Cognitive performance is impaired in euthymic Chinese patients with Bipolar 1 Disorder

Background

Data from euthymic patients with Bipolar Disorder (BD) has shown cognitive impairment and the notion that sufferers of BD achieve full recovery between illness episodes is questionable. These findings have not been replicated in a Chinese population. The present study examined the cognitive profile of euthymic Chinese patients with Bipolar 1 Disorder (BD-1) and matched healthy control participants.

Methods

Euthymic patients with BD-1 and matched controls (n=104 in total) completed serial measures to assess mood and also completed an IQ test and the Central Nervous System Vital Signs (CNSVS) computerized battery assessing memory (verbal and visual), executive functions, attention, psychomotor and processing speed.

Results

Patients with BD-1 performed worse than controls on all cognitive domains. When using 2 or more scores below the 5th percentile as a cutoff for neurocognitive impairment, 46.2% of the patients with BD-1 and none of the control sample scored in this range (p<.001). Correlational analysis among the illness variables in BD-1 revealed that cognitive performance was inversely correlated with the number of manic episodes and duration of illness.

Limitations

It was not possible to determine the causal relationship between associated illness and performance. The effect of medication on cognitive performance requires further study.

Conclusions

Euthymic Chinese patients with BD-1 demonstrate marked cognitive impairments and these correlated with illness parameters. Cognitive impairment in BD may be independent of language and culture.     

认知操作、认知方式与神经质人格特质的关系

目的：考察认知操作、认知方式与神经质人格特质的关系。方法：对30名高神经质被试和30名低神经质被试进行实验性认知测试。结果：高低神经质被试在紧张、松弛条件下的认知操作测试总分方面差异不显著，但在紧张性-松弛性认知方式的评价分数上存在显著差异。高神经质被试更多地倾向于松弛型认知方式，低神经质被试更多地倾向于紧张型认知方式。结论：神经质人格与紧张、松弛条件下的认知操作测试总分无关，而与紧张性-松弛性认知方式存在相关关系。     

Cognitive inhibition in patients with medial orbitofrontal damage

Inhibition underlies cognitive processes such as overcoming habitual responses, suppressing of goal-irrelevant information, and switching of attention between stimuli or task rules. These processes are thought to depend on the frontal lobes. However, the precise role of the ventral frontal regions (orbitofrontal cortex) in these processes remains elusive. In the present study, our goal was to clarify the role of the orbitofrontal cortex in cognitive inhibition by examining the effects of focal lesions to the medial orbitofrontal cortex (posterior part of the gyrus rectus) on performance in tasks that required inhibitory control. Patients who had undergone surgery for an anterior communicating artery aneurysm and normal control subjects (C) participated in the study. The patients were subdivided into three groups: those with resection of the left (LGR+) or right (RGR+) gyrus rectus, and without such a resection (GR-). The Stroop Color-Word test, Trail Making B test, and the Category test were used as instruments for assessing response inhibition, switching between concrete stimuli, and switching between abstract task rules, respectively. In addition, the Digit Symbol test was used to examine sustained attention and processing speed. In the Stroop Color-Word test, the RGR+ group performed worse than all other groups. In the Trail Making B test, the RGR+ and LGR+ groups performed worse than both the GR- and C groups. In the Category test and Digit Symbol test, the groups did not differ significantly from each other. Our study indicates a specific contribution of the medial orbitofrontal cortex to response inhibition and stimulus-based switching of attention.     

脑肿瘤患者认知功能障碍的初步研究

目的 :探索脑肿瘤患者认知功能障碍的特点。方法 :采用CLB测验对 31例左侧大脑肿瘤患者、34例右侧大脑肿瘤患者及正常对照组进行测验。结果 :(1)左侧大脑脑肿瘤组四项语言—序贯能力测验成绩明显低于对照组 (P <0 .0 5 ) ,四项空间认知能力成绩无明显差别 (P >0 .0 5 ) ,病例组CLQ为正值 ,表明右半球信息加工能力无明显损害 ;(2 )右侧大脑脑肿瘤组四项空间认知能力测验成绩明显低于对照组 (P <0 .0 5 ) ,四项语言—序贯能力测验成绩中系列数字、偏旁组字、类别组词与对照组间无明显差异 (P >0 .0 5 ) ,系列声音测验成绩有明显差异 (P <0 .0 5 ) ,病例组CLQ为负值 ,表明左半球信息加工能力基本正常。结论 :CLB可以对脑肿瘤患者认知功能障碍进行量化 ,是一种评估左右侧大脑肿瘤患者认知功能障碍的有效方法。     

Cognitive functions and cognitive styles in young euthymic patients with bipolar I disorder

Background

Recent evidences suggest that bipolar disorder patients do not return to premorbid functioning levels during the inter-episode periods. Cognitive deficits may impair patients working and functioning status and may also have negative impact on other aspects of thinking.

Objectives

To assess the prevalence of cognitive dysfunction in patients with bipolar disorder in euthymic state and to explore any evident cognitive style problems.

Method

Case-control naturalistic study 60 patients with bipolar I disorder in euthymic state according to DSM-IV were recruited and subdivided into two groups each contains of 30 patients; (Group BPM) euthymic patients with recent manic episode, and Group BPD euthymic patients with recent depressive episode. Both groups were further compared with control group (Group C) consisted of 30 frequency matched healthy volunteers. Groups were subjected to the following: 1-clinical psychiatric examination, 2-Hamilton Depression Scale (HAMD-17) and Bech–Rafaelsen Melancholia Scale (MES) for patients’ group (BPD), 3-Young Mania Rating Scale (YMRS) and Bech–Rafaelsen Mania Scale (MAS) for patients’ group (BPM), 4-assessment of euthymic state of mood included both MAS and MES, 5-MMSE, MTS and CDT were performed to assess cognitive functions, 6-cognitive styles evaluation included Fear of Failure, Hopelessness Scale, (the Social Dysfunction and Aggression Scale SDAS-9 and Arabic Anger Scale.

Results

Definite cognitive function impairment and different patterns of cognitive style were detected in case groups. MMSE, MTS and CDT scores were statistically significant. Fear of Failure Scale Scores were higher in BPM; 16 (53.33%) reported severe intensity compared to 16 (53.33%) of BPD Group reporting moderate intensity and 30 (100%) of the control group reporting only mild intensity of fear of failure with statistically significant differences. Although patients were in euthymic state; Hopelessness Scale discriminated between those with affective disorders and controls and other scores for hostility SADS-9 and Arabic Anger Scale. Moreover, measures of cognitive styles showed differences among patients of the case groups who joined psychotherapy program in their management (28) compared to those who did not (32).

Limitation

Cognitive impact of psychotropic drugs could not be eliminