84 years old with normal cognitive function were divided into 5 five-year age groups. The results on Cognistat are reported for each subtest and age group. Age has a significant effect in only two subtests (Attention and Language Comprehension), which suggests a reduced performance for older participants. However, these effects are very weak and irregular. For this reason and given data distribution, norms are proposed to define performance thresholds for the 15th (lower limit of the normal range), 10th (mild cognitive impairment) and 5th (clinically significant) percentiles for each subtest for the clinical use of Cognistat with individuals 60 years of age and older.
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24
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Clesse C, Salime S, Dumand I, Concetta-Ciciarelli SB, Lavenir S, Kacemi K, Heckel-Chalet P, Sissung F, Poinsignon A, Simon A, Decker M, Batt M. The French Integrative Psychosocial Rehabilitation Assessment for Complex Situations (FIPRACS): Modelization of an Adapted Assessment Method Toward Long-Term Psychiatric Inpatients With Disabling, Severe and Persistent Mental Illness. Front Psychiatry 2020; 11:540680. [PMID: 33192655 PMCID: PMC7531021 DOI: 10.3389/fpsyt.2020.540680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 08/18/2020] [Indexed: 12/16/2022] Open
Abstract
For the past forty years, the generalization of community-based approaches has prompted psychiatry into promoting a deinstitutionalization movement and a psychosocial rehabilitation approach (PSR) for individuals with schizophrenia and related difficulties. Unfortunately, this approach generally does not involve the most severe cognitive and psycho-affective clinical situations among this population despite an increasing number of publications advocating that all individuals should be included in PSR and deinstitutionalization programs. In this context, considering the absence of an assessment battery designed for French individuals with particularly disabling, severe, and persistent mental illness (IDSPMI), we constructed an integrative assessment model adapted to this specific population. To select the most suitable tools for this population, a literature review (inspired by the PRISMA protocol) and a systematic review were combined with a clinical assessment study. The literature review first identified the cognitive and psycho-affective functions which mainly influence the day-to-day life adaptation of individuals engaged in a PSR/deinstitutionalization program. The systematic review then gathered all of the useable French validated tools to assess the initially selected dimensions (n = 87). To finish, for each dimension, the selected 87 tools were included in a clinical assessment study performed within a French psychiatric hospital. The authors collected and verified the characteristics of each tool (validity, French norms, French version, the average speed of the test, ease of use, ability to assess other dimensions). Their suitability was also assessed when applied to IDSPMI. Based on this final clinical evaluation, the authors selected one tool per function to create the French Integrative Psychosocial Rehabilitation Assessment for Complex Situations (FIPRACS). This battery is an assessment tailored to the neurocognitive and psycho-affective potentials of IDSPMI. While further validation studies of this battery are ultimately required, the practical/clinical implications of this battery are presented and discussed.
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Affiliation(s)
- Christophe Clesse
- Center for Psychiatry, Wolfson Institute of Preventive Medicine, Barth & The London School of Medicine & Dentistry, Queen Mary University of London, London, United Kingdom.,Centre Hospitalier de Jury-les-Metz, Metz, France.,Laboratoire INTERPSY (EA 4432), Université de Lorraine, Nancy, France.,IREPS Grand-Est, Laxou, France
| | - S Salime
- Laboratoire INTERPSY (EA 4432), Université de Lorraine, Nancy, France.,Association Espoir 54, Nancy, France
| | - I Dumand
- Centre Hospitalier de Jury-les-Metz, Metz, France
| | | | - S Lavenir
- Centre Hospitalier de Jury-les-Metz, Metz, France
| | - K Kacemi
- Centre Hospitalier de Jury-les-Metz, Metz, France
| | | | - Frank Sissung
- Association d'Information et d'Entraide Mosellane, Metz, France
| | - Aurore Poinsignon
- Association d'Information et d'Entraide Mosellane, Metz, France.,Association Famille Rurale de Moselle, Solgne, France
| | - Anthony Simon
- Laboratoire INTERPSY (EA 4432), Université de Lorraine, Nancy, France
| | - M Decker
- Centre Hospitalier de Jury-les-Metz, Metz, France
| | - M Batt
- Laboratoire INTERPSY (EA 4432), Université de Lorraine, Nancy, France
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25
