Journal articles on the topic 'Cognition disorders – Diagnosis'
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Trotti, Rebekah L., Sunny Abdelmageed, David A. Parker, Dean Sabatinelli, Carol A. Tamminga, Elliot S. Gershon, Sarah K. Keedy, et al. "Neural Processing of Repeated Emotional Scenes in Schizophrenia, Schizoaffective Disorder, and Bipolar Disorder." Schizophrenia Bulletin 47, no. 5 (March 6, 2021): 1473–81. http://dx.doi.org/10.1093/schbul/sbab018.
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Abstract Impaired emotional processing and cognitive functioning are common in schizophrenia, schizoaffective disorder, and bipolar disorders, causing significant socioemotional disability. While a large body of research demonstrates abnormal cognition/emotion interactions in these disorders, previous studies investigating abnormalities in the emotional scene response using event-related potentials (ERPs) have yielded mixed findings, and few studies compare findings across psychiatric diagnoses. The current study investigates the effects of emotion and repetition on ERPs in a large, well-characterized sample of participants with schizophrenia-bipolar syndromes. Two ERP components that are modulated by emotional content and scene repetition, the early posterior negativity (EPN) and late positive potential (LPP), were recorded in healthy controls and participants with schizophrenia, schizoaffective disorder, bipolar disorder with psychosis, and bipolar disorder without psychosis. Effects of emotion and repetition were compared across groups. Results displayed significant but small effects in schizophrenia and schizoaffective disorder, with diminished EPN amplitudes to neutral and novel scenes, reduced LPP amplitudes to emotional scenes, and attenuated effects of scene repetition. Despite significant findings, small effect sizes indicate that emotional scene processing is predominantly intact in these disorders. Multivariate analyses indicate that these mild ERP abnormalities are related to cognition, psychosocial functioning, and psychosis severity. This relationship suggests that impaired cognition, rather than diagnosis or mood disturbance, may underlie disrupted neural scene processing in schizophrenia-bipolar syndromes.
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Kauliņa, Anda. "Cognitive Analysis of 9 to 11-Year-Old Children With Intellectual Development Disorders." Journal of Pedagogy and Psychology "Signum Temporis" 9, no. 1 (December 20, 2017): 16–22. http://dx.doi.org/10.1515/sigtem-2017-0006.
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Abstract Cognitive development significantly influences efficiency and results of child’s understanding and comprehension of the world. Attention and cognition play a significant role to ensure academic achievement and success. Attention is essential for purposeful planning of action and systematic work. Attention is necessary to follow the study material and for physical survival in everyday life. Cognition is significant in decision making and evaluating possible outcomes, being especially important in children with cognitive development disorders. The aim of the present study was to find out the peculiarities of the cognitive processes in 9 to 11-year-old children with cognitive development disorders. Previous literature suggests that children with intellectual development disorders are at increased risk of general cognitive disorders. To test this assumption and establish cognitive abilities in children with intellectual development disorders, the following subtests of the Vienna Test System (VTS) were used: CPM/S2 (Raven's Coloured Progressive Matrices), B19 (Double Labyrinth Test) and WAFF (Perception and Attention Functions: Focused Attention). VTS is one of the leading computer-based psychophysiological testing systems in Europe. In addition to testing, behavioural observations were also carried out. Study results reveal that children with a shared diagnosis are not as similar when it comes to cognition and attention. Not all children within the sample group exhibited reduced attention and concentration, although the whole participant sample was diagnosed with intellectual development disorder. Meanwhile, risk factors hindering normal cognitive development were identified.
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Foley, J. M., M. J. Wright, A. L. Gooding, M. Ettenhofer, M. Kim, M. Choi, S. A. Castellon, et al. "Operationalization of the updated diagnostic algorithm for classifying HIV-related cognitive impairment and dementia." International Psychogeriatrics 23, no. 5 (November 19, 2010): 835–43. http://dx.doi.org/10.1017/s1041610210002085.
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ABSTRACTBackground: This study applies the updated HIV-Associated Neurocognitive Disorders (HAND) diagnostic algorithm.Methods: Participants were 210 HIV-infected-adults, classified using proposed HAND criteria: HIV-Associated Dementia (HAD), Mild Neurocognitive Disorder (MND), Asymptomatic Neurocognitive Impairment (ANI).Results: The algorithm yielded: normal = 32.8%, ANI = 21.4%, MND = 34.3%, and HAD = 11.4%. Normal participants performed superior to HAND-defined participants on cognition, and HAD participants performed more poorly on global cognition and executive functioning. Two distinct subgroups of interest emerged: (1) functional decline without cognitive impairment; (2) severe cognitive impairment and minimal functional compromise.Conclusions: The algorithm discriminates between HIV-infected cognitively impaired individuals. Diagnosis yields two unique profiles requiring further investigation. Findings largely support the algorithm's utility for diagnosing HIV-cognitive-impairment, but suggest distinct subsets of individuals with discrepant cognitive/functional performances that may not be readily apparent by conventional application of HAND diagnosis.
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Lewandowski, K. E., S. H. Sperry, B. M. Cohen, and D. Öngür. "Cognitive variability in psychotic disorders: a cross-diagnostic cluster analysis." Psychological Medicine 44, no. 15 (April 7, 2014): 3239–48. http://dx.doi.org/10.1017/s0033291714000774.
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Background.Cognitive dysfunction is a core feature of psychotic disorders; however, substantial variability exists both within and between subjects in terms of cognitive domains of dysfunction, and a clear ‘profile’ of cognitive strengths and weaknesses characteristic of any diagnosis or psychosis as a whole has not emerged. Cluster analysis provides an opportunity to group individuals using a data-driven approach rather than predetermined grouping criteria. While several studies have identified meaningful cognitive clusters in schizophrenia, no study to date has examined cognition in a cross-diagnostic sample of patients with psychotic disorders using a cluster approach. We aimed to examine cognitive variables in a sample of 167 patients with psychosis using cluster methods.Method.Subjects with schizophrenia (n = 41), schizo-affective disorder (n = 53) or bipolar disorder with psychosis (n = 73) were assessed using a battery of cognitive and clinical measures. Cognitive data were analysed using Ward's method, followed by a K-means cluster approach. Clusters were then compared on diagnosis and measures of clinical symptoms, demographic variables and community functioning.Results.A four-cluster solution was selected, including a ‘neuropsychologically normal’ cluster, a globally and significantly impaired cluster, and two clusters of mixed cognitive profiles. Clusters differed on several clinical variables; diagnoses were distributed amongst all clusters, although not evenly.Conclusions.Identification of groups of patients who share similar neurocognitive profiles may help pinpoint relevant neural abnormalities underlying these traits. Such groupings may also hasten the development of individualized treatment approaches, including cognitive remediation tailored to patients' specific cognitive profiles.
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Chen, Ruei-An, Chun-Yi Lee, Yu Lee, Chi-Fa Hung, Yu-Chi Huang, Pao-Yen Lin, Sheng-Yu Lee, and Liang-Jen Wang. "Defining cognitive profiles of depressive patients using the Brief Assessment of Cognition in Affective Disorders." PeerJ 7 (August 1, 2019): e7432. http://dx.doi.org/10.7717/peerj.7432.
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Background Cognitive impairments in patients with depressive disorders have a negative impact on their daily skill functioning and quality of life. In this study, we evaluated the cognitive profiles and associated factors of patients with depressive disorders with the Brief Assessment of Cognition in Affective Disorders (BAC-A). Methods This cross-sectional study consisted of 75 patients with depressive disorders (56 patients with major depressive disorder (MDD) and 19 patients with depressive disorder NOS or dysthymic disorder (non-MDD)). We evaluated the participants’ cognitive functions at euthymic status using the BAC-A. The BAC-A includes six subtests derived from the Brief Assessment of Cognition in Schizophrenia (BAC-S) and Affective Processing Tests. The current severity of depressive symptoms was assessed with the 17-item Hamilton Depression Rating Scale (HAMD-17), and we recorded any psychotropic drugs being used by the patients. Results We observed no differences in cognitive profiles in the MDD group and non-MDD group after adjusting for educational levels, severity of depression, and psychotropic drugs. Instead, the HAMD-17 scores were negatively correlated to cognitive performance in working memory, motor speed, verbal fluency, attention and processing speed, executive function, composite score, and the six indexes of the Affective Processing Test measured by the BAC-A. A longer illness duration was associated with worse performance of four indexes of the Affective Processing Test. Furthermore, benzodiazepine use was associated with a worse performance of verbal memory, and antidepressant use was associated with better motor speed performance. Conclusion The current severity of depressive symptoms and psychotropic drugs being taken, not the diagnosis category, are associated with cognitive impairments in patients with depressive disorders. Clinicians should pay particular attention to managing residual depressive symptoms and prescribing adequate psychotropic drugs in order to eliminate depressive patients’ cognitive deficits.
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Kuklińska, Marta, Emilia J. Sitek, Bogna Brockhuis, Anna Barczak, Beata Hintze, and Ewa Narożańska. "Behavioural variant frontotemporal dementia – selected diagnostic dilemmas in neuropsychiatry." Aktualności Neurologiczne 20, no. 2 (October 30, 2020): 71–81. http://dx.doi.org/10.15557/an.2020.0010.
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Introduction: Differential diagnosis of behavioural variant frontotemporal dementia remains a challenge for neurologists and psychiatrists as some behavioural symptoms of this illness and psychiatric disorders, such as apathy, are not specific. Aim: The paper aims at presenting the differential diagnosis of behavioural variant frontotemporal dementia and primary psychiatric disorders. Discussion: Behavioural symptoms of behavioural variant frontotemporal dementia overlap with symptoms typical for primary psychiatric disorders. Psychotic symptoms, apathy and inappropriate behaviour are prominent in schizophrenia. Repetitive behaviours are typical for obsessive-compulsive disorders. Inattention and impulsivity are common in attention deficit and hyperactivity disorder. Disinhibition is typical of mania in the context of bipolar disorder. Thus, all these psychiatric diagnoses need to be considered in the differential diagnosis of behavioural variant frontotemporal dementia. This condition is associated with language deficits and more widespread executive and social cognition deficits. Also, the presence of neurological symptoms, such as oculomotor dysfunction, upper/lower motor neuron dysfunction or bradykinesia, may facilitate the diagnosis. Functional decline is observed during follow-up in behavioural variant frontotemporal dementia, but not in phenocopy syndrome. Conclusions: Differential diagnosis requires integration of behavioural and neuropsychological data with the results of neurological assessment and neuroimaging work-up. In ambiguous cases, if genetic testing is negative, only longitudinal observation can confirm the diagnosis of behavioural variant frontotemporal dementia or phenocopy syndrome.
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Pillon, B., B. Dubois, and Y. Agid. "Testing cognition may contribute to the diagnosis of movement disorders." Neurology 46, no. 2 (February 1, 1996): 329–34. http://dx.doi.org/10.1212/wnl.46.2.329.
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Vega-Rodríguez, Yuri E., Elena Garayzabal-Heinze, and Esther Moraleda-Sepúlveda. "Language Development Disorder in Fetal Alcohol Spectrum Disorders (FASD), a Case Study." Languages 5, no. 4 (October 10, 2020): 37. http://dx.doi.org/10.3390/languages5040037.
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Prenatal alcohol exposure can cause developmental damage in children. There are different types and ranges of alterations that fall under the name of fetal alcohol spectrum disorders (FASD). Disabilities in learning, cognition, and behavior are observed. Environmental conditions are an influencing factor in this population since they are generally adverse and are either not diagnosed at an early stage or given the appropriate support and approach. We present a case study of a 9-year-old child, in which all the variables affecting his development (FASD diagnosis and socioenvironmental conditions) were observed and analyzed. His early childhood under institutional care, the move to a foster home at the age of 6, and several measures of evaluation from foster care to the present are described. Difficulties in vocabulary, access to vocabulary, morphology, syntax, grammar, oral narrative, pragmatics, speech, and communication were observed, along with cognitive difficulties in memory, perception and executive functioning, social adaptation, learning, and behavior. An early diagnosis and approach enable this population to develop skills in different dimensions to address early adversity despite their neurological and behavioral commitment. Speech-language pathologist services are crucial for the diagnosis and treatment of the language and communication difficulties that characterize this syndrome.
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Ducharme, Simon, Annemiek Dols, Robert Laforce, Emma Devenney, Fiona Kumfor, Jan van den Stock, Caroline Dallaire-Théroux, et al. "Recommendations to distinguish behavioural variant frontotemporal dementia from psychiatric disorders." Brain 143, no. 6 (March 4, 2020): 1632–50. http://dx.doi.org/10.1093/brain/awaa018.
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Abstract The behavioural variant of frontotemporal dementia (bvFTD) is a frequent cause of early-onset dementia. The diagnosis of bvFTD remains challenging because of the limited accuracy of neuroimaging in the early disease stages and the absence of molecular biomarkers, and therefore relies predominantly on clinical assessment. BvFTD shows significant symptomatic overlap with non-degenerative primary psychiatric disorders including major depressive disorder, bipolar disorder, schizophrenia, obsessive-compulsive disorder, autism spectrum disorders and even personality disorders. To date, ∼50% of patients with bvFTD receive a prior psychiatric diagnosis, and average diagnostic delay is up to 5–6 years from symptom onset. It is also not uncommon for patients with primary psychiatric disorders to be wrongly diagnosed with bvFTD. The Neuropsychiatric International Consortium for Frontotemporal Dementia was recently established to determine the current best clinical practice and set up an international collaboration to share a common dataset for future research. The goal of the present paper was to review the existing literature on the diagnosis of bvFTD and its differential diagnosis with primary psychiatric disorders to provide consensus recommendations on the clinical assessment. A systematic literature search with a narrative review was performed to determine all bvFTD-related diagnostic evidence for the following topics: bvFTD history taking, psychiatric assessment, clinical scales, physical and neurological examination, bedside cognitive tests, neuropsychological assessment, social cognition, structural neuroimaging, functional neuroimaging, CSF and genetic testing. For each topic, responsible team members proposed a set of minimal requirements, optimal clinical recommendations, and tools requiring further research or those that should be developed. Recommendations were listed if they reached a ≥ 85% expert consensus based on an online survey among all consortium participants. New recommendations include performing at least one formal social cognition test in the standard neuropsychological battery for bvFTD. We emphasize the importance of 3D-T1 brain MRI with a standardized review protocol including validated visual atrophy rating scales, and to consider volumetric analyses if available. We clarify the role of 18F-fluorodeoxyglucose PET for the exclusion of bvFTD when normal, whereas non-specific regional metabolism abnormalities should not be over-interpreted in the case of a psychiatric differential diagnosis. We highlight the potential role of serum or CSF neurofilament light chain to differentiate bvFTD from primary psychiatric disorders. Finally, based on the increasing literature and clinical experience, the consortium determined that screening for C9orf72 mutation should be performed in all possible/probable bvFTD cases or suspected cases with strong psychiatric features.
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Korostil, M., and A. Feinstein. "Anxiety disorders and their clinical correlates in multiple sclerosis patients." Multiple Sclerosis Journal 13, no. 1 (January 2007): 67–72. http://dx.doi.org/10.1177/1352458506071161.
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Objective To assess prevalence rates and clinical correlates of anxiety disorders in patients with multiple sclerosis (MS). Methods Demographic and neurological data were collected on 140 consecutive clinic attendees, and their lifetime and point prevalences of anxiety disorders were determined with the Structured Clinical Interview for DSM-IV disorders (SCID-IV). All subjects completed the self-report Hospital Anxiety and Depression Scale (HADS). Suicidal intent was rated with the Beck Suicide Scale (BSS), psychosocial stressors and supports were quantified with Social Stress and Support Interview (SSSI), and cognition assessed with Neuropsychological Screening Battery for MS. Results The lifetime prevalence of any anxiety disorder was 35.7%, with panic disorder (10%), obsessive compulsive disorder (8.6%), and generalized anxiety disorder (18.6%), the most common diagnoses obtained. Subjects with an anxiety disorder were more likely to be female, have a history of depression, drink to excess, report higher social stress and have contemplated suicide. The diagnosis of an anxiety disorder had been missed in the majority of subjects, therefore, they had not received treatment. A discriminant function analysis identified a series of variables that correctly classified 75% of patients with an anxiety disorder. Conclusion Anxiety disorders are common in patients with MS, but are frequently overlooked and under-treated. Risk factors include being female, a co-morbid diagnosis of depression, and limited social support. Clinicians should evaluate all MS subjects for anxiety disorders, as they represent a treatable cause of disability in MS.
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Mulrine, Christopher F., and Betty Kollia. "Diagnosing and Teaching Students with Social Communication Disorder in Included Classrooms." Journal of Education and Learning 9, no. 4 (June 25, 2020): 94. http://dx.doi.org/10.5539/jel.v9n4p94.
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Autism Spectrum Disorder (ASD) was for many years considered to be one of five pervasive developmental disorders (PDD) as defined in the 4th edition of the Diagnostic Statistical Manual of Mental Disorders (DSM-IV-TR) published by the American Psychiatric Association (APA, 2000). These disorders included Autism, Rett Syndrome, Childhood Disintegrative Disorder, PDD-NOS (not otherwise specified), and Asperger’s syndrome. The 2013, fifth revision of the manual (DSM-5) presented a modification in the diagnosis for Autism Spectrum Disorder. It is now being diagnosed as an inclusive disorder of a range of symptoms or autism related symptoms from mild to severe (APA, 2013). It has dropped four of the previous diagnoses and is now only one encompassing disability called Autism Spectrum Disorder. Using the new DSM-5 diagnostic criteria some students who were previously diagnosed as having Asperger’s Syndrome do not fit the new Autism Spectrum Disorder criteria. These students might now be diagnosed with Social Communication Disorder (SCD). This diagnosis meets the symptoms presented by these individuals more appropriately. SCD describes the social difficulties and pragmatic language differences that impact comprehension, production, and awareness in conversation that are not caused by delayed cognition or other language delays.
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Isaksson, Johan, Mark J. Taylor, Karl Lundin, Janina Neufeld, and Sven Bölte. "Familial confounding on the ability to read minds: A co-twin control study." Autism 23, no. 8 (March 21, 2019): 1948–56. http://dx.doi.org/10.1177/1362361319836380.
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Alterations in social cognition are hypothesized to underlie social communication challenges in autism spectrum disorder. However, the etiologic underpinnings driving this association, as well as the impact of other psychiatric conditions on the association, remain unclear. Using a co-twin control design, we examined n = 308 twins (mean age = 16.63; 46% females) with autism spectrum disorder, attention-deficit/hyperactivity disorder, affective disorders, or typical development using the Reading the Mind in the Eyes Test to operationalize social cognition ability. Clinical diagnosis of autism spectrum disorder, as well as the extent of quantitative autistic traits, as measured by parental reports using the Social Responsiveness Scale-2, predicted fewer expected responses on the Reading the Mind in the Eyes Test across the pairs. The association remained when adjusting for other diagnoses and IQ. In addition, male sex, lower age, and lower IQ predicted poorer performance on the Reading the Mind in the Eyes Test. The associations between autism and social cognition ability were lost within pairs in both the full sample and the monozygotic subsample. We conclude that the association between autism and social cognition across the sample highlights the importance of social cognition alterations in autism spectrum disorder when compared with other conditions. The attenuation of the association in the within-pair models indicate familial confounding, such as genes and shared environment, influencing both autism and social cognition.
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Llamas-Velasco, Sara, Fernando Sierra-Hidalgo, Lucia Llorente-Ayuso, Alejandro Herrero-San Martín, Alberto Villarejo Galende, and Félix Bermejo Pareja. "Inter-Rater Agreement in the Clinical Diagnosis of Cognitive Status: Data from the Neurological Disorders in Central Spain 2 Pilot Study." Neuroepidemiology 47, no. 1 (2016): 32–37. http://dx.doi.org/10.1159/000447699.
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Background: To assess the diagnostic agreement of cognitive status (dementia, mild cognitive impairment (MCI), normal cognition) among neurologists in the field of neurological disorders in Central Spain 2 study. Methods: Full medical histories of 30 individuals were provided to 27 neurologists: 9 seniors, 10 juniors and 8 residents. For each case, we were asked to assign a diagnosis of dementia, MCI or normal cognition using the National Institute on Aging-Alzheimer's Association workgroup (NIA-AA) core clinical criteria for all-cause dementia, Winblad et al. criteria for MCI, and analyze intensity and etiology if dementia was diagnosed. Inter-rater agreement was assessed both with percent concordance and non-weighted κ statistics. Results: Overall inter-rater agreement on cognitive status was κ = 0.76 (95% CI 0.65-0.86), being slightly higher among junior neurologists (κ = 0.85, 95% CI 0.73-0.95) than among seniors (κ = 0.71, 95% CI 0.59-0.83) and residents (κ = 0.69, 95% CI 0.54-0.81) but without statistical significance among groups. Dementia severity showed an overall κ of 0.34, 0.44 and 0.64 for mild, moderate and severe dementia respectively. Conclusions: Substantial agreement was demonstrated for the diagnosis of cognitive status (dementia, MCI and normal cognition) among neurologists of different levels of experience in a population-based epidemiological study using NIA-AA and Winblad et al. criteria. The agreement rate was lower in the diagnosis of dementia severity.
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McHutchison, Caroline A., Danielle Jane Leighton, Andrew McIntosh, Elaine Cleary, Jon Warner, Mary Porteous, Siddharthan Chandran, Suvankar Pal, and Sharon Abrahams. "Relationship between neuropsychiatric disorders and cognitive and behavioural change in MND." Journal of Neurology, Neurosurgery & Psychiatry 91, no. 3 (December 23, 2019): 245–53. http://dx.doi.org/10.1136/jnnp-2019-321737.
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ObjectiveIn this population-based study, we aimed to determine whether neuropsychiatric history, medication or family history of neuropsychiatric disorders predicted cognitive and/or behavioural impairment in motor neuron disease (MND).MethodsPeople with MND (pwMND) on the Scottish Clinical, Audit, Research and Evaluation of MND (CARE-MND) register, diagnosed from January 2015 to January 2018, with cognitive and/or behavioural data measured using the Edinburgh Cognitive and Behavioural ALS Screen were included. Data were extracted on patient neuropsychiatric, medication and family history of neuropsychiatric disorders. We identified patients with cognitive impairment (motor neuron disease with cognitive impairment (MNDci)), behavioural impairment (motor neuron disease with behavioural impairment (MNDbi), both (motor neuron disease with cognitive and behavioural impairment (MNDcbi)) or motor neuron disease–frontotemporal dementia (MND-FTD).ResultsData were available for 305 pwMND (mean age at diagnosis=62.26 years, SD=11.40), of which 60 (19.7%) had a neuropsychiatric disorder. A family history of neuropsychiatric disorders was present in 36/231 (15.58%) of patients. Patient premorbid mood disorders were associated with increased apathy (OR=2.78, 95% CI 1.083 to 7.169). A family history of any neuropsychiatric disorder was associated with poorer visuospatial scores, MNDbi (OR=3.14, 95% CI 1.09 to 8.99) and MND-FTD (OR=5.08, 95% CI 1.26 to 20.40). A family history of mood disorders was associated with poorer overall cognition (exp(b)=0.725, p=0.026), language, verbal fluency and visuospatial scores, and MND-FTD (OR=7.57, 95% CI 1.55 to 46.87). A family history of neurotic disorders was associated with poorer language (exp(b)=0.362, p<0.001), visuospatial scores (exp(b)=0.625, p<0.009) and MND-FTD (OR=13.75, 95% CI 1.71 to 110.86).ConclusionNeuropsychiatric disorders in patients and their families are associated with cognitive and behavioural changes post-MND diagnosis, with many occurring independently of MND-FTD and C9orf72 status. These findings support an overlap between MND, frontotemporal dementia and neuropsychiatric disorders, particularly mood disorders.
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Kaplan, Richard F., and Michael C. Stevens. "A Review of Adult ADHD: A Neuropsychological and Neuroimaging Perspective." CNS Spectrums 7, no. 5 (May 2002): 355–62. http://dx.doi.org/10.1017/s1092852900017818.
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ABSTRACTAttention-deficit/hyperactivity disorder (ADHD) is a developmental disorder which effects an estimated 3% to 5% of children. Despite estimates that ADHD persists in 30% to 70% of adults having had the disorder in childhood, ADHD in adulthood remains controversial. This report summarizes current thinking in the diagnosis and etiology of adult ADHD. Most theories posit that ADHD is related to anomalies in frontal lobe function and dopaminergic transmission. However, there is debate as to whether ADHD is a unitary disorder with different manifestations, a syndrome, or multiple disorders. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, classifies ADHD into inattention, hyperactivity-impulsivity, and combined subtypes. Although problems with cognition are core ADHD symptoms, self reporting has not been a reliable predictor of neuropsychological test performance. Nevertheless, we suggest that a performance-based diagnosis, including empirically derived, age-sensitive neuropsychological tests, provides the best hope of dissociating ADHD from psychiatric disorders with similar symptoms. We also describe the promise of new neuroimaging technologies, such as functional magnetic resonance imaging, in elucidating the pathophysiology of ADHD and similar psychiatric disorders.
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Requena-Ocaña, Nerea, Pedro Araos, Pedro J. Serrano-Castro, María Flores-López, Nuria García-Marchena, Begoña Oliver-Martos, Juan Jesús Ruiz, et al. "Plasma Concentrations of Neurofilament Light Chain Protein and Brain-Derived Neurotrophic Factor as Consistent Biomarkers of Cognitive Impairment in Alcohol Use Disorder." International Journal of Molecular Sciences 24, no. 2 (January 7, 2023): 1183. http://dx.doi.org/10.3390/ijms24021183.
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For a long time, Substance Use Disorders (SUDs) were not considered a component in the etiology of dementia. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders introduced substance-induced neurocognitive disorders, incorporating this notion to clinical practice. However, detection and monitoring of neurodegenerative processes in SUD patients remain a major clinical challenge, especially when early diagnosis is required. In the present study, we aimed to investigate new potential biomarkers of neurodegeneration that could predict cognitive impairment in SUD patients: the circulating concentrations of Neurofilament Light chain protein (NfL) and Brain-Derived Neurotrophic Factor (BDNF). Sixty SUD patients were compared with twenty-seven dementia patients and forty healthy controls. SUD patients were recruited and assessed using the Psychiatric Research Interview for Substance and Mental (PRISM) and a battery of neuropsychological tests, including the Montreal Cognitive Assessment test for evaluation of cognitive impairment. When compared to healthy control subjects, SUD patients showed increases in plasma NfL concentrations and NfL/BDNF ratio, as well as reduced plasma BDNF levels. These changes were remarkable in SUD patients with moderate–severe cognitive impairment, being comparable to those observed in dementia patients. NfL concentrations correlated with executive function and memory cognition in SUD patients. The parameters “age”, “NfL/BDNF ratio”, “first time alcohol use”, “age of onset of alcohol use disorder”, and “length of alcohol use disorder diagnosis” were able to stratify our SUD sample into patients with cognitive impairment from those without cognitive dysfunction with great specificity and sensibility. In conclusion, we propose the combined use of NfL and BDNF (NfL/BDNF ratio) to monitor substance-induced neurocognitive disorder.
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McIntyre, Roger S., Nicole Anderson, Bernhard T. Baune, Elisa Brietzke, Katherine Burdick, Phillipe Fossati, Philip Gorwood, et al. "Expert Consensus on Screening and Assessment of Cognition in Psychiatry." CNS Spectrums 24, no. 1 (January 15, 2019): 154–62. http://dx.doi.org/10.1017/s1092852918001189.
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During the past two decades, it has been amply documented that neuropsychiatric disorders (NPDs) disproportionately account for burden of illness attributable to chronic non-communicable medical disorders globally. It is also likely that human capital costs attributable to NPDs will disproportionately increase as a consequence of population aging and beneficial risk factor modification of other common and chronic medical disorders (e.g., cardiovascular disease). Notwithstanding the availability of multiple modalities of antidepressant treatment, relatively few studies in psychiatry have primarily sought to determine whether improving cognitive function in MDD improves patient reported outcomes (PROs) and/or is cost effective. The mediational relevance of cognition in MDD potentially extrapolates to all NPDs, indicating that screening for, measuring, preventing, and treating cognitive deficits in psychiatry is not only a primary therapeutic target, but also should be conceptualized as a transdiagnostic domain to be considered regardless of patient age and/or differential diagnosis.
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Sezgin, Mine, Basar Bilgic, Sule Tinaz, and Murat Emre. "Parkinson's Disease Dementia and Lewy Body Disease." Seminars in Neurology 39, no. 02 (March 29, 2019): 274–82. http://dx.doi.org/10.1055/s-0039-1678579.
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AbstractDementia with Lewy bodies (DLB) and Parkinson's disease dementia (PD-D) are Lewy body-related neurodegenerative disorders sharing common clinical and neuropathological findings. The clinical features of both conditions include cognitive impairment, behavioral symptoms, autonomic dysfunction, sleep disorders, and parkinsonism. The cognitive profile of both disorders is characterized by particularly severe deficits in executive and visuospatial functions as well as attention. Clinical differentiation between DLB and PD-D is based on an arbitrary distinction between the time of onset of parkinsonism and cognitive symptoms; extrapyramidal symptoms precede dementia in PD-D, whereas it coincides with or follows dementia within 1 year in DLB. When the clinical picture is fully developed, DLB and PD-D are practically indistinguishable. Although the diagnosis is basically clinical, structural and functional neuroimaging as well as cerebrospinal fluid biomarkers may help the clinician in the diagnosis. Placebo-controlled randomized trials of the cholinesterase inhibitors have shown modest but significant benefits in cognition, global function, and neuropsychiatric symptoms in both disorders. Behavioral symptoms such as hallucinations and delusions should be treated with caution with antipsychotics, as they have the potential to worsen motor and cognitive symptoms.
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Hovendon, Bridget, and Michelle Kaufman. "Dementia With Lewy Bodies: An Overview." McGill Science Undergraduate Research Journal 10, no. 1 (March 31, 2015): 45–48. http://dx.doi.org/10.26443/msurj.v10i1.122.
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Background: Dementia is a neurocognitive disorder that involves multiple cognitive deficits, including memory impairment. Dementia occurs in a variety of disease processes, including Alzheimer disease (AD) and dementia with Lewy bodies, the two most prevalent neurocognitive diseases. This paper reviews the signs and symptoms, neuropathology, diagnosis, prognosis, and treatment of Dementia with Lewy bodies (DLB).
Methods: Terms searched included “Lewy body dementia,” “Lewy body disease,” “cognitive disorders,” and “neurodegenerative diseases.” Priority was given to peer-reviewed sources published within the last five years.
Summary: In addition to standard neurocognitive disorder symptoms, patients with DLB present clinically fluctuating cognition, visual hallucinations, and Parkinsonism as well as a variety of other symptoms with lower diagnostic sensitivity. Clinical signs, cognitive assessments, and radiologic imaging are used to diagnose DLB as being distinct from disorders like AD, Parkinson disease dementia (PDD), delirium, and normal aging changes. Interventions for this disease may be pharmacological or non-pharmacological. Pharmacological treatments include cholinesterase inhibitors, Levadopa, and selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors. Non-pharmacological interventions include occupational therapy, cognitive stimulation, and physical activity.
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Rabbani, N., and P. J. Thornalley. "Autism Spectrum Disorders — in Search of Mechanistic Biomarkers." Autism and Developmental Disorders 17, no. 1 (2019): 15–23. http://dx.doi.org/10.17759/autdd.2019170103.
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Autism spectrum disorders are a group of neuropsychiatric conditions of increasing prevalence. They are initially detected in early development of children. Diagnosis is currently made on the basis of clinical behaviour and cognition. Improvements in accuracy, timeliness and access to diagnosis to help manage the condition is high on the agenda of the autistic communities. A blood test may help for early-stage detection of autism spectrum disorders to focus support where required — particularly when symptoms are most challenging. This article discusses briefly the scientific basis of diagnosis of autism spectrum disorders and recent emergence of candidate blood tests for autism. We conclude that further validation and improvements in understanding of autism spectrum disorders are required to provide the scientific basis and classifier characteristics for accurate and reliable diagnosis by clinical chemistry blood test.
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Brand, Bodyl. "S57. CHARACTERIZING COGNITIVE HETEROGENEITY IN INDIVIDUALS WITH A SCHIZOPHRENIA SPECTRUM DISORDER: A CLUSTER ANALYTIC APPROACH." Schizophrenia Bulletin 46, Supplement_1 (April 2020): S54—S55. http://dx.doi.org/10.1093/schbul/sbaa031.123.
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Abstract Background Cognitive impairment is a core symptom of patients with schizophrenia, yet substantial heterogeneity in the degree of impairment exists within and between diagnoses of the schizophrenia spectrum, leading to sub-optimal understanding of the general and individual pathology of schizophrenia. By means of a cluster-analytic approach, individuals are grouped based on profiles of traits regardless of specific diagnoses. As this approach has already proven itself in decreasing cognitive heterogeneity within specific psychotic disorders, we investigated the structure of cognitive heterogeneity within a broader spectrum of psychotic disorders by including a large sample of schizophrenia patients and healthy individuals. Methods An agglomerative hierarchical clustering analysis was performed using cognitive data (patients n = 324, healthy controls n = 40). All patients were diagnosed with a DSM-IV-TR diagnosis of schizophrenia (SZ), schizoaffective (SZA) or schizophreniform (SZP) disorder or another psychotic disorder/psychosis not otherwise specified (PNOS). To measure cognitive function, the composite Z-score was calculated, based on six cognitive domains as defined by the Brief Assessment of Cognition in Schizophrenia (BACS). Results Four clusters emerged from the clustering analysis, gradually and significantly distinguishable in cognitive impairment. The first cluster (n=50) contained relatively intact individuals, the second cluster (n=122) consisted of individuals with minimal to mild cognitive impairment, the third cluster (n=114) contained individuals with moderate cognitive impairment and individuals with most severe cognitive impairment were placed in the fourth cluster (n=78). All six cognitive domains show similar differences between clusters. While symptom severity and educational attainment show the same classification patterns as the neurocognitive profiles do, cluster assignment was not affected by illness duration and antipsychotic intake. Discussion Results confirm that data-driven formed groups based on the clustering of neurocognitive profiles contain less cognitive heterogeneity compared to predefined diagnostic groups. Our results demonstrate that clustering patients with a schizophrenia spectrum disorder based on their neurocognitive profile decreases cognitive heterogeneity within the formed groups, creating more meaningful groupings and findings accentuate a cognitive continuum irrespective of a specific diagnosis, providing insight into the underlying pathology of clinical manifestation of schizophrenia.
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Robillard, Manon, Annie Roy-Charland, and Sylvie Cazabon. "The Role of Cognition on Navigational Skills of Children and Adolescents With Autism Spectrum Disorders." Journal of Speech, Language, and Hearing Research 61, no. 7 (July 13, 2018): 1579–90. http://dx.doi.org/10.1044/2018_jslhr-s-17-0206.
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Purpose This study examined the role of cognition on the navigational process of a speech-generating device (SGD) among individuals with a diagnosis of autism spectrum disorder (ASD). The objective was to investigate the role of various cognitive factors (i.e., cognitive flexibility, sustained attention, categorization, fluid reasoning, and working memory) on the ability to navigate an SGD with dynamic paging and taxonomic grids in individuals with ASD. Method Twenty individuals aged 5 to 20 years with ASD were assessed using the Leiter International Performance Scale–Revised (Roid & Miller, 1997) and the Automated Working Memory Assessment (Alloway, 2007). They also completed a navigational task using an iPad 4 (Apple, 2017; taxonomic organization). Results Significant correlations between all of the cognitive factors and the ability to navigate an SGD were revealed. A stepwise linear regression suggested that cognitive flexibility was the best predictor of navigational ability with this population. Conclusion The importance of cognition in the navigational process of an SGD with dynamic paging in children and adolescents with ASD has been highlighted by the results of this study.
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Schnakers, Caroline, Michaela Hirsch, Enrique Noé, Roberto Llorens, Nicolas Lejeune, Vigneswaran Veeramuthu, Sabrina De Marco, et al. "Covert Cognition in Disorders of Consciousness: A Meta-Analysis." Brain Sciences 10, no. 12 (December 2, 2020): 930. http://dx.doi.org/10.3390/brainsci10120930.
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Covert cognition in patients with disorders of consciousness represents a real diagnostic conundrum for clinicians. In this meta-analysis, our main objective was to identify clinical and demographic variables that are more likely to be associated with responding to an active paradigm. Among 2018 citations found on PubMed, 60 observational studies were found relevant. Based on the QUADAS-2, 49 studies were considered. Data from 25 publications were extracted and included in the meta-analysis. Most of these studies used electrophysiology as well as counting tasks or mental imagery. According to our statistical analysis, patients clinically diagnosed as being in a vegetative state and in a minimally conscious state minus (MCS−) show similar likelihood in responding to active paradigm and responders are most likely suffering from a traumatic brain injury. In the future, multi-centric studies should be performed in order to increase sample size, with similar methodologies and include structural and functional neuroimaging in order to identify cerebral markers related to such a challenging diagnosis.
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Ferretti, Renata Eloah de Lucena, Antonio Eduardo Damin, Sonia Maria Dozzi Brucki, Lilian Schafirovits Morillo, Tibor Rilho Perroco, Flávia Campora, Eliza Guccione Moreira, et al. "Post-Mortem diagnosis of dementia by informant interview." Dementia & Neuropsychologia 4, no. 2 (June 2010): 138–44. http://dx.doi.org/10.1590/s1980-57642010dn40200011.
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Abstract The diagnosis of normal cognition or dementia in the Brazilian Brain Bank of the Aging Brain Study Group (BBBABSG) has relied on postmortem interview with an informant. Objectives: To ascertain the sensitivity and specificity of postmortem diagnosis based on informant interview compared against the diagnosis established at a memory clinic. Methods: A prospective study was conducted at the BBBABSG and at the Reference Center for Cognitive Disorders (RCCD), a specialized memory clinic of the Hospital das Clínicas, University of São Paulo Medical School. Control subjects and cognitively impaired subjects were referred from the Hospital das Clínicas to the RCCD where subjects and their informants were assessed. The same informant was then interviewed at the BBBABSG. Specialists' panel consensus, in each group, determined the final diagnosis of the case, blind to other center's diagnosis. Data was compared for frequency of diagnostic equivalence. For this study, the diagnosis established at the RCCD was accepted as the gold standard. Sensitivity and specificity were computed. Results: Ninety individuals were included, 45 with dementia and 45 without dementia (26 cognitively normal and 19 cognitively impaired but non-demented). The informant interview at the BBBABSG had a sensitivity of 86.6% and specificity of 84.4% for the diagnosis of dementia, and a sensitivity of 65.3% and specificity of 93.7% for the diagnosis of normal cognition. Conclusions: The informant interview used at the BBBABSG has a high specificity and sensitivity for the diagnosis of dementia as well as a high specificity for the diagnosis of normal cognition.
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Tedaldi, Ellen M., Nancy L. Minniti, and Tracy Fischer. "HIV-Associated Neurocognitive Disorders: The Relationship of HIV Infection with Physical and Social Comorbidities." BioMed Research International 2015 (2015): 1–13. http://dx.doi.org/10.1155/2015/641913.
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The prevalence of HIV (human immunodeficiency virus) associated neurocognitive disorders (HAND) will undoubtedly increase with the improved longevity of HIV-infected persons. HIV infection, itself, as well as multiple physiologic and psychosocial factors can contribute to cognitive impairment and neurologic complications. These comorbidities confound the diagnosis, assessment, and interventions for neurocognitive disorders. In this review, we discuss the role of several key comorbid factors that may contribute significantly to the development and progression of HIV-related neurocognitive impairment, as well as the current status of diagnostic strategies aimed at identifying HIV-infected individuals with impaired cognition and future research priorities and challenges.
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Diotte, Felix, Stephane Potvin, Donna Lang, Amal Abdel-Baki, Alicia Spidel, Marie Villeneuve, and Tania Lecomte. "Comparison of Methamphetamine Induced Psychosis and Primary Psychotic Disorder: Scoping Review of Social Cognition." Journal of Mental Health & Clinical Psychology 6, no. 2 (March 24, 2022): 1–18. http://dx.doi.org/10.29245/2578-2959/2022/2.1144.
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As many as 43% of methamphetamine users will have a psychotic episode in their lifetime. Of these, 30% will develop a primary psychotic disorder, such as schizophrenia. The current state of the literature does not currently allow us to determine who will develop a primary psychotic disorder following a methamphetamine-induced psychosis (MIPD). This distinction is important, since people with a first episode of a psychotic disorder need specific and rapid treatments to ensure optimal recovery. Social cognition could help predict distinct profiles. The aim of this scoping review is to evaluate the literature in order to extract the differences between MIPD and primary psychotic disorders in the domain of social cognition. Articles were recovered from PsychINFO, Medline and Web of science and were retained if they met the following inclusion criteria: (a) original research or meta-analyses, (b) complete or partial sample with a psychotic disorder diagnosis with comorbid methamphetamine use, or MIPD, (c) studies focusing on the difference between a methamphetamine-induced psychosis and a primary psychotic disorder, and (d) studies focusing on social cognition in psychotic or methamphetamine using population. A total of 17 articles were identified, with none directly aiming at distinguishing MIPD and primary psychotic disorder using social cognition. Future studies on social cognition are needed in order to determine differences in the severity of deficits between the two profiles.
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López-Carrilero, Raquel, Sara Mendoza-Garcia, Irene Birulés, Ana Barajas, Esther Lorente, Antonio Gutierrez-Zotes, Eva Grasa, et al. "T120. INFLUENCE OF MATERNAL AND PATERNAL HISTORY IN SYMPTOMS, COGNITION AND METACOGNITION IN PEOPLE WITH FIRST-EPISODE PSYCHOSIS." Schizophrenia Bulletin 46, Supplement_1 (April 2020): S276. http://dx.doi.org/10.1093/schbul/sbaa029.680.
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Abstract Background Previous studies have found that the best predictor of individual risk when developing one or several mental and neurocognitive disorders is family history of mental disorder, more specifically, first degree relatives. The estimated risk of developing schizophrenia is of approximately 10% in individuals that present a paternal or maternal risk of psychosis, increasing to a 50% if both parents are affected; in comparison to a 1% risk in general population (Hall, 1994; Hannon et al., 2016). Having a first-degree family member with psychosis is the best individual risk predictor in developing mental or neurocognitive disorders (Bhatia et al., 2016; Thorup et al., 2018). However, literature exploring the role of family history of psychosis on symptoms, cognition, social cognition and metacognition in first-episode of psychosis (FEP) is scarce, and there is a dearth of studies examining the influence of the maternal and paternal history of psychosis independently. Methods The main aim of the present study is to assess the clinical, cognitive, social cognitive and metacognitive variables in people with FEP with family risk, considering the maternal and paternal history of mental disorder separately. As secondary aims, we will assess the clinical, cognitive, social cognition and metacognition variables considering the presence of a maternal and paternal history of psychosis. Methods A transversal, descriptive, observational design was chosen for this study. The sample was composed of people with a recent onset of psychosis, recruited from 10 public centers in Spain. We recruited 186 individuals with FEP between 18 and 45 years of age. We collected information about the diagnosis of mother and father with mental disorders. Symptoms were assed with the PANSS. A battery of questionnaires on metacognition and social cognition variables was included. Neurocognitive functioning was measured. The statistical analysis was done using SPSS. Results Individuals with a maternal history of a mental disorder showed higher scores in delusional experiences (p=0.004) and scored lower in general functioning as measured by the GAF (p=0.029). The individuals with the presence of a maternal history of psychosis scored significantly higher in the positive subscale of the PANSS (p=0.030). Individuals with a paternal history of psychotic disorder scored worse in high expectations and the need for adapting to the others and they had a greater presence of externalizing bias than those without a paternal history (p=0.026). Discussion Results yield that there is a higher prevalence of a maternal history of psychosis than the paternal history of psychosis, and furthermore, these individuals exhibit a specific clinical, cognitive, social and metacognitive profile. This study raises awareness on the different profiles of persons with first-episode psychosis and the influence of the family history on clinical, cognitive, social and metacognitive variables, which should be taken into account when offering individualized early treatment.
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Giménez, Sandra, Miren Altuna, Esther Blessing, Ricardo M. Osorio, and Juan Fortea. "Sleep Disorders in Adults with Down Syndrome." Journal of Clinical Medicine 10, no. 14 (July 6, 2021): 3012. http://dx.doi.org/10.3390/jcm10143012.
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Sleep disorders, despite being very frequent in adults with Down syndrome (DS), are often overlooked due to a lack of awareness by families and physicians and the absence of specific clinical sleep guidelines. Untreated sleep disorders have a negative impact on physical and mental health, behavior, and cognitive performance. Growing evidence suggests that sleep disruption may also accelerate the progression to symptomatic Alzheimer’s disease (AD) in this population. It is therefore imperative to have a better understanding of the sleep disorders associated with DS in order to treat them, and in doing so, improve cognition and quality of life, and prevent related comorbidities. This paper reviews the current knowledge of the main sleep disorders in adults with DS, including evaluation and management. It highlights the existing gaps in knowledge and discusses future directions to achieve earlier diagnosis and better treatment of sleep disorders most frequently found in this population.
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Lynham, Amy Joanne, Ian R. Jones, and James T. R. Walters. "Web-Based Cognitive Testing in Psychiatric Research: Validation and Usability Study." Journal of Medical Internet Research 24, no. 2 (February 10, 2022): e28233. http://dx.doi.org/10.2196/28233.
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Background Cognitive impairments are features of many psychiatric disorders and affect functioning. A barrier to cognitive research on psychiatric disorders is the lack of large cross-disorder data sets. However, the collection of cognitive data can be logistically challenging and expensive. Web-based collection may be an alternative; however, little is known about who does and does not complete web-based cognitive assessments for psychiatric research. Objective The aims of this study are to develop a web-based cognitive battery for use in psychiatric research, validate the battery against the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery, and compare the characteristics of the participants who chose to take part with those of the individuals who did not participate. Methods Tasks were developed by The Many Brains Project and selected to measure the domains specified by the MATRICS initiative. We undertook a cross-validation study of 65 participants with schizophrenia, bipolar disorder, depression, or no history of psychiatric disorders to compare the web-based tasks with the MATRICS Consensus Cognitive Battery. Following validation, we invited participants from 2 large ongoing genetic studies, which recruited participants with psychiatric disorders to complete the battery and evaluated the demographic and clinical characteristics of those who took part. Results Correlations between web-based and MATRICS tasks ranged between 0.26 and 0.73. Of the 961 participants, 887 (92.3%) completed at least one web-based task, and 644 (67%) completed all tasks, indicating adequate completion rates. Predictors of web-based participation included being female (odds ratio [OR] 1.3, 95% CI 1.07-1.58), ethnicity other than White European (OR 0.66, 95% CI 0.46-0.96), higher levels of education (OR 1.19, 95% CI 1.11-1.29), diagnosis of an eating disorder (OR 2.17, 95% CI 1.17-4) or depression and anxiety (OR 5.12, 95% CI 3.38-7.83), and absence of a diagnosis of schizophrenia (OR 0.59, 95% CI 0.35-0.94). Lower performance on the battery was associated with poorer functioning (B=−1.76, SE 0.26; P<.001). Conclusions Our findings offer valuable insights into the advantages and disadvantages of testing cognitive function remotely for mental health research.
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Mughal, Rabya, Catherine M. Hill, Anna Joyce, and Dagmara Dimitriou. "Sleep and Cognition in Children with Fetal Alcohol Spectrum Disorders (FASD) and Children with Autism Spectrum Disorders (ASD)." Brain Sciences 10, no. 11 (November 16, 2020): 863. http://dx.doi.org/10.3390/brainsci10110863.
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Children with Fetal Alcohol Spectrum Disorders (FASD) and Autism Spectrum Disorders (ASD) experience significantly higher rates of sleep disturbances than their typically developing peers. However, little is known about the association between sleep and the cognitive phenotype in these clinical populations. Structural damage affecting cortical and subcortical connectivity occurs as a result of prenatal alcohol exposure in children with FASD, whilst it is believed an abundance of short-range connectivity explains the phenotypic manifestations of childhood ASD. These underlying neural structural and connectivity differences manifest as cognitive patterns, with some shared and some unique characteristics between FASD and ASD. This is the first study to examine sleep and its association with cognition in individuals with FASD, and to compare sleep in individuals with FASD and ASD. We assessed children aged 6–12 years with a diagnosis of FASD (n = 29), ASD (n = 21), and Typically Developing (TD) children (n = 46) using actigraphy (CamNTech Actiwatch 8), digit span tests of working memory (Weschler Intelligence Scale), tests of nonverbal mental age (MA; Ravens Standard Progressive Matrices), receptive vocabulary (British Picture Vocabulary Scale), and a choice reaction time (CRT) task. Children with FASD and ASD presented with significantly shorter total sleep duration, lower sleep efficiency, and more nocturnal wakings than their TD peers. Sleep was significantly associated with scores on the cognitive tests in all three groups. Our findings support the growing body of work asserting that sleep is significant to cognitive functioning in these neurodevelopmental conditions; however, more research is needed to determine cause and effect.
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Ridenour, Jeremy M., Katie C. Lewis, John M. Poston, and Destiny N. Ciecalone. "Performance-Based Assessment of Social Cognition in Borderline Versus Psychotic Psychopathology." Rorschachiana 40, no. 2 (December 1, 2019): 95–111. http://dx.doi.org/10.1027/1192-5604/a000114.
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Abstract. Individuals diagnosed with borderline personality disorder (BPD) and schizophrenia spectrum disorders (SSD) are known to display deficits in social cognition (SC). Our sample comprised 81 patients enrolled in residential treatment for complex psychopathology. We used performance-based assessments to test the hypothesis that individuals with SSD would display decrements on the cognitive/perceptual facets of SC, whereas individuals with BPD would evidence greater dysfunction on the affective/interpersonal facets of SC, with consideration taken for how gender may interact with diagnosis to influence results. Our findings suggested that women with SSD displayed more impaired understanding of social causality compared with their female BPD counterparts, while female patients with BPD evidenced greater expectation for aggression in their SC compared with women with SSD. These findings provide partial support for our hypotheses while highlighting the importance of accounting for the influence of gender on SC functional disparities between these two groups.
