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Статті в журналах з теми "Minor cognitive disorderss":
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Monahan, R., A. Blonk, H. Middelkoop, M. Kloppenburg, T. Huizinga, N. Van der Wee, and G. M. Steup-Beekman. "POS0708 PSYCHIATRIC DISORDERS IN PATIENTS WITH DIFFERENT PHENOTYPES OF NEUROPSYCHIATRIC SYSTEMIC LUPUS ERYTHEMATOSUS (NPSLE)." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 603.2–604. http://dx.doi.org/10.1136/annrheumdis-2021-eular.423.
Анотація:
Background:Patients with systemic lupus erythematosus (SLE) may present with psychiatric disorders. These are important to recognize, as they influence quality of life and treatment outcomes and strategies.Objectives:We aimed to study the frequency of psychiatric morbidity as classified by the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) in patients with SLE and neuropsychiatric symptoms of different origins.Methods:In the neuropsychiatric SLE (NPSLE) clinic of the Leiden University Medical Center, patients undergo a standardized multidisciplinary assessment by a neurologist, neuropsychologist, vascular internal medicine, rheumatologist, physician assistant and psychiatrist. After two weeks, a multidisciplinary consensus meeting takes place, in which the symptoms are attributed to SLE requiring treatment (major NPSLE) or to minor involvement of SLE or other causes (minor/non-NPSLE). Consecutive patients visiting the NPSLE clinic between 2007-2019 were included. Data of psychiatric evaluation and current medication use were extracted from medical records. The presence of cognitive dysfunction was established during formal neuropsychological assessment.Results:371 consecutive SLE patients were included, of which 110 patients had major NPSLE (30%). Mean age was 44 ± 14 years and 87% was female.The most frequently diagnosed psychiatric disorders in the total group were cognitive dysfunction (42%) and depression (23%), as shown in Table 1. Furthermore, anxiety was present in 5% and psychotic disorders in 4% of patients. In patients with minor/non-NPSLE, especially depression (26% vs 15%) and anxiety (6% vs 2%) were more common than in major NPSLE. Cognitive dysfunction (54% vs 36%) and psychotic disorders (6% vs 4%) were more common in patients with major NPSLE than minor/non-NPSLE.Psychiatric medication was used in 33% of patients, of which antidepressants and benzodiazepines the most frequently (both: 18% in both subgroups). Antipsychotics were more often used in patients with NPSLE (10% vs 7%) and benzodiazepines more often in minor/non-NPSLE (20% vs 14%).In addition, 17 patients (5%) had a history of suicide attempt, which was more common in patients with minor/non-NPSLE than major NPSLE (6% vs 2%).Conclusion:Psychiatric morbidity, especially cognitive dysfunction and depression, are common in patients with lupus and differ between underlying cause of the neuropsychiatric symptoms (minor/non-NPSLE vs major NPSLE).Table 1.Presence of psychiatric diagnoses in patients with SLE and neuropsychiatric symptomsAll patients(n = 371)Minor/non-NPSLE(n = 261)Major NPSLE(n = 110)DSM V diagnosis, n (%)Neurodevelopmental disorder5 (1)2 (1)3 (2)Schizophrenia Spectrum and Other Psychotic Disorders16 (4)10 (4)6 (6)Bipolar and related disorders7 (2)5 (2)2 (2)Depressive disorders84 (23)68 (26)16 (15)Anxiety disorders17 (5)15 (6)2 (2)Obsessive-Compulsive and Related Disorders1 (0)1 (0)0 (0)Trauma- and Stressor-Related Disorders16 (4)12 (5)4 (3)Dissociative Disorders2 (1)2 (1)0 (0)Somatic Symptom and Related Disorders1 (0)1 (0)0 (0)Feeding and Eating Disorders0 (0)1 (0)0 (0)Elimination Disorders0 (0)0 (0)0 (0)Sleep-wake disorders2 (1)2 (1)0 (0)Sexual dysfunctions0 (0)0 (0)0 (0)Gender dysphoria0 (0)0 (0)0 (0)Disruptive, Impulse-Control, and Conduct Disorder0 (0)0 (0)0 (0)Substance-related and addictive disorders9 (2)8 (3)1 (1)Cognitive dysfunction154 (42)95 (36)59 (54)Personality disorders10 (3)9 (3)1 (1)Paraphilic disorders0 (0)0 (0)0 (0)Other mental disorders12 (3)7 (3)5 (5)Medication-Induced Movement Disorders and Other Adverse Effects of Medication0 (0)0 (0)0 (0)Unknown3 (1)3 (1)0 (0)NPSLE = neuropsychiatric systemic lupus erythematosus.Disclosure of Interests:None declared
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Aguilar-Navarro, Sara Gloria, Alberto José Mimenza-Alvarado, Rafael Martínez-Sánchez, Silvia Mejía-Arango, Lidia Gutiérrez-Gutiérrez, and José Alberto Ávila-Funes. "Spanish validation and cultural adaptation of the Five-Word Test for the detection of the neurocognitive disorder in older adults." Salud mental 42, no. 6 (December 27, 2019): 281–87. http://dx.doi.org/10.17711/sm.0185-3325.2019.037.
Анотація:
Introduction. “Episodic” memory problems are common in people with cognitive impairment due to Alzheimer’s disease and related disorders. Dubois et al. developed the Five-Word Test (5WT) to evaluate episodic memory, which has proved to be an easy and valid test for identifying cognitive disorders. However, its validation and cultural adaptation from French to Spanish has not been undertaken and its usefulness in Mexican population is unknown. Objective. Validation and cultural adaptation of the 5WT for screening minor and major neurocognitive disorder (ND) in Mexican older adults with probable Alzheimer’s disease. Method. Two hundred and fifteen participants (70 cognitively healthy subjects, 73 with minor ND and 72 with major ND were included). The cognitive status (gold standard) was determined using current clinical criteria and neuropsychological evaluation. The Spearman coefficient, ROC curve, and multinomial logistic regression models were used to determine the concurrent validity of the 5WT. Results. The correlation between the 5WT and the Mini-Mental State Exam (MMSE) was .58, whereas for the clock face test it was -.37 (p < .001). The area under the 5WT curve was .97 (95% CI [.94, .99]), with a cut-off point of ≤ 16/20 for the diagnosis of major ND (89% sensitivity, 98% specificity) and .77 (95% CI [.70, .85]) for minor ND with a cut-off point of ≤ 18/20 (66% sensitivity, 77% specificity). Discussion and conclusion. Since the 5WT is a simple, valid instrument for the identification of neurocognitive disorders like Alzheimer’s disease, it could be a practical screening test.
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Wuthrich, Viviana M. "Cognitive Behavioral Therapy for Anxiety in Cognitively Intact Older Adults." Journal of Cognitive Psychotherapy 31, no. 1 (2017): 57–71. http://dx.doi.org/10.1891/0889-8391.31.1.57.
Анотація:
This article discusses potential adaptations to cognitive behavioral therapy (CBT) needed when working with older adults. Although CBT has been demonstrated to be efficacious in older anxious populations in meta-analyses, more research is needed to better understand the efficacy of CBT for the individual anxiety disorders, for older adults aged 80 years and older, and the efficacy of individual CBT elements. Despite normal age-related reductions in cognitive and physical abilities, most research suggests that only minor adaptations to CBT, if any, are needed for older adults. More significant adaptations relate to therapist attitudes and beliefs rather than the pragmatic CBT delivery, for example, negative attitudes related to aging and the likely benefit of CBT. Despite normal age-related declines in some cognitive domains, research to date suggests that normal cognitive changes do not significantly impact on treatment outcomes over the course of CBT; a case example is presented.
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Botero-Rodríguez, Felipe, Ana Melisa Córdoba Sastoque, José Manuel Santacruz Escudero, and Hernando Santamaría-García. "Neuropsychiatric Symptoms in Patients with Neurocognitive Disorder and Their Performance Between Mild and Major Stages." Journal of Alzheimer's Disease 85, no. 4 (February 15, 2022): 1735–44. http://dx.doi.org/10.3233/jad-215283.
Анотація:
Background: The neuropsychiatric symptoms (NPS) in patients with neurocognitive disorders (NCD) increases the risk of exhibiting significant cognitive and functional decline. However, to the best of our knowledge, few studies have evaluated to what extent the presence of chronic and early NPS impacts cognition and functionality in patients with minor or major stages of NCD. Objective: We aimed to assess the interplay between early and chronic NPS and cognitive and functional presentation of patients with mild and major forms of NCD. Methods: We used two NPS tools tracking early and late NPS and assessed to what extent they determine cognitive and functional outcomes in patients with mild and major forms of NCD. Results: We found an inverse relationship between the presence of NPS, as measured by the Neuropsychiatric Inventory and Mild Behavioral Impairment Checklist (MBI-C), and cognitive and functional variables in major forms of NCD. In contrast, the minor stage of NCD was associated with increased MBI-C scores. Conclusion: Our results revealed that NPS are associated with cognitive and functional outcomes in mild and chronic forms of NCD. Crucially our results suggest that NPS could be considered as a pathological marker of the clinical course of dementia. Additionally, our study calls to study early and late forms of NPS as both impact cognition and functionality of NCD.
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Filippova, N. V., A. A. Shuldyakov, V. I. Eremin, Y. B. Barylnik, K. K. Ramazanova, A. N. Smagina, N. A. Sheshina, and A. A. Zhuk. "REHABILITATION OF PATIENTS AFTER COVID-19 WITH MINOR (PREDEMENTAL) COGNITIVE DISORDERS." Современные проблемы науки и образования (Modern Problems of Science and Education), no. 2 2023 (2023): 92. http://dx.doi.org/10.17513/spno.32564.
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Macedo Soares, Lara, and Marcelo Adrián Estrin. "Cognitive impact of chronic opioid use: A systematic review." SCT Proceedings in Interdisciplinary Insights and Innovations 1 (November 10, 2023): 151. http://dx.doi.org/10.56294/piii2023151.
Анотація:
Background: The impact of chronic opioid use has been linked to a wide range of cognitive disorders, ranging from minor deficits in cognitive abilities such as attention, learning, memory and executive functions. The objective of this work is to carry out a systematic review to investigate the cognitive impact in patients who chronically use opioids and to evaluate the severity of this impact. Material and methods: Randomized clinical trials, case-control studies, prospective and retrospective cohorts werw evaluated in two databases: PubMed and Cochrane Central. The search in english, spanish and portuguese languages of stududies carried out in adult humans an chronic use of opioids and their cognitive impact. Results: 7 studies were selected, 5 of wich the patients used Tramadol and the negative cognitive impact was verified, 1 study with the use of Tapentadol with a positive impact on cognition and 1 study with the use of Hydrocodone with a positive impact on neurocognition of the patients. Conclusion: (In conclusion, despite the limitations found here, we consider that tramadol has a negative impact on neurocognition, which does not occur in relation to tapentadol and hydrocodone, which presents an improvement in the quality of life and cognition of patients
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AIRAKSINEN, E., M. LARSSON, I. LUNDBERG, and Y. FORSELL. "Cognitive functions in depressive disorders: evidence from a population-based study." Psychological Medicine 34, no. 1 (January 2004): 83–91. http://dx.doi.org/10.1017/s0033291703008559.
Анотація:
Background. Most of the available evidence on the effects of depression is based on in- and out-patient samples focusing on individuals suffering from major depression. The aims of this study were to examine cognitive functioning in population-based samples and to determine whether cognitive performance varies as a function of depression subgroup.Method. Population-based samples (aged 20–64 years) with major depression (N=68), dysthymia (N=28), mixed anxiety-depressive disorder (N=25) and minor depression (N=66) were examined on a variety of cognitive tasks (i.e. episodic memory, verbal fluency, perceptual-motor speed and mental flexibility). One hundred and seventy-five non-depressed individuals served as controls.Results. The total group of depressed individuals showed impairments in tasks tapping episodic memory and mental flexibility. Of more interest, however, was the observation that the pattern of impairments varied as a function of depression subgroup: the major depression and mixed anxiety-depressive disorder groups exhibited significant memory dysfunction, whereas individuals with dysthymia showed pronounced difficulties in mental flexibility. Minor depression did not affect cognitive performance. Verbal fluency and perceptual-motor speed were not affected by depression.Conclusions. These results indicate that persons with depressive disorders in the population exhibit cognitive impairments in tasks tapping episodic memory and mental flexibility and that cognitive impairment varies as a function of depressive disorder.
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Shishkova, V. N. "Place of arterial hypertension in brain lesion development - from minor cognitive disorders to dementia." Systemic Hypertension 11, no. 1 (March 15, 2014): 45–51. http://dx.doi.org/10.26442/sg29008.
Анотація:
He problem of cognitive impairment in patients with somatic diseases today occupies a leading position, as it represents one of the most widespread manifestations of organic brain damage. The role of arterial hypertension(AH) in the formation of cognitive impairment (CI) has been shown in large epidemiological studies. CI detected in 73% of patients of both middle and senior age with hypertension duration of more than 5 years. Early detection of potentially treatable cognitive disorders is one of the most important tasks of the modern practitioner, cardiologist, endocrinologist, family doctor, as the patients in the early stages of CI constitute the majority of people seeking help. In today's world, primary care physicians' actions are often crucial in the prediction of dementia, since the detection of early forms of non-dementia CI and timely and adequate treatment of cardiovascular disease, especially hypertension, is often enough for the severity of the CI patients was significantly decreased, and dementia never came.
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Vasilevsky, S. S., and T. L. Alenskaya. "PHYTOTHERAPY IN THE REHABILITATION OF MILD AND MODERATE COGNITIVE DISORDERS." Journal of the Grodno State Medical University 21, no. 3 (July 2023): 215–21. http://dx.doi.org/10.25298/2221-8785-2023-21-3-215-221.
Анотація:
An increase in life expectancy creates prerequisites for the appearance of more patients with cognitive impairments. Early diagnosis, treatment and rehabilitation of cognitive disorders improves the quality of life of patients, prevents the development of dementia, and is of great social importance. Herbal medicines are highly effective in the treatment of mild and moderate cognitive impairment, affect various links of pathogenesis, have minor side effects. The most effective of them are: galantamine from snowdrop tubers; hyperzine from sawtooth grass; ginkgo two-lobed flavanoids; biologically active substances of medicinal sage and periwinkle.
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Munteanu, Valentin, Ionut Luca-Husti, Teodora Camelia Coman, and Alexandru Vlad Ciurea. "Differential diagnostic problems in elderly chronic subdural hematoma patients." Romanian Neurosurgery 30, no. 2 (June 1, 2016): 195–99. http://dx.doi.org/10.1515/romneu-2016-0030.
Анотація:
Abstract Chronic subdural hematomas (CSDH) are recognized as common in older people (over 70 years). They are produced in minor injuries (falls on the same level). These CSDH have minor symptoms (headache, memory disorders, balance disorders, cognitive disorders, etc. and are classified as signs for the onset of dementia, circulatory failure - basilar vertebra, Alzheimer, etc. A simple brain CT scan can highlight these hematomas and a neurosurgical intervention will achieve extremely favorable prognosis. There are many pitfalls in the differential diagnosis of CSH especially with strokes being so common at this age.
Книги з теми "Minor cognitive disorderss":
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Hodges, John R. Localized Cognitive Functions. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198749189.003.0003.
Анотація:
This chapter discusses localized cognitive functions. The functions ascribed to the dominant, usually left, cerebral hemisphere show much more clear-cut laterality than those associated with the so-called minor hemisphere. This applies particularly to spoken language. This chapter discusses aspects of normal and abnormal language function in the framework of contemporary cognitive neuroscience with descriptions of the classic post-stroke variants of aphasia (Broca’s, Wernicke’s, conduction, etc.) although these are rarely seen in the context of neurodegenerative diseases. There is also a description of disorders of written language (the dyslexias and dysgraphias), of calculation (acalculia), and of higher-order motor control (apraxia). This is followed by descriptions of the syndromes associated with disturbed right hemisphere functions: neglect phenomena, dressing and constructional apraxia, and complex visuoperceptual disorders (agnosias). Each cognitive syndrome is placed in the context of its neural basis, disorders which affect the ability and methods of assessment at the bedside and using neuropsychological tasks.
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Morese, Rosalba, Sara Palermo, and Antonella Carassa, eds. Affective, Cognitive and Social Neuroscience: New Knowledge in Normal Aging, Minor and Major Neurocognitive Disorders. Frontiers Media SA, 2022. http://dx.doi.org/10.3389/978-2-88974-748-1.
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Croskerry, Pat. The Cognitive Autopsy. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780190088743.001.0001.
Анотація:
Behind heart disease and cancer, medical error is now listed as one of the leading causes of death. Of the medical errors that lead to injury and death, diagnostic failure is regarded as the most significant. Generally, the majority of diagnostic failures are attributed to the clinicians directly involved with the patient, and to a lesser extent, the system in which they work. In turn, the majority of errors made by clinicians is due to decision making failures manifested by various departures from rationality. Of all the medical environments in which patients are seen and diagnosed, the emergency department is the most challenging. It has been described as a ‘wicked’ environment where illness and disease may range from minor ailments and complaints to severe, life-threatening disorders. The Cognitive Autopsy is a novel strategy towards understanding medical error and diagnostic failure in 42 clinical cases with which the author was directly involved or became aware of at the time. Essentially, it describes a cognitive approach towards root cause analysis of medical adverse events or near misses. Whereas root cause analysis typically focuses on the observable and measurable aspects of adverse events, the cognitive autopsy attempts to identify covert cognitive processes that may have contributed to outcomes. In this clinical setting, no cognitive process is directly observable but must be inferred from the behaviour of the individual clinician. The book illustrates unequivocally that chief among these cognitive processes are cognitive biases and other flaws in decision making, rather than knowledge deficits.
Частини книг з теми "Minor cognitive disorderss":
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Sacco, Marco, Claudia Redaelli, Andrea Zangiacomi, Luca Greci, Simona Di Santo, Alessandro Leone, and Alessandra Vezzoli. "GOJI an Advanced Virtual Environment Supporting Training of Physical and Cognitive Activities to Prevent Dementia Occurrence in Elderly with Minor Cognitive Disorders." In Biosystems & Biorobotics, 429–37. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-18374-9_40.
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Kola, Sushma, and Anhar Hassan. "Issues to Consider When Mild Cognitive Impairment Is Revealed in Preoperative Screening." In Deep Brain Stimulation, edited by Laura S. Surillo Dahdah, Padraig O’Suilleabhain, Hrishikesh Dadhich, Mazen Elkurd, Shilpa Chitnis, and Richard B. Dewey, 65–68. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780190647209.003.0012.
Анотація:
A 72-year-old man with Parkinson disease of 7 years duration, multifactorial gait disorder, and minor memory complaints underwent deep brain stimulation (DBS) evaluation to treat motor fluctuations and dyskinesia. Neuropsychometric evaluation revealed multidomain mild cognitive impairment, which was stable to improved on repeat testing 6 months later. He underwent bilateral subthalamic nucleus DBS with improvement in dyskinesia, and residual motor fluctuations were medically managed. He denied postoperative cognitive changes, although repeat neuropsychometric evaluation 9 months later showed decline in cognition. The patient moved to an assisted living facility shortly afterward because of progressive gait disability. One year later, he developed florid Parkinson disease psychosis, with partial improvement after cessation of entacapone. We discuss the rationale for the assessment of mild cognitive impairment before DBS, DBS target selection, risk factors associated with postoperative cognitive decline, and strategies to minimize this.
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Zinin, Sergey Valerevich. "Social Dispatch Assistance with Iron Deficiency Anemia in Students with the Consequences of Early Organic Damage to the Central Nervous System." In Directions for educational development in the Year of the Teacher and Tutor, 175–82. Publishing house Sreda, 2023. http://dx.doi.org/10.31483/r-107951.
Анотація:
The chapter is devoted to determining the prevalence of iron deficiency anemia (IDA) in students with the consequences of early organic damage to the central nervous system. The increased interest in this disease is due to a number of circumstances. Firstly, hypoxia of the brain in IDA affects the cognitive abilities of minors. Secondly, this disease in children with intellectual disabilities provokes diseases of the cardiovascular system in 62.5%, visual impairment in 31.2%, and pathology of the urinary system in 38.7%. Research methods. For the presence or absence of iron deficiency anemia, in the period from 2015 to 2023, medical documents of 653 students from different nosological groups associated with cognitive impairment were examined. The study made it possible to draw the following conclusions: the prevalence of IDA in children with F80 (expressive speech disorder) is 20%, with F83 (mixed specific disorders of psychological development) – 31%, with F70 (mild mental retardation) – 52%, with F71 (moderate mental retardation) – 33%. The total number of minors with a history of iron deficiency anemia is high. More than 40% of all students and pupils with disabilities (HIA) who study according to adapted programs due to intellectual and speech disorders may need social dispatching assistance from specialists of PMPC and school councils. The results of the study may be of interest to a wide range of medical and pedagogical specialists. Doctors are asked a problematic question about why, with moderate mental retardation and more pronounced (significant) cognitive impairments, the prevalence of IDA is significantly lower compared to mild mental retardation. Using specific clinical examples, teachers are described various algorithms of social dispatching assistance to families to prevent possible secondary violations in minors.
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Maj, Mario. "Dementia due to HIV disease." In New Oxford Textbook of Psychiatry, 384–86. Oxford University Press, 2012. http://dx.doi.org/10.1093/med/9780199696758.003.0049.
Анотація:
The first description of a syndrome consisting of cognitive, motor, and behavioural disturbances in patients with AIDS was published in 1986. The syndrome was named ‘AIDS dementia complex’. In 1990, the World Health Organization (WHO) introduced the term ‘HIV-associated dementia’, pointing out that subclinical or mild cognitive and/or motor dysfunctions without impairment of performance in daily living activities cannot be subsumed under the term ‘dementia’. The expression ‘mild cognitive/motor disorder’ was proposed for those conditions. The same distinction was made in 1991 by the American Academy of Neurology, which identified an ‘HIV-associated dementia complex’ and an ‘HIV-associated minor cognitive/motor disorder’. The present chapter focuses on the dementia syndrome associated with HIV infection.
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Devinsky, Orrin, and Mark D’esposito. "Executive Function and the Frontal Lobes." In Neurology Of Cognitive And Behavioral Disorders, 308–29. Oxford University PressNew York, NY, 2003. http://dx.doi.org/10.1093/oso/9780195137644.003.0009.
Анотація:
Abstract At one time, the most anterior portion of the frontal lobes, the prefrontal cortex, was considered “silent” because moderate-sized lesions of this region produced few or no abnormalities on the neurological examination and electrical stimulation rarely altered behavior. Moreover, following prefrontal resections of the dominant hemisphere, patients had normal memory and an intelligence quotient (IQ) of 150 or more. Although behavioral and cognitive changes challenge clinical measurement at the bedside, most families of patients with bilateral frontal lobe damage recognize them as “very different.” For example, these patients may drive past stop signs, fail to show concern when a kettle is boiling over, become slovenly and unkempt, joke about someone’s physical deformity in front of him or her, become violent after a minor provocation and quickly return to their previous calm state, urinate on the street, or leave a baby unattended to watch television.
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Thorne, John C., and Tracy Jirikowic. "Fetal Alcohol Spectrum Disorders." In Cognitive and Behavioral Abnormalities of Pediatric Diseases. Oxford University Press, 2010. http://dx.doi.org/10.1093/oso/9780195342680.003.0068.
Анотація:
Fetal alcohol spectrum disorders (FASD) is an umbrella term used to refer to the range of negative outcomes associated with prenatal ethyl-alcohol exposure (PAE). Although the impact of maternal drinking on the pre and postnatal development of children was examined as early as the late 19th century (Sullivan 1899), the teratogenic effects of PAE were not widely recognized until 1973, when Jones and Smith discussed PAE. The fetal alcohol syndrome (FAS) they described is now recognized internationally as a permanent birth defect syndrome resulting from PAE. Fetal alcohol syndrome is characterized by growth deficiency, a unique cluster of three minor facial anomalies, and evidence of central nervous system (CNS) abnormalities. At an estimated prevalence of one to three cases per 1,000 live births, FAS is the leading known preventable cause of developmental and intellectual disabilities (Bailey and Sokol 2008). Because the distinctive FAS facial phenotype provides a specific diagnostic marker of PAE (Astley 2006), FAS is the most readily recognized of the FASD. Fetal alcohol spectrum disorders that lack the tell-tale facial phenotype of FAS are more difficult to diagnose, but share a similar range and severity of CNS impairments and social costs. Other FASDs are many times more prevalent than FAS (Bailey and Sokol 2008) and may occur in as many as 1% of all children. Along with CNS, craniofacial, and growth impairments, FASD may also include ophthalmologic, cardiac, renal, and orthopedic abnormalities. Although heavier PAE, particularly binge drinking, leads to increased risk of FASD, no safe exposure level has been established. It is apparent that risk is substantially increased if the mother is older, has a history of alcoholism, has a family history of FASD, or is living in poverty. However, no clear set of risk or protective factors has been determined for any FASD that would allow for evidence-based advice to a particular mother on the relative risk that a particular level of drinking might have on her child’s development (Bailey and Sokol 2008; Jacobson et al. 2004; Maier and West 2001; Nulman et al. 2004; see also Disney et al. 2008).
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Post, Robert M. "Introduction: Emotion and Psychopathology." In Handbook of Affective Sciences, 899–903. Oxford University PressNew York, NY, 2002. http://dx.doi.org/10.1093/oso/9780195126013.003.0048.
Анотація:
Abstract Given the complexity and exquisite regulation of emotion described in previous chapters, it is not surprising that emotional dysfunction lies at the core of a variety of psychopathological conditions. The syndromes of emotional dysregulation lie on a continuum of temporal characteristics, ranging from seconds/minutes (panic attacks) to hours/days (borderline personality disorder) to weeks/ months (unipolar and bipolar illness) to years/lifetime (schizophrenia and autism). The panic/anxiety disorders are characterized by paroxysmal episodes of panic, sometimes superimposed on more chronic components of dysphoria, agoraphobia, and depression. The marked mood lability of borderline personality disorder and its interdigitation with posttraumatic stress disorder (PTSD) syndromes are typified by extremely rapid and major mood shifts. Included in this phasic dysregulation are prominent components of anxiety, depression, proneness to substance abuse, and chaotic experience of the self and relationships to others. The unipolar and bipolar affective disorders range from chronic dysthymia to irregular bursts of recurrent brief depression to minor and major depression to these conditions in the context of hypomania (bipolar II) and fullblown mania (bipolar I). This range of depressive and manic mood disorders is common in the general population and most typical of psychopathologies involving dysfunction of emotional regulation. The schizophrenias are more commonly associated with a persistent disconnection of affect from its appropriate context, and thus they present with prominent autistic components. In childhood autism itself there is an early and chronic breakdown of emotional communication that often involves an absence of normal language and affective responsiveness to others. Given this range of type and temporal dissimilarities among the major psychopathological syndromes of emotion, we chose to highlight in this part several of the more prominent syndromes and components that bridge diagnostic categories Although each of the chapters has a separate focus, it is worth emphasizing the constant interaction and interplay of cognition, emotion, and neurobiology that is important not only for understanding the psychological and neurobiological substrates of affective dysregulation but also for approaches to therapeutics that can also involve each of three domains (affective, cognitive, and somatic) as primary targets.
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Schott, Jonathan M. "Alzheimer’s disease and other dementias." In Oxford Textbook of Medicine, edited by Christopher Kennard, 5830–59. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198746690.003.0574.
Анотація:
Dementia is defined as a syndrome consisting of progressive impairment in memory and other cognitive deficits (aphasia, apraxia, agnosia, or disturbance in executive function) in the absence of another explanatory central nervous system disorder, depression, or delirium, sufficient to interfere with activities of daily living. In recent years there has been a move to consider and classify patients with less severe forms of cognitive impairment—so-called mild cognitive impairment—and non-memory presentations, with the latest DSM-V criteria identifying individuals with major or minor neurocognitive syndromes. Ongoing research using biomarkers suggest that there is a long presymptomatic phase for many causes of dementia.
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Curatolo, Paolo, and Elisa D’Agati. "Tuberous Sclerosis Complex." In Cognitive and Behavioral Abnormalities of Pediatric Diseases. Oxford University Press, 2010. http://dx.doi.org/10.1093/oso/9780195342680.003.0046.