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Zarino B, Verrua E, Ferrante E, Sala E, Carosi G, Giavoli C, Serban AL, Del Sindaco G, Sirtori MA, Bertani GA, Rampini P, Carrabba GG, Arosio M, Spada A, Locatelli M, Mantovani G. Cushing's disease: a prospective case-control study of health-related quality of life and cognitive status before and after surgery. J Neurosurg 2019; 133:1721-1731. [PMID: 31731265 DOI: 10.3171/2019.8.jns19930] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 08/22/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Some studies have highlighted psychological and neuropsychological difficulties and a potential reduction in health-related quality of life (HRQOL) in patients with pituitary tumors, despite hormone deficits or excess. To the authors' knowledge, this study is the first prospective longitudinal case-control study with the aim of simultaneously testing whether HRQOL and psychiatric and neuropsychological disabilities are related to neural dysfunction due to hypercortisolism per se, or tumor mass and/or surgery in patients with Cushing's disease (CD). The authors evaluated a homogeneous cohort of patients with CD and nonfunctioning pituitary adenomas (NFPAs) before and after neurosurgery and compared these patients with healthy controls. METHODS Twenty patients (10 with NFPA and 10 with CD) were evaluated using 3 validated questionnaires (SF-36, Beck Depression Inventory-II [BDI-II], and Minnesota Multiphasic Personality Inventory-II [MMPI-II]) to assess HRQOL and psychological status preoperatively and 12 months after neurosurgery. Neuropsychological tests were assessed preoperatively, 3-7 days postoperatively, and 12 months postoperatively. Twenty healthy matched controls were recruited. RESULTS Preoperatively, the NFPA and CD subgroups had worse HRQOL scores than controls on the basis of SF-36 scores, although the NFPA subgroup experienced significant recovery 12 months postoperatively. Preoperatively, CD patients had depressive symptoms according to the BDI-II and MMPI-II that persisted 12 months postoperatively, together with social introversion and hypochondriasis; NFPA patients were similar to controls except for hypochondriasis scores that were clinically significant at all timepoints. Preoperatively and 3-7 days postoperatively, both subgroups showed significant neuropsychological disabilities compared with controls, but only the CD subgroup did not completely recover over time. CONCLUSIONS HRQOL and neuropsychological impairments were observed in all patients at early timepoints, independent of hypercortisolism, tumor mass, and successful surgery. Over time, CD patients showed persistent changes in HRQOL, in particular in social activities. In this light, CD seems to have a strong impact on HRQOL and to be associated with more psychological and neuropsychological comorbidities than NFPA.
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Affiliation(s)
| | - Elisa Verrua
- 2Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan
| | - Emanuele Ferrante
- 2Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan
| | - Elisa Sala
- 2Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan
| | - Giulia Carosi
- 2Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan
- Departments of3Clinical Sciences and Community Health, and
| | - Claudia Giavoli
- 2Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan
- Departments of3Clinical Sciences and Community Health, and
| | - Andreea L Serban
- 2Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan
- 6Department of Experimental Medicine, Sapienza University of Rome, Italy
| | - Giulia Del Sindaco
- 2Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan
- Departments of3Clinical Sciences and Community Health, and
| | - Martina A Sirtori
- 1Neurosurgery Unit and
- 5Department of Psychology, University of Milano-Bicocca, Milan; and
| | | | | | | | - Maura Arosio
- 2Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan
- Departments of3Clinical Sciences and Community Health, and
| | - Anna Spada
- Departments of3Clinical Sciences and Community Health, and
| | - Marco Locatelli
- 1Neurosurgery Unit and
- 4Pathophysiology and Transplantation, University of Milan
| | - Giovanna Mantovani
- 2Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan
- Departments of3Clinical Sciences and Community Health, and
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26
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Formica C, Corallo F, Morabito R, Allone C, De Salvo S, Micchia K, Corallo F, Todaro A, Marino S. A multidisciplinary approach to assess recovery of consciousness in a patient with moyamoya disease. Brain Behav 2019; 9:e01241. [PMID: 30953395 PMCID: PMC6520290 DOI: 10.1002/brb3.1241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 12/14/2018] [Accepted: 12/24/2018] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Moyamoya disease (MMD) meaning "hazy puff of smoke" in Japanese is a rare chronic cerebrovascular syndrome characterized by progressive stenosis and occlusion of the internal carotid arteries (ICAs) anterior cerebral arteries (ACAs), and middle cerebral arteries (MCAs). METHODS Our moyamoya patient with severely impaired cognitive and motor functions underwent a specific motor and neuropsychological rehabilitative treatments to assess the recovery of consciousness. RESULTS Results obtained showed an improvement of clinical and neuropsychological examination. These findings highlighted the importance of an intensive rehabilitation techniques used in the care of disorders of consciousness patients. CONCLUSIONS The use of sensory methods provides advantages for the rehabilitation. In fact, in this study, we showed a correlation between sensory stimulation and changes in patient's clinical status.
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Affiliation(s)
- Caterina Formica
- Neuroimaging Laboratory, IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy.,Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Francesco Corallo
- Neuroimaging Laboratory, IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
| | - Rosa Morabito
- Neuroimaging Laboratory, IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
| | - Cettina Allone
- Neuroimaging Laboratory, IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
| | - Simona De Salvo
- Neuroimaging Laboratory, IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
| | - Katia Micchia
- Neuroimaging Laboratory, IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
| | - Federica Corallo
- Neuroimaging Laboratory, IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
| | - Antonino Todaro
- Neuroimaging Laboratory, IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
| | - Silvia Marino
- Neuroimaging Laboratory, IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy.,Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy
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Gupta SS, Maheshwari SM, Shah UR, Bharath RD, Dawra NS, Mahajan MS, Desai A, Prajapati A, Ghodke M. Imaging & neuropsychological changes in brain with spiritual practice: A pilot study. Indian J Med Res 2019; 148:190-199. [PMID: 30381542 PMCID: PMC6206776 DOI: 10.4103/ijmr.ijmr_194_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 11/08/2022] Open
Abstract
Background & objectives: Some studies have systematically assessed the effects of spiritual practice (SP) on the brain using combined neuropsychological testing and functional imaging. The objective of the present study was to compare imaging and neuropsychological changes in healthy individuals after SP and those with only physical exercise. Methods: Healthy adult male volunteers, aged 25-45 yr were randomized into two groups. Group 1 (SP group) underwent the SP and group 2 (controls) did brisk walk for 30 min daily. Detailed neuropsychological evaluation, resting-state functional magnetic resonance imaging (fMRI) and brain 99mTc ethyl cysteinate dimer single-photon emission computed tomography (SPECT) were carried out for both groups before and three months after intervention. Results: Post-intervention, resting state fMRI showed increased connections of left precuneus (in the posterior cingulate cortex area of default mode network) in group 1 and increased left frontal connections in group 2. The neuropsychological tests showed significant improvement in ‘Speed of Processing’ (Digit Symbol Test) in group 1 and in Focused Attention (Trail Making A) in group 2. The SPECT data in group 1 showed significant improvement in perfusion of the frontal areas, with relatively lesser improvement in parietal areas. Group 2 showed significant improvement in perfusion predominantly in parietal areas, as compared to frontal areas. In addition, significantly improved mood was reported by group 1 and not by group 2. Interpretation & conclusions: This pilot study shows important functional imaging and neuropsychological changes in the brain with SP.
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Affiliation(s)
- Santosh S Gupta
- Department of MRI, P.D. Hinduja Hospital & Medical Research Centre, Mumbai, India
| | | | | | - Rose Dawn Bharath
- Department of Neuroimaging & Interventional Radiology, National Institute of Mental Health & Neurosciences, Bengaluru, India
| | - Natasha Singh Dawra
- Department of Nuclear Medicine, P.D. Hinduja Hospital & Medical Research Centre, Mumbai, India
| | - Madhuri Shimpi Mahajan
- Department of Nuclear Medicine and PET-CT, Bombay Hospital and Medical Research Centre, Mumbai, India
| | - Aishani Desai
- Department of Neurology, Kokilaben Dhirubhai Ambani Hospital, Mumbai, India
| | - Arvind Prajapati
- Department of Neuroimaging & Interventional Radiology, National Institute of Mental Health & Neurosciences, Bengaluru, India
| | - Mangesh Ghodke
- Shanti Kshetra Premgiri Ashram, Global HQ, Raigad, India
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Janecek JK, Dorociak KE, Piper LE, Kelleher T, Pliskin NH, Gowhari M, Molokie RE. Integration of neuropsychology services in a sickle cell clinic and subsequent healthcare use for pain crises. Clin Neuropsychol 2018; 33:1195-1211. [PMID: 30472925 DOI: 10.1080/13854046.2018.1535664] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 01/27/2023]
Abstract
Objective: Growing literature has documented the clinical utility of neuropsychological evaluations for predicting functional outcomes, including reduced healthcare service utilization, in a variety of clinical samples. The present study investigates the relationship between the integration of clinical neuropsychology services into an existing outpatient sickle cell clinic and frequency of emergency department (ED) visits and hospitalizations for pain crises. Method: Participants included 144 adults diagnosed with sickle cell disease (SCD) who either underwent neuropsychological evaluation (NP+), including interview, neuropsychological testing, and feedback, or treatment as usual (NP-). Medical records were reviewed for a two-year period, one year prior to study enrollment (pre-assessment) and one year post-study enrollment (post-assessment), to track the number of ED visits and hospitalizations related to sickle cell pain crises. Results: When examining pain crises ED visits prior to and following neuropsychological evaluation, there was a significant decrease in ED visits for the NP + group, but no change for the NP - group. No significant changes in pain crises hospitalizations were observed for the NP + and NP - groups. For the NP + group, the decreased incidence of pain crises ED visits and hospitalizations was associated with an estimated total cost savings of $994,821. Discussion: Results highlight that integration of neuropsychology services into an existing outpatient sickle cell clinic may reduce healthcare costs, particularly use of pain crises ED services, for adults with SCD.
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Affiliation(s)
- Julie K Janecek
- Neuroscience Department, Waukesha Memorial Hospital , Waukesha , WI , USA
| | - Katherine E Dorociak
- Department of Psychiatry, University of Illinois at Chicago , Chicago , IL , USA
| | - Lauren E Piper
- Department of Neurology, University of Iowa , Iowa City , IA , USA
| | - Thomas Kelleher
- Chicago College of Osteopathic Medicine, Midwestern University , Downers Grove , IL , USA
| | - Neil H Pliskin
- Department of Psychiatry, University of Illinois at Chicago , Chicago , IL , USA
| | - Michel Gowhari
- Department of Medicine, University of Illinois at Chicago , Chicago , IL , USA
| | - Robert E Molokie
- Department of Medicine, University of Illinois at Chicago , Chicago , IL , USA.,Jesse Brown VA Medical Center , Chicago , IL , USA
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29
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Rubiño J, Andrés P. The Face-Name Associative Memory Test as a Tool for Early Diagnosis of Alzheimer's Disease. Front Psychol 2018; 9:1464. [PMID: 30154753 PMCID: PMC6102474 DOI: 10.3389/fpsyg.2018.01464] [Citation(s) in RCA: 13] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 07/25/2018] [Indexed: 01/21/2023] Open
Abstract
One current challenge for neuropsychologists is to design assessment methods capable of detecting cognitive deficits in the early or preclinical phases of Alzheimer's disease (AD). The objective of this paper is to review the studies that have explored the use of the Face-Name Associative Memory Exam (FNAME) as a test for early diagnosis of AD. Studies looking at correlations between performance on the FNAME test and biomarkers in healthy people and studies comparing healthy controls and people with mild cognitive impairment are reviewed. These studies are based on the evidence that AD's pathological process begins years before the most visible clinical manifestations. We conclude that the FNAME test may be a valuable tool for early diagnosis but that some important questions remain to be resolved in future research.
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Affiliation(s)
- José Rubiño
- Department of Psychology and Research Institute of Health Sciences (IUNICS), University of the Balearic Islands - Balearic Islands Health Research Institute (IdISBA), Palma de Mallorca, Spain
| | - Pilar Andrés
- Department of Psychology and Research Institute of Health Sciences (IUNICS), University of the Balearic Islands - Balearic Islands Health Research Institute (IdISBA), Palma de Mallorca, Spain
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Järvenpää S, Rosti-Otajärvi E, Rainesalo S, Laukkanen L, Lehtimäki K, Peltola J. Executive Functions May Predict Outcome in Deep Brain Stimulation of Anterior Nucleus of Thalamus for Treatment of Refractory Epilepsy. Front Neurol 2018; 9:324. [PMID: 29867733 PMCID: PMC5952045 DOI: 10.3389/fneur.2018.00324] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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: 10/04/2017] [Accepted: 04/24/2018] [Indexed: 12/04/2022] Open
Abstract
Background Deep brain stimulation (DBS) of the anterior nucleus of thalamus (ANT) is an emerging treatment option for patients suffering from refractory epilepsy. ANT has extensive connections with hippocampus and retrosplenial cingulum, areas associated mainly with spatial memory and with anterior cingulum which is important in executive functions. As refractory epilepsy is often associated with cognitive decline and neuronal damage, the decreased connectivity between ANT and remote structures might impact on the effects of DBS. Objective We hypothesized that the neuropsychological profile could reflect the connectivity of ANT and further predict the efficacy of ANT DBS. We evaluated the cognitive performance of patients with refractory epilepsy with DBS to evaluate whether neuropsychological profiles could reflect the connectivity of ANT and further predict the efficacy of ANT DBS. Method Sixteen patients with refractory epilepsy treated with ANT DBS with at least 2 years of follow-up were included in the study. Patients underwent a neuropsychological evaluation as a part of the protocol and their clinical outcome was determined by seizure frequency in the last 6 months compared to baseline. The patients were classified as responders if there was a ≥50% reduction in the frequency of the predominant seizure type, otherwise as nonresponders. Results There were 12 responders and 4 nonresponders for ANT DBS treatment in the study population. Nonresponders performed worse than responders in neuropsychological tasks measuring executive functions and attention, such as the Trail-Making Test. Conclusion Better executive functions and attention seemed to predict improved clinical outcome after the ANT DBS surgery. Based on our preliminary descriptive findings and the anatomical connectivity hypothesis, we suggest that deficits in executive functions may relate to an inferior outcome. This finding might offer new tools for refining the selection of patients with refractory epilepsy scheduled to undergo ANT DBS surgery. Moreover, it highlights the need for further investigations of neural connectivity in epilepsy.
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Affiliation(s)
- Soila Järvenpää
- Department of Neurosciences and Rehabilitation, Tampere University Hospital, Tampere, Finland
| | - Eija Rosti-Otajärvi
- Department of Neurosciences and Rehabilitation, Tampere University Hospital, Tampere, Finland
| | - Sirpa Rainesalo
- Department of Neurosciences and Rehabilitation, Tampere University Hospital, Tampere, Finland
| | - Linda Laukkanen
- Department of Neurosciences and Rehabilitation, Tampere University Hospital, Tampere, Finland
| | - Kai Lehtimäki
- Department of Neurosciences and Rehabilitation, Tampere University Hospital, Tampere, Finland
| | - Jukka Peltola
- Department of Neurosciences and Rehabilitation, Tampere University Hospital, Tampere, Finland.,University of Tampere, Tampere, Finland
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Abstract
There is a minimal amount of knowledge regarding the cognitive abilities of people with aphasia. We evaluated the performance of individuals with chronic aphasia (AP) and control participants without aphasia (CP) with left hemisphere stroke in a battery of nonverbal cognitive tests and its relationship with aphasia severity, comprehension abilities, and speech fluency in a prospective cross-sectional study. Cognitive evaluation comprised 10 nonverbal tests. Scores were converted to age and education adjusted standard scores. Forty-eight AP and 32 CP were included. AP average scores were below normal range in three tests: Camel and Cactus Test, immediate recall of 5 Objects Test and Spatial Span. The mean test scores were significantly lower in AP than in CP, except in four tests. Aphasia severity and verbal comprehension ability correlated significantly with semantic memory, constructive abilities and attention/processing speed tests. Subjects with nonfluent aphasia had lower scores than CP in memory, executive functions and attention tests, while subjects with fluent aphasia showed lower scores in memory tests only. On average half of the individuals with aphasia exhibit results within the normal range. Nonetheless, their performance was worse than that of controls, despite the fact that many tests do not correlate with the severity of language disorder.
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Affiliation(s)
- José Fonseca
- a Faculdade de Medicina , Universidade de Lisboa, Instituto de Medicina Molecular, Laboratório de Estudos de Linguagem , Lisbon , Portugal
| | - Ana Raposo
- b Faculdade de Psicologia , Universidade de Lisboa , Lisbon , Portugal
| | - Isabel Pavão Martins
- a Faculdade de Medicina , Universidade de Lisboa, Instituto de Medicina Molecular, Laboratório de Estudos de Linguagem , Lisbon , Portugal
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Bang SA, Song YS, Moon BS, Lee BC, Lee HY, Kim JM, Kim SE. Neuropsychological, Metabolic, and GABAA Receptor Studies in Subjects with Repetitive Traumatic Brain Injury. J Neurotrauma 2015; 33:1005-14. [PMID: 26414498 DOI: 10.1089/neu.2015.4051] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [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: 11/12/2022] Open
Abstract
Repetitive traumatic brain injury (rTBI) occurs as a result of mild and accumulative brain damage. A prototype of rTBI is chronic traumatic encephalopathy (CTE), which is a degenerative disease that occurs in patients with histories of multiple concussions or head injuries. Boxers have been the most commonly studied patient group because they may experience thousands of subconcussive hits over the course of a career. This study examined the consequences of rTBI with structural brain imaging and biomolecular imaging and investigated whether the neuropsychological features of rTBI were related to the findings of the imaging studies. Five retired professional boxers (mean age, 46.8 ± 3.19 years) and four age-matched controls (mean age, 48.5 ± 3.32 years) were studied. Cognitive-motor related functional impairment was assessed, and all subjects underwent neuropsychological evaluation and behavioral tasks, as well as structural brain imaging and functional-molecular imaging. In neuropsychological tests, boxers showed deficits in delayed retrieval of visuospatial memory and motor coordination, which had a meaningful relationship with biomolecular imaging results indicative of neuronal injury. Morphometric abnormalities were not found in professional boxers by structural magnetic resonance imaging (MRI). Glucose metabolism was impaired in frontal areas associated with cognitive dysfunction, similar to findings in Alzheimer's disease. Low binding potential (BP) of (18)F-flumazenil (FMZ) was found in the angular gyrus and temporal cortical regions, revealing neuronal deficits. These results suggested that cognitive impairment and motor dysfunction reflect chronic damage to neurons in professional boxers with rTBI.
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Affiliation(s)
- Seong Ae Bang
- 1 Department of Neuroscience, Seoul National University College of Medicine , Seoul, Republic of Korea.,2 Department of Nuclear Medicine, Seoul National University Bundang Hospital , Seongnam, Republic of Korea
| | - Yoo Sung Song
- 2 Department of Nuclear Medicine, Seoul National University Bundang Hospital , Seongnam, Republic of Korea
| | - Byung Seok Moon
- 2 Department of Nuclear Medicine, Seoul National University Bundang Hospital , Seongnam, Republic of Korea
| | - Byung Chul Lee
- 2 Department of Nuclear Medicine, Seoul National University Bundang Hospital , Seongnam, Republic of Korea.,4 Center for Nanomolecular Imaging and Innovative Drug Development, Advanced Institutes of Convergence Technology , Suwon, Republic of Korea
| | - Ho-Young Lee
- 2 Department of Nuclear Medicine, Seoul National University Bundang Hospital , Seongnam, Republic of Korea
| | - Jong-Min Kim
- 5 Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital , Seongnam, Republic of Korea
| | - Sang Eun Kim
- 1 Department of Neuroscience, Seoul National University College of Medicine , Seoul, Republic of Korea.,2 Department of Nuclear Medicine, Seoul National University Bundang Hospital , Seongnam, Republic of Korea.,3 Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University , Seoul, Republic of Korea.,4 Center for Nanomolecular Imaging and Innovative Drug Development, Advanced Institutes of Convergence Technology , Suwon, Republic of Korea
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33
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Cavalari RNS, Donovick PJ. Agenesis of the corpus callosum: symptoms consistent with developmental disability in two siblings. Neurocase 2015; 21:95-102. [PMID: 24417213 DOI: 10.1080/13554794.2013.873059] [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: 10/25/2022]
Abstract
Agenesis of the corpus callosum (AgCC) is a congenital disorder that disrupts the development of neurological structures connecting the right and left hemispheres of the brain. In addition to neurological symptoms, many individuals with AgCC demonstrate marked deficits in social, communication, and adaptive skills. This paper presents two case studies of congenital AgCC in siblings with socioemotional and behavioral symptoms consistent with developmental disability, but with notably different symptom presentations and clinical needs. Conclusions from these cases suggest that unique symptom profiles of individuals with AgCC warrant careful consideration for referral to appropriate academic and habilitative services.