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Olichney, John, Jiangyi Xia, Kevin J. Church, and Hans J. Moebius. "Predictive Power of Cognitive Biomarkers in Neurodegenerative Disease Drug Development: Utility of the P300 Event-Related Potential." Neural Plasticity 2022 (November 8, 2022): 1–13. http://dx.doi.org/10.1155/2022/2104880.
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Neurodegenerative diseases, such as Alzheimer’s disease (AD), and their associated deterioration of cognitive function are common causes of disability. The slowly developing pathology of neurodegenerative diseases necessitates early diagnosis and monitored long-term treatment. Lack of effective therapies coupled with an improved rate of early diagnosis in our aging population have created an urgent need for the development of novel drugs, as well as the need for reliable biomarkers for treatment response. These issues are especially relevant for AD, in which the rate of clinical trial drug failures has been very high. Frequently used biomarker evaluation procedures, such as positron emission tomography or cerebrospinal fluid measurements of phospho-tau and amyloid beta, are invasive and costly, and not universally available or accessible. This review considers the functionality of the event-related potential (ERP) P300 methodology as a surrogate biomarker for predicting the procognitive potential of drugs in clinical development for neurocognitive disorders. Through the application of standardized electroencephalography (EEG) described here, ERP P300 can be reliably measured. The P300 waveform objectively measures large-scale neuronal network functioning and working memory processes. Increased ERP P300 latency has been reported throughout the literature in disorders of cognition, supporting the potential utility of ERP P300 as a biomarker in many neurological and neuropsychiatric disorders, including AD. Specifically, evidence presented here supports ERP P300 latency as a quantitative, unbiased measure for detecting changes in cognition in patients with AD dementia through the progression from mild to moderate cognitive impairment and after drug treatment.
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Rockwood, Kenneth, Heather Davis, Chris MacKnight, Robert Vandorpe, Serge Gauthier, Antonio Guzman, Patrick Montgomery, et al. "The Consortium to Investigate Vascular Impairment of Cognition: Methods and First Findings." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 30, no. 3 (August 2003): 237–43. http://dx.doi.org/10.1017/s0317167100002663.
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Background:The Consortium to Investigate Vascular Impairment of Cognition (CIVIC) is a Canadian, multi-centre, clinic-based prospective cohort study of patients with Vascular Cognitive Impairment (VCI). We report its organization and the impact of diagnostic criteria on the study of VCI.Methods:Nine memory disability clinics enrolled patients and recorded their usual investigations and care. A case report form included all vascular dementia (VaD) individual criteria for each of four sets (National Institute of Neurological Disorders and Stroke (NINDS-AIREN), Alzheimer’s Disease Diagnostic Treatment Centers (ADDTC), the ICD-10 Classification of Mental and Behavioural Disorders (ICD-10), and the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)) of consensus-based diagnostic criteria and for the Hachinski Ischemia Score (HIS). Investigators, having completed the case report form, were asked to make a clinical judgement about the cognitive diagnosis based on the best available information, including neuroimaging.Results:Of 1,347 patients (mean age 72 years; 56% women), 846 (63%) were diagnosed with dementia and 324 (24%) were diagnosed with VCI. The proportion of patients diagnosed with VaD by the diagnostic criteria was: 23.9% (n=322) by DSM-IV, 10.2% (n=137) by HIS, 4.3% (n=58) by ICD-10, 3.8% (n=51) by ADTCC, and 3.6% (n=48) by NINDS-AIREN. Judged against a clinical diagnosis of VaD, the sensitivity/specificity of each was: DSM-IV (0.77/0.80); HIS (0.41/0.92); ICD-10 (0.29/0.98); ADTCC (0.24/0.98); NINDS-AIREN (0.42/0.995). Compared with a clinical diagnosis of VCI, sensitivities were lower for the diagnostic criteria, reflecting the exclusion of patients who did not have dementia.Conclusions:Consensus-based criteria for VaD omit patients who do not meet dementia criteria that are modeled on Alzheimer’s disease. Even for patients who do, the proportion identified with VaD varies widely. Criteria based on empirical analyses need to be developed and validated.
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Mairs, Rebecca, and Dasha Nicholls. "Assessment and treatment of eating disorders in children and adolescents." Archives of Disease in Childhood 101, no. 12 (June 28, 2016): 1168–75. http://dx.doi.org/10.1136/archdischild-2015-309481.
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Feeding and eating disorders (FEDs) are serious mental health disorders that cause impairments in physical health, development, cognition and psychosocial function and can go undetected for months or years. They are characterised by disturbed eating behaviour associated with concerns about weight and shape or by disinterest in food, phobic avoidance or avoidance due to sensory aspects of food. Restrictive forms of FEDs lead to significant weight loss requiring intervention. Without specific knowledge of these conditions, they can evade detection, delaying time to diagnosis and treatment and potentially influencing outcome. This review article focuses on the key factors involved in the psychiatric assessment and treatment of four feeding or eating disorders (EDs): anorexia nervosa, avoidant-restrictive food intake disorder, bulimia nervosa and binge eating disorder. They have been chosen for discussion as they are most likely to be encountered in both a psychiatric and paediatric setting. It emphasises the importance of a family-focused, developmentally appropriate and multidisciplinary approach to care. It does not address aspects of medical assessment and treatment. Other feeding or EDs not included in this article are pica, rumination disorder, other specified feeding and eating disorder and unspecified feeding and eating disorder.
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Morais, J., and S. Fonseca. "Cognitive conversion disorder (functional cognitive disorder) – what’s new?" European Psychiatry 64, S1 (April 2021): S188. http://dx.doi.org/10.1192/j.eurpsy.2021.498.
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IntroductionSome patients present with significant subjective cognitive symptoms, sometimes interfering with day-to-day live, that are not compatible with any recognizable psychiatric, neurodegenerative or systemic condition. Recent studies have proposed that these patients can be diagnosed with Conversion Disorder (Subtype Cognitive), also known as Functional Cognitive Disorder (FCD). This is a relatively recent concept, that still lacks consensus.ObjectivesReview the current state of knowledge regarding prevalence, diagnosis criteria, core clinical features and proposed treatment of Functional Cognitive Disorder.MethodsBibliographic review of the literature published in English in the last 5 years, in the databases Pubmed, PsycINFO and Cochrane. The keywords used were: Functional Cognitive Disorder; Cognition; Conversion Disorder. A review of the titles and abstracts of the resulting articles was made, and selected according to their relevance to the study.ResultsTen articles related to prevalence, diagnosis, clinical associations and treatment of Functional Cognitive Disorder were selected, of which two were systematic reviews, three descriptive studies, three cross sectional clinical studies of memory clinics attendants, one cohort prospective study and one article was a case series report.ConclusionsThe prevalence of FCD is estimated between 11.6% and 56% of patients presenting to memory clinics. However, the prevalence of FCD is hindered by the lack of consensus regarding its definition. Recently, Ball et al proposed a definition in line with the DSM-5 definition of Conversion Disorder with emphasis on positive criteria with the identification of positive evidence of internal inconsistency. Treatment discussion is still limited, and the approach is similar to other conversion disorders.
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TAVARES, J. V. TAYLOR, W. C. DREVETS, and B. J. SAHAKIAN. "Cognition in mania and depression." Psychological Medicine 33, no. 6 (July 31, 2003): 959–67. http://dx.doi.org/10.1017/s0033291703008432.
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The inclusion of cognitive symptoms in the DSM-IV criteria for major depressive and manic episodes highlight the importance of cognition in both of these psychiatric disorders (American Psychiatric Association, 1994). For example, criteria for diagnosis of these conditions include a diminished ability to concentrate and indecisiveness. In addition, numerous studies have demonstrated wide-ranging cognitive deficits in depression (for example Elliott et al. 1996; Purcell et al. 1997; Murphy et al. 2003) and mania (Goldberg et al. 1993; Murphy et al. 1999, 2001; Sweeney et al. 2000). These include deficits in early information processing (Tsourtos et al. 2002), recollection memory (MacQueen et al. 2002) and planning (Elliott et al. 1996) as well as affective biases (Murphy et al. 1999) and abnormal responses to negative feedback (Elliott et al. 1996, 1997; Murphy et al. 2003). Some residual deficits are also evident in a proportion of remitted subjects, even when controlling for mood (for example, Clark et al. 2002).
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Kn, Poornima. "MIGRAINE: A POSSIBLE CAUSE FOR COGNITIVE DECLINE." Asian Journal of Pharmaceutical and Clinical Research 10, no. 5 (May 1, 2017): 228. http://dx.doi.org/10.22159/ajpcr.2017.v10i5.17436.
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Objectives:Migraine is the second most common type of headache and seventh most disabling disease worldwide. In general, obesity is often related to headache disorders in several clinical and epidemiologic studies. Obese migraine patients may have an increased attack frequency due to increase in inflammatory response. Cognitive decline is the major pitfall of migraine disorder and there exists a conflicting result between cognition and migraine and the effect of Body Mass Index (BMI) on migraine. So this study is done to find out the relationship between cognition and migraine and its association with BMI.Methods:The study protocol was approved by the ethical committee of SRM Medical College Hospital & Research Centre. The study group consisted of 30 migraine patients and 30 healthy controls aged between 18-40 years of age. Informed consent was obtained from all the participants. Diagnosis of migraine was made using the criteria of 2nd edition of International Headache Classification (IHC). Patients affected by Diabetes mellitus, Hypertension, allergy, inflammation, infection or immune disorders were excluded. Height and weight of the subjects were taken to calculate the BMI. Cognitive tests such as stroop interference trial & trial making tests (A&B) were done to evaluate working memory, mental flexibility and attention.Results:Compared to controls, cases took more time for performing stroop colour card test (106.40 ± 15.87 seconds vs. 132.17±7.027seconds, p<0.001) and trial making pattern B (54.77± 8.169 seconds vs. 56.23 ± 23.457seconds, p=0.004). Among the migraine subjects, obese individuals had an increased frequency of migraine attack per month (Correlation coefficient r=0.797)Conclusion:Cognitive decline in migraine is one of the underestimated problems in migraine. Identifying such problems early can prevent major consequences in day to day activities of migraine patients. Since there is an increased frequency of migraine with increase in BMI, obese migraine subjects can be recommended to do regular exercises.Key words: Migraine, Cognition, Stroop test, Obesity.
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Morais, A. S., R. Gomes, and N. Descalço. "Lost in Translation – What is Alexithymia." European Psychiatry 65, S1 (June 2022): S218. http://dx.doi.org/10.1192/j.eurpsy.2022.568.
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Introduction Alexithymia is considered a personality trait characterized by difficulties in identifying and expressing emotions, impoverished fantasy life and tendency toward action-oriented or ‘operational’ Thinking. There are alterations in cognitive processing and regulation of emotions, and tendency to somatization. Objectives The authors examine literature regarding the concept of alexithymia, exploring the current definition and role in the clinic, research findings and proposed management. Methods A brief non-systematized review is presented, using the literature available on PubMed and Google Scholar. Results Alexithymia is not a discrete psychiatric diagnosis. It has been reported in 9-10% of the general population. It is related to numerous psychiatric disorders (substance use disorders, anxiety disorders, depression and eating disorders), but also to somatic illnesses (essential hypertension, functional gastrointestinal disorders, diabetes mellitus, psoriasis, fibromyalgia and cancer pain). Neuroimaging and neurobiological studies found evidence for morphological and functional brain alterations that integrate the classification introduced by Bermond. Affective type I is characterized by the absence of emotional experience and, consequently, by the absence of cognition accompanying the emotion (associated to right unilateral cortical lesions). Cognitive Type II is characterized by a selective deficit of emotional cognition with sparing of emotional experience (associated to a right-to-left unidirectional deficit in interhemispheric transfer). Conclusions There is little consensus on the subject. Clarification of the mechanisms underlying alexithymia can improve our management of these individuals. Identification of effective strategies could improve the patients’ capacities for adaptive emotional processing and enhance other aspects of functioning. Disclosure No significant relationships.
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Saletu, Bernd, Peter Anderer, Gerda M. Saletu-Zyhlarz, and Roberto D. Pascual-Marqui. "EEG Mapping and Low-Resolution Brain Electromagnetic Tomography (LORETA) in Diagnosis and Therapy of Psychiatric Disorders: Evidence for a Key-Lock Principle." Clinical EEG and Neuroscience 36, no. 2 (April 2005): 108–15. http://dx.doi.org/10.1177/155005940503600210.
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Different psychiatric disorders, such as schizophrenia with predominantly positive and negative symptomatology, major depression, generalized anxiety disorder, agoraphobia, obsessive-compulsive disorder, multi-infarct dementia, senile dementia of the Alzheimer type and alcohol dependence, show EEG maps that differ statistically both from each other and from normal controls. Representative drugs of the main psychopharmacological classes, such as sedative and non-sedative neuroleptics and antidepressants, tranquilizers, hypnotics, psychostimulants and cognition-enhancing drugs, induce significant and typical changes to normal human brain function, which in many variables are opposite to the above-mentioned differences between psychiatric patients and normal controls. Thus, by considering these differences between psychotropic drugs and placebo in normal subjects, as well as between mental disorder patients and normal controls, it may be possible to choose the optimum drug for a specific patient according to a keylock principle, since the drug should normalize the deviant brain function. This is supported by 3–dimensional low-resolution brain electromagnetic tomography (LORETA), which identifies regions within the brain that are affected by psychiatric disorders and psychopharmacological substances.
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Gupta, Aman, and Aashish Gambhir. "PET CT Brain for the Differential Diagnosis of Dementia -Indian Case Reports." Open Neurology Journal 14, no. 1 (September 22, 2020): 68–73. http://dx.doi.org/10.2174/1874205x02014010068.
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India has been termed as Diabetic hub of the globe. Along with other complications, one of the underestimated complication is cognitive decline and memory loss associated with poor diabetes control. In the Indian context, structural imaging like MRI-Magnetic Resonance imaging is more commonly used in Neurological disorders such as stroke, head injury, Functional imaging of the human brain has been underutilized in the Indian scenario. One such technique is PET CT which has been typically used as a cancer biomarker in India. By virtue of current case study, we propose i) association between poor control of Diabetes and poor cognition ii) role of PET CT brain in differential diagnosis of Dementia. We present two case reports providing strong findings for utilization of PET CT brain in Dementia protocols.
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Lozupone, M., F. Veneziani, L. Lofano, I. Galizia, E. Stella, M. Copetti, S. Arcuti, et al. "Educational level influenced the gold standard diagnosis of late-life depression in the GreatAGE study." European Psychiatry 41, S1 (April 2017): S173. http://dx.doi.org/10.1016/j.eurpsy.2017.01.2068.
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IntroductionThe validity of the 30-item Geriatric Depression Scale (GDS-30) in detecting late-life depression (LLD) requires a certain level of cognitive functioning. Further research is needed in population-based setting on other socio-demographic and cognitive variables that could potentially influence the accuracy of clinician rated depression.ObjectiveTo compare the diagnostic accuracy of two instruments used to assess depressive disorders [(GDS-30) and the Semi-structured Clinical Diagnostic Interview for DSM-IV-TR Axis I Disorders (SCID)] among three groups with different levels of cognitive functioning (normal, Mild Cognitive Impairment – MCI, Subjective Memory Complain – SMC) in a random sampling of the general population 65+ years.MethodsThe sample, collected in a population-based study (GreatAGE Study) among the older residents of Castellana Grotte, South-East Italy, included 844 subjects (54.50% males). A standardized neuropsychological battery was used to assess MCI, SMC and depressive symptoms (GDS-30). Depressive syndromes were diagnosed through the SCID IV-TR. Socio-demographic and cognitive variables were taken into account in influencing SCID performance.ResultsAccording to the SCID, the rate of depressive disorders was 12.56%. At the optimal cut-off score (≥ 4), GDS-30 had 65.1% sensitivity and 68.4% specificity in diagnosing depressive symptoms. Using a more conservative cut-off (≥ 10), the GDS-30 specificity reached 91.1% while sensitivity dropped to 37,7%. The three cognitive subgroups did not differ in the rate of depression diagnosis. Educational level is the only variable associated to the SCID diagnostic performance (P = 0.015).ConclusionsAt the optimal cut-off, GDS-30 identified lower levels of screening accuracy for subjects with normal cognition rather than for SMC (AUC 0.792 vs. 0.692); educational attainment possibly may modulate diagnostic clinician performance.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Swanson, Keith A., and Ryan M. Carnahan. "Dementia and Comorbidities: An Overview of Diagnosis and Management." Journal of Pharmacy Practice 20, no. 4 (August 2007): 296–317. http://dx.doi.org/10.1177/0897190007308594.
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The term “dementia” describes various neurodegenerative disorders that effect cognition, including Alzheimer disease, vascular dementia, and others. This article reviews the diagnosis and management of common types of dementia and comorbidities. Dementias are differentiated clinically by history, symptom presentation, and exclusion of other causes through laboratory and imaging studies. Cholinesterase inhibitors are useful but may not be effective for all types of dementia and provide only modest benefits. Certain medical comorbidities may increase the risk of dementia, although genetics are also important in its etiology. Psychiatric comorbidities in dementia include delirium, which is treated primarily by addressing underlying medical disorders, but antipsychotics can be useful for symptom management and patient comfort. Nonpharmacologic interventions are first-line treatments for other psychiatric comorbidities, although drug therapy may be useful in some cases. The management of patients with dementia presents many challenges and will continue to do so unless agents with pronounced disease-modifying capabilities are developed.
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Jang Chung, Sung. "SELF-CONTROLS BRAIN ACTIVITY BY INTERACTING WITH PREFRONTAL CORTEX: FMRI STUDY IN NORMALCY AND PSYCHIATRIC DISORDERS." EPH - International Journal of Medical and Health Science 4, no. 3 (July 8, 2018): 17–25. http://dx.doi.org/10.53555/eijmhs.v4i3.39.
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The relationship among self, mind and brain is not clearly known. Self’s subjective experiences of perception and cognition of words, feelings, thoughts etc. is supported by the integrity of human brain. The relationship between the self and the human brain activity is not understood. Recent experimental evidence suggests that the neural correlate of consciousness is located in certain parts of the corticothalamic system. However, it is not known specifically which parts of the human brain are involved in the human cognitive activity. Functional magnetic resonance imaging (fMRI) has been used in the study of normalcy and psychiatric disorders. FMRI is applied in diagnosis and drug treatment of psychiatric disorders. In this study, the author analyzed results of published articles related to the above described fields to find the relationship among self, mind and body, and proposed the mechanism involved in the self, mind and brain in normalcy and psychiatric disorders.
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Rapin, Isabelle. "Hearing Disorders." Pediatrics In Review 14, no. 2 (February 1, 1993): 43–49. http://dx.doi.org/10.1542/pir.14.2.43.
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Definition Hearing is the usual channel for acquisition of this most important of human attributes, language. Language enables humans to communicate at a distance and across time and has played a decisive role in the development of society and its many cultures. Language is the major channel through which children learn about what is not immediately evident, and it plays a central role in thinking and cognition. Because speech is the chief vehicle for communication in all families (except those in which the parents are deaf), deafness is a profound handicap whose effects greatly transcend the inability to speak. Responsibility for detecting hearing loss in infancy rests on the primary physician, inasmuch as early diagnosis and appropriate habilitation will prevent the most serious consequences of infantile hearing loss: growing up without language. Two primary types of hearing loss are attributable to disease of the ear: conductive hearing loss, a deficiency in the transduction of energy in the form of sound waves in air to hydraulic waves in the inner ear; and sensorineural hearing loss, inadequate transduction of these waves to neural activity. Other disorders of hearing include cortical hearing impairment and perceptual disorders. Although much is said about perceptual disorders by educators, such disorders probably play a minor role in the genesis of learning disabilities and will not be addressed in this review, which focuses on severe-to-profound hearing losses.
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Moskovko, S. P., G. S. Moskovko, M. I. Andriievska, and Ya V. Spivak. "PECULIARITIES OF COMORBID PAIN SYNDROME AND COGNITIVE DYSFUNCTION IN PATIENTS WITH MULTIPLE SCLEROSIS." Актуальні проблеми сучасної медицини: Вісник Української медичної стоматологічної академії 20, no. 4 (December 30, 2020): 216–24. http://dx.doi.org/10.31718/2077-1096.20.4.216.