Анотація:
Tuberous sclerosis complex (TSC) is a genetic, variably expressed, multisystem disorder that can cause circumscribed, benign, noninvasive lesions in any organ (Curatolo 2003; Gomez 1999). It affects about 1 newborn in every 6000 (Osborne, Fryer et al. 1991). The term tuberous sclerosis of the cerebral convolutions was used more than a century ago to describe the distinctive findings at autopsy in some patients with seizures and mental subnormality; the term tuberous describes the potato-like consistency of gyri with hypertrophic sclerosis (Bourneville 1880). The wide range of organs affected by the disease implies an important role for the TSC1 and TSC2 genes encoding hamartin and tuberin in the regulation of cell proliferation and differentiation. Tuberous sclerosis complex is a protean disease: the random distribution, number, size, and location of lesions cause varied clinical manifestations, involving the brain, skin, eyes, heart, kidney, lung (Curatolo et al. 2008). Some lesions, such as renal angiomyolipomas, do not occur until a certain age; by contrast, cardiac rhabdomyomas appear in the fetus and almost always regress spontaneously in infancy (Sosunov et al. 2008). About 85% of children and adolescents with TSC have central nervous system (CNS) manifestations, including epilepsy, learning difficulties, mental retardation, challenging behavioral problems, autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD), which can be associated with the structural CNS features generally seen in TSC (Curatolo et al. 1991; Gillberg et al. 1994). Abnormalities of neuronal migration and cellular differentiation, and excessive cell proliferation, all contribute to the formation of the various TSC brain lesions including cortical tubers, subependymal nodules (SENs), subependymal giant cell astrocytomas (SEGAs), and widespread gray and white matter abnormalities, these latter being identified even in patients with average intelligence (Ridler et al. 2001; de Vries et al. 2005; Ridler et al. 2007). Further characterization of these typical lesions has been provided by progress in structural and functional imaging (DiMario 2004; Luat et al. 2007). Major and minor criteria exist to diagnose TSC (Table 32.1). The diagnosis is made when two major features, or one major and two minor ones, can be detected.
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Murphy, Elaine. "Cognitive and Behavioral Manifestations of Disorders of Homocysteine Metabolism." In Cognitive and Behavioral Abnormalities of Pediatric Diseases. Oxford University Press, 2010. http://dx.doi.org/10.1093/oso/9780195342680.003.0041.
Анотація:
This chapter reviews the metabolism of homocysteine and its associated defects, focusing on the clinical manifestations of cognitive and behavioral disturbances. The terminology of homocysteine and its derivatives can be confusing, so I begin by clarifying that. Next, the metabolism of homocysteine is outlined, followed by discussion of the disorders of homocysteine transsulfuration. Vitamin B12 (cobalamin, CBL) is important in the effective metabolism of homocysteine and thus defects of CBL absorption, transport, and intracellular transport are also discussed. Finally, disorders of remethylation of methionine will be described. Diagnostic criteria, imaging results, and the pathophysiology of these disorders are also considered. The terminology related to homocysteine metabolism can be confusing. In 2000, a consensus statement on homocysteine nomenclature was published (Mudd et al. 2000). Normal human plasma contains total concentrations of homocysteine and its derivative disulfides of less than 15 μmol/L, although there is some variation due to genetic and other factors. Of this total, only 1%–2% occurs as the thiol (i.e., sulfhydryl) containing amino acid homocysteine. The remaining 98% is in the form of disulfides. Approximately 75%–80% of the total is bound to protein through disulfide bonds with protein cysteines, mainly in albumin, whereas the remainder occurs in non–protein-bound or free forms: the disulfide homocystine-homocystine (Hcy-Hcy), homocysteine-cysteine mixed disulphide, and minor amounts of other mixed disulfides. Together all these moieties make up what is referred to as total homocysteine (tHcy). As all these disulfide bonds can be cleaved by reducing agents, giving the thiol homocysteine, this allows measurement of tHcy as the sum of any thiol homocysteine originally present plus that originally present as a disulfide. In patients with homocystinuria, the percentage contribution of the thiol homocysteine to the total of these forms in plasma rises, reaching 10%–25% as the total homocysteine concentration reaches 150–400 μmol/L. The methionine/homocysteine cycle, also known as the single carbon transfer pathway, is found in all tissues and can broadly be divided into transsulfuration and remethylation components. The cycle aims to conserve methionine and provide sufficient S-adenosylmethionine (AdoMet) for vital transmethylation reactions.