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Affiliation(s)
- Rachel N S Cavalari
- a Department of Psychology , Binghamton University - State University of New York , USA
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34
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Nunnari D, Bonanno L, Bramanti P, Marino S. Diffusion tensor imaging and neuropsychologic assessment in aphasic stroke. J Stroke Cerebrovasc Dis 2014; 23:e477-e478. [PMID: 25284718 DOI: 10.1016/j.jstrokecerebrovasdis.2014.07.047] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 07/21/2014] [Accepted: 07/27/2014] [Indexed: 11/18/2022] Open
Abstract
With the recent advances in neuroimaging it has become possible to characterize the cerebral reorganization that occurs in response to therapy and the conditions under which this reorganization occurs. Diffusion tensor imaging (DTI) is a neuroimaging technique that allows us to visualize white matter tracts and potential changes associated with different treatments. To date, only few data on structural neuroplasticity related to the recovery of poststroke aphasia were reported. We describe a case of aphasic stroke patient, who was studied before and after the intense rehabilitative treatment by using neuropsychologic evaluation and DTI examination, to assess the integrity of the arcuate fasciculus related to motor, language, and cognitive recovery.
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Affiliation(s)
| | - Lilla Bonanno
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy
| | | | - Silvia Marino
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy; Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy.
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35
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Corallo F, Marra A, Bramanti P, Calabrò RS. Effect of cranioplasty on functional and neuro - psychological recovery after severe acquired brain injury: fact or fake? Considerations on a single case. Funct Neurol 2014; 29:273-275. [PMID: 25764258 PMCID: PMC4370441] [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: 06/04/2023]
Abstract
Cranioplasty is performed, using autograft materials, to treat the "trephined syndrome" in patients previously submitted to craniectomy. Indeed, considerable improvements in neuropsychological deficits, control of convulsions and partial prevention of cerebral atrophy are achieved after this surgical procedure. We describe the pre- and post-operative neuropsychological and functional evaluation of a 30-year-old male patient who underwent cranioplasty following previous craniectomy for a subarachnoid hemorrhage due to a spontaneously ruptured aneurysm of the right middle cerebral artery.
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Abstract
Diagnosis of Alzheimer's disease (AD) requires a reliable neuropsychological
assessment, but major barriers are still encountered when such tests are used
across cultures and during the lifespan. This is particularly problematic in
developing countries where most of the available assessment tools have been
adapted from developed countries. This represents a major limitation as these
tests, although properly translated, may not embody the wealth of challenges
that a particular culture poses on cognition. This paper centers on two
shortcomings of available cognitive tests for AD, namely, their sensitivity to
the educational background and to the age of the individual assessed.
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Affiliation(s)
- Mario Alfredo Parra
- MD, PhD. Centre for Cognitive Ageing and Cognitive Epidemiology, Human Cognitive Neuroscience, Department of Psychology, University of Edinburgh, UK; Scottish Dementia Clinical Research Network, NHS Scotland, UK; Alzheimer Scotland Dementia Research Centre, University of Edinburgh, UK; Neuroscience Group, University of Antioquia, Colombia; UDP-INECO Foundation Core on Neuroscience (UIFCoN), Diego Portales University, Santiago, Chile
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37
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Silk-Eglit GM, Gunner JH, Miele AS, Lynch JK, McCaffrey RJ. A comparison of the standard category test with a new computer version. Appl Neuropsychol Adult 2014; 21:9-13. [PMID: 24826490 DOI: 10.1080/09084282.2012.716802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The Halstead Category Test is a popular measure of abstraction, concept formation, and logical analysis skills. Due to its large apparatus, however, ease of administration of the standard Category Test is limited. For this reason, a number of computer versions of the Category Test have been developed to facilitate its administration. The current study evaluated the equivalence of a new computer version to the standard Category Test in a sample of undergraduate students. Analyses revealed that the two versions did not differ significantly on subtest error scores, total error scores, or Neuropsychological Deficit Scale scores. Results of the current study support the equivalence of this new computer version to the standard version of the Category Test.
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Affiliation(s)
- Graham M Silk-Eglit
- a Department of Psychology , University at Albany, State University of New York , Albany , New York
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38
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Walker D, Thomas SA, Talbot EJ, Bennett EJ, Starza-Smith A, Da Silva SL. Cerebellar mutism: the rehabilitation challenge in pediatric neuro-oncology: case studies. J Pediatr Rehabil Med 2014; 7:333-40. [PMID: 25547885 DOI: 10.3233/prm-140309] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [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: 11/15/2022] Open
Abstract
Cerebellar Mutism Syndrome (CMS), also known as posterior fossa syndrome (CMS/PFS), refers to a transient loss of speech followed by dysarthria and is a common complication in the pediatric population following resection of a cerebellar tumor. Recognition and rehabilitation of CMS is critical in the post-operative phases of recovery. Two case studies, including neuropsychological assessments, along with the family and patient's perspectives are reviewed.