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In this paper, we reviewed scientific sources on multiple sclerosis, analyzed the latest data on the peculiarities of cognitive dysfunction and comorbid pain syndrome in patients with multiple sclerosis. Multiple sclerosis belongs to the group of chronic progressive demyelinating diseases with a predominant lesion of the central nervous system. It affects over 2.5 million people worldwide and is considered as one of the most disabling neurological disorders. Symptoms range from physical ones including loss of vision, spasticity, bladder and bowel dysfunction, problems with walking and balance, fatigue and pain, to mental problems such as cognitive impairment, depression, and anxiety. Comorbid conditions have a significant impact on the quality of life of patients with multiple sclerosis. This evokes considerable scientific interest, since their presence can cause a delay in diagnosis, change the progression of neurological deficits, reduce physical activity and increase the severity of symptoms of the underlying disease. One of the most common comorbid conditions associated with multiple sclerosis is pain. The prevalence of pain syndrome ranges from 29% to 86%. Patients can consider pain as one of the first symptoms of multiple sclerosis. Moreover, in the treatment and diagnosis of multiple sclerosis, in most cases, the state of cognition is missed or neglected, but it always accompanies the patients in the form of cognitive disorders of varying severity. Cognitive function is understood as the most complex mechanism by which the process of rational cognition of the environment and interaction with it is carried out. Both a series of cognitive tests for multiple sclerosis and an MRI evaluation of gray matter atrophy can help to assess the state of cognition. Also, an additional diagnostic method is transcranial magnetic stimulation, with which it is possible to create a model for mapping the cerebral cortex using evoked motor potentials. Thus, the analysis of the literature has shown that the issues of the influence of comorbidity and cognitive dysfunction on the course of multiple sclerosis, the relationship of the onset of multiple sclerosis with comorbid conditions, and the correlation of neurological deficit with the cognitive ability of patients are not studied completely yet.
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Correia, Pamela, Roopal Panchani, Rajeev Ranjan, and Chandrashekhar Agrawal. "Insulinoma presenting as refractory seizure disorder." F1000Research 1 (September 21, 2012): 15. http://dx.doi.org/10.12688/f1000research.1-15.v1.
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Hypoglycaemia can lead to acute disorders of cognition, consciousness, epilepsy, transient ischemia, psychosis and chronic disorders of dementia and neuropathy. Misdiagnosis and delay in treatment are common and prolonged hypoglycemia can lead to permanent neurological deficit or fatal coma. Hypoglycemia caused by an insulinoma is a readily treatable condition that should be considered in the differential diagnosis of intractable seizures. The following case report highlights the need for careful reassessment of all seizures that are atypical and refractory to medication.
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Drost, Rolinda, Albert Postma, and Erik Oudman. "Cognitive and affective theory of mind in Korsakoff’s syndrome." Acta Neuropsychiatrica 31, no. 03 (December 18, 2018): 128–34. http://dx.doi.org/10.1017/neu.2018.35.
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AbstractObjectiveKorsakoff’s syndrome (KS) is a chronic neuropsychiatric disorder characterised by severe anterograde amnesia and executive deficits. Theory of Mind (ToM) is the capacity to represent others’ mental states such as their knowledge, thoughts, feelings, beliefs, and intentions in order to explain and predict their behaviour. Surprisingly this topic has received hardly any attention in research on KS, although the severity of behavioural problems in KS suggest possible ToM difficulties. The aim of the present study was therefore to assess whether cognitive and affective ToM are impaired in patients with KS.MethodsWe examined 21 KS patients and 21 age- and gender-matched healthy controls on three standardised tests that assess cognitive and affective ToM, including the subtests of the mini-Social Cognition and Emotional Assessment battery and a specialised version of the Sally–Anne Test.ResultsKS patients showed largely impaired cognitive and affective ToM compared to healthy controls, as reflected in large effect sizes on both cognitive and affective ToM tests. Executive deficits explained problems in emotion recognition, but not other ToM aspects.ConclusionKS patients have large impairments in both cognitive and affective aspects of social cognition. Their ability to recognise emotions, take the perspective of others, and understand socially awkward situations is vastly compromised. The impairments in ToM functioning are to a large degree functionally discrepant from executive disorders that are commonly present in KS. This study therefore highlights the importance to properly index ToM functioning in neuropsychological assessments for individuals with a possible KS diagnosis.
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Larner, Andrew J. "Free-Cog: Pragmatic Test Accuracy Study and Comparison with Mini-Addenbrooke’s Cognitive Examination." Dementia and Geriatric Cognitive Disorders 47, no. 4-6 (2019): 254–63. http://dx.doi.org/10.1159/000500069.
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Background/Aims: Canonical definitions of the dementia construct encompass deficits in both cognition and function, but most screening instruments for possible dementia address only cognitive abilities. Free-Cog is a recently described brief screening instrument for dementia designed to address not only cognitive but also functional abilities. Methods: A pragmatic test accuracy study of Free-Cog was undertaken in consecutive patients seen over 1 year in a secondary care setting. The performance of Free-Cog for diagnosis of dementia and mild cognitive impairment (MCI) was compared to that of Mini-Addenbrooke’s Cognitive Examination (MACE). Results: In a cohort of 141 patients (prevalence of dementia and MCI 11 and 32%, respectively) both Free-Cog and MACE were quick and easy to use and acceptable to patients. Both tests had high sensitivity (1.00) and large effect sizes (Cohen’s d) for diagnosis of dementia, but Free-Cog was more specific. For diagnosis of MCI, Free-Cog lacked sensitivity (0.58) but was specific (0.81), whereas MACE was sensitive (0.91) but not specific (0.35). Weighted comparison suggested equivalence for dementia diagnosis but a net benefit for MACE regarding MCI diagnosis. Conclusion: Free-Cog is an acceptable and accurate test for dementia screening in a dedicated cognitive disorders clinic, but it appears less sensitive than MACE for the identification of MCI.
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Virgilio, Eleonora, Valentina Solara, Maria Francesca Sarnelli, Domizia Vecchio, and Cristoforo Comi. "Early Successful Eye Movement Desensitization and Reprocessing (EMDR) Therapy for Verbal Memory Impairment in an Adjustment Disorder: A Case Report in a Newly-Diagnosed Multiple Sclerosis Patient." Reports 5, no. 2 (May 25, 2022): 17. http://dx.doi.org/10.3390/reports5020017.
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Multiple sclerosis (MS) is a chronic inflammatory disease of the immune system affecting the central nervous system. Several phenotypes are possible, and cases usually present with a relapsing-remitting (RR) course with disease onset at a young age. MS diagnosis can represent a traumatic event for the patient, possibly evolving into adjustment disorder (AD). AD is defined by the presence of emotional or behavioral symptoms in response to identifiable stress occurring within the prior three months and similarly to post-traumatic stress disorder (PTSD) can significantly affect quality of life. Usually, neuropsychological disorders are not associated with AD. Several treatments are available for AD, and among them, eye movement desensitization and reprocessing (EMDR) is one of the most effective in relieving depression and anxiety. However, little is known about AD and PTSD in the MS population and no data are available on the effectiveness of EMDR for cognitive impairment associated with AD. We describe a 25-year-old patient with RR MS developing an AD with a verbal memory deficit after being diagnosed. Both the psychological and cognitive deficits were diagnosed using an extensive neuropsychological battery. Considering the high impact of the verbal memory deficit, on the patient’s quality of life, an EMDR intervention was planned. After a six-month EMDR intervention performed by two trained neuropsychologists, the patient was retested. There was an improvement in verbal memory tests and depression anxiety scales and the Dissociative Experiences Scale. It is recognized that emotional changes and psychiatric disorders, frequently affect MS patients at diagnosis. It is imperative to recognize this and promptly set a neuropsychological treatment. Moreover, we suggest checking cognition along with depression and anxiety. Finally, to our knowledge, this is the first report of AD with an isolated neuropsychological deficit (verbal memory) developed after the MS diagnosis and treated beneficially with e EMDR. More studies are needed to confirm the efficacy of EMDR in treating cognitive impairment associated with AD in MS patients.
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Keshtkarjahromi, Marzieh, Danielle S. Abraham, Ann L. Gruber-Baldini, Katrina Schrader, Stephen G. Reich, Joseph M. Savitt, Rainer Von Coelln, and Lisa M. Shulman. "Confirming Parkinson Disease Diagnosis: Patterns of Diagnostic Changes by Movement Disorder Specialists." Parkinson's Disease 2022 (May 9, 2022): 1–6. http://dx.doi.org/10.1155/2022/5535826.
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Background. The American Academy of Neurology Parkinson Disease (PD) quality measures include an annual diagnostic review. Objective. To investigate the frequency and pattern of changes in diagnoses between PD and other causes of parkinsonism. Methods. This prospective longitudinal cohort study included consented patients diagnosed with PD at least once and a minimum of two times at the Movement Disorders Center between 2002 and 2017. Movement disorder specialists confirmed and documented diagnoses at every visit. Longitudinal changes in diagnoses were identified across visits. Results. Of 1567 patients with parkinsonism, 174 had non-PD parkinsonism with no change over time. Of 1393 patients diagnosed with PD at least once, 94% (N = 1308) had no change of diagnosis over time and 6% (N = 85) had a change of diagnosis including PD ⟷ drug-induced parkinsonism (DIP) (27.1%), PD ⟷ multiple system atrophy (MSA) (20.0%), PD ⟷ progressive supranuclear palsy (PSP) (18.8%), PD ⟷ Lewy body dementia (DLB) (16.5%), PD⟷ vascular parkinsonism (9.4%), more than two diagnoses (4.7%), and PD ⟷ corticobasal syndrome (CBS) (3.5%). The direction of diagnostic switches was as follows: PD ⟶ other parkinsonism diseases (36.5%), other parkinsonism diseases ⟶ PD (31.8%), and 31.8% of multiple switches. There were no significant differences in duration of follow-up, age at first visit, gender, race, marital status, education, income, cognition, or employment between the stable and unstable groups. Diagnostic change was associated with greater PD severity and greater medical comorbidity. Conclusion. Over a 15-year period, movement disorder specialists changed their clinical diagnosis of PD in 6% of patients. The most common diagnostic switches, to or from PD, were DIP, MSA, PSP, and DLB. This study describes routine clinical diagnostic patterns in the absence of pathologic confirmation. The presence of diverse diagnostic changes over time underscores the value of confirming PD diagnosis.