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Affiliation(s)
- David Walker
- Children's Brain Tumor Research Center, University of Nottingham, UK
| | - S A Thomas
- Psychology Service, Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, UK
| | - E J Talbot
- Psychology Service, Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, UK
| | - E J Bennett
- Psychology Service, Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, UK
| | - A Starza-Smith
- Psychology Service, Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, UK
| | - Stephanie L Da Silva
- Division of Neurosurgery, Children's Hospital Los Angeles, Los Angeles, CA, USA Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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39
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Miller DI, Talbot V, Gagnon M, Messier C. Administration of neuropsychological tests using interactive voice response technology in the elderly: validation and limitations. Front Neurol 2013; 4:107. [PMID: 23950755 PMCID: PMC3738914 DOI: 10.3389/fneur.2013.00107] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Accepted: 07/19/2013] [Indexed: 12/02/2022] Open
Abstract
Interactive voice response (IVR) systems are computer programs, which interact with people to provide a number of services from business to health care. We examined the ability of an IVR system to administer and score a verbal fluency task (fruits) and the digit span forward and backward in 158 community dwelling people aged between 65 and 92 years of age (full scale IQ of 68–134). Only six participants could not complete all tasks mostly due to early technical problems in the study. Participants were also administered the Wechsler Intelligence Scale fourth edition (WAIS-IV) and Wechsler Memory Scale fourth edition subtests. The IVR system correctly recognized 90% of the fruits in the verbal fluency task and 93–95% of the number sequences in the digit span. The IVR system typically underestimated the performance of participants because of voice recognition errors. In the digit span, these errors led to the erroneous discontinuation of the test: however the correlation between IVR scoring and clinical scoring was still high (93–95%). The correlation between the IVR verbal fluency and the WAIS-IV Similarities subtest was 0.31. The correlation between the IVR digit span forward and backward and the in-person administration was 0.46. We discuss how valid and useful IVR systems are for neuropsychological testing in the elderly.
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40
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Ciolli L, Pescini F, Salvadori E, Del Bene A, Pracucci G, Poggesi A, Nannucci S, Valenti R, Basile AM, Squarzanti F, Bianchi S, Dotti MT, Adriano E, Balestrino M, Federico A, Gandolfo C, Inzitari D, Pantoni L. Influence of vascular risk factors and neuropsychological profile on functional performances in CADASIL: results from the MIcrovascular LEukoencephalopathy Study (MILES). Eur J Neurol 2013; 21:65-71. [PMID: 23869710 DOI: 10.1111/ene.12241] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [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: 03/16/2013] [Accepted: 06/17/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an inherited cerebral small vessel disease that may lead to disability and whose phenotype modulators are still unknown. METHODS In the MIcrovascular LEukoencephalopathy Study (MILES), we assessed the influence of vascular risk factors and the effect of different cognitive domains (memory, psychomotor speed and executive functions) performances on functional abilities in CADASIL in comparison with age-related leukoencephalopathy (ARL). RESULTS We evaluated 51 CADASIL patients (mean age 50.3 ± 13.8 years, 47.1% males) and 68 ARL patients (70.6 ± 7.4 years, 58.8% males). Considering vascular risk factors, after adjustment for age, CADASIL patients had higher mean BMI values than ARL patients. Stroke history frequency was similar in the two groups. After adjustment for age, more CADASIL patients were disabled (impaired on ≥ 2 items of the Instrumental Activities of Daily Living scale) in comparison with ARL patients, and CADASIL patients had worse functional performances evaluated with the Disability Assessment for Dementia (DAD) scale. In CADASIL patients, hypertension was related to both DAD score and disability. The cognitive profile of CADASIL and ARL patients was similar, but on a stepwise linear regression analysis functional performances were mainly associated with the memory index (β = -0.418, P < 0.003) in CADASIL patients and the executive function index (β = -0.321, P = 0.028) in ARL. CONCLUSIONS This study suggests that hypertension may contribute to functional impairment in CADASIL and that memory impairment has a large influence on functional decline in contrast with that observed in a sample of subjects with ARL.
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Affiliation(s)
- L Ciolli
- NEUROFARBA Department, Neuroscience section, University of Florence, Florence, Italy
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Abstract
The Iowa Gambling Task (IGT) is assumed to measure executive functioning, but this has not been empirically tested by means of both convergent and discriminant validity. We used structural equation modeling (SEM) to test whether the IGT is an executive function (EF) task (convergent validity) and whether it is not related to other neuropsychological domains (discriminant validity). Healthy community-dwelling participants (N = 214) completed a comprehensive neuropsychological battery. We analyzed the conventional IGT metric and three alternative metrics based on the overall difference of advantageous minus disadvantageous choices made during the last 60 IGT responses and advantageous minus disadvantageous choices based on two specific decks of cards (D minus A). An a priori six-factor hierarchical model of neuropsychological functioning was confirmed with SEM. Attention and processing speed were grouped as "non-associative" factors. Fluency, executive functioning, visual learning/memory, and verbal learning/memory were grouped as higher-level "associative" factors. Of the non-associative factors, attention, but not speed, predicted IGT performance. When each associative factor was entered along with attention, only EF improved the model fit and that was only for metrics based on trials 41-100. SEM indicates metrics based on trails 1-100 are influenced by attention, and metrics based on trails 41-100 are influenced by attention and EF. Its associative strength with attention is twice that of EF. Conceptually, the IGT is a multi-trait task involving novel problem-solving and attentional domains to a greater extent, and executive functioning to a lesser extent.
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Affiliation(s)
- David A Gansler
- Department of Psychology, Suffolk University, Boston, MA 02114, USA.
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Abstract
Multiple system atrophy (MSA) is characterized by a variable combination of
cerebellar ataxia, parkinsonism and pyramidal signs associated with autonomic
failure. Classically, cognitive impairment was not considered a clinical feature
of MSA and dementia was pointed out as an exclusion diagnostic criteria. Based
on comprehensive neuropsychological assessment, cognitive impairment was found
to be a frequent feature in MSA, and clinically-defined dementia is now reported
in 14-16% of cases. This article reviews the current data on cognitive
impairment in MSA along with its neuropsychological profile and
pathophysiology.
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Affiliation(s)
- Agessandro Abrahão
- Division of General Neurology and Ataxias, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo SP, Brazil
| | - Livia Almeida Dutra
- Division of General Neurology and Ataxias, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo SP, Brazil
| | - Pedro Braga Neto
- Division of General Neurology and Ataxias, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo SP, Brazil
| | - José Luiz Pedroso
- Division of General Neurology and Ataxias, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo SP, Brazil
| | - Ricardo Araújo de Oliveira
- Division of General Neurology and Ataxias, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo SP, Brazil
| | - Orlando Graziani Povoas Barsottini
- Division of General Neurology and Ataxias, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo SP, Brazil
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Abstract
There is a current concept that illiteracy and lower educational levels are risk
factors for cognitive decline and dementia. Our aims were to review the
association between illiteracy and dementia; and to describe some results on
neuropsychological findings in illiteracy. A literature search of the PubMed
database was performed. The search terms were “dementia”, “illiteracy”,
“neuropsychological evaluation”, “educational levels”, and “education”. Only
papers published in Portuguese, English, and Spanish were reviewed. Illiteracy
is an incontestable risk factor for dementia. It influences performance on
almost cognitive tests. Many other factors could be connected to the high
prevalence of dementia among illiterates: low cognitive reserve, poor control of
cerebrovascular disease risk factors, difficulties in cognitive evaluation, and
poor adaptation of neuropsychological tests for this specific population.
Functional tests must be coupled with cognitive tests to ameliorate diagnostic
accuracy.
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Affiliation(s)
- Sonia Maria Dozzi Brucki
- MD, Behavioral and Cognitive Neurology Unit, Department of Neurology, University of São Paulo School of Medicine and Hospital Santa Marcelina, São Paulo SP, Brazil
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44
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Abstract
The diagnosis of dementia is based on cognitive and functional evaluation. One of the difficulties in ascertaining the number of people with dementia in developing countries is the population's lack of formal education. Independent effects of age, sex and education have been identified on scores for most but not all cognitive tests. OBJECTIVES Identify the most-used cognitive and functional assessment tools in Brazil, related to dementia diagnosis and treatment outcome; and identify adaptations or normative data, when available. METHODS Data were generated from PubMed, LILACS and Portal Periodicos CAPES (thesis database) databases using the search terms 'dementia' and 'Alzheimer'. Data collection criteria were a. Articles with abstract; b. Brazilian abstracts, related to adult Brazilian population; c. Clear mention of assessment tool in the abstract text. A total of 108 abstracts were selected for the main analysis: a. to identify the instruments used b. to determine how many of the selected abstracts mentioned each tool and c. to search in the mentioned databases for respective test adaptations or normative data. RESULTS Some 52 different assessment tools, 41 cognitive instruments and 11 functional instruments were identified. The most cited assessment tests were the Mini Mental State Examination (64 abstracts) and Pfeffer Functional Activities Questionnaire (4 abstracts). DISCUSSION Many of the instruments used only have the description of the translation process into Portuguese, along with some suggestions of validation or normative data. Few of these followed the recommended procedures of validation, replication, normalization or transcultural adaptation.
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Affiliation(s)
- Luciano Góis Vasconcelos
- Post-graduate student; From the Department of Psychobiology, Federal University of São Paulo, São Paulo, Brazil
| | - Sonia Maria Dozzi Brucki
- Affiliated researcher; From the Department of Psychobiology, Federal University of São Paulo, São Paulo, Brazil
| | - Orlando Francisco Amodeo Bueno
- Adjunct Professor and Head of Department. From the Department of Psychobiology, Federal University of São Paulo, São Paulo, Brazil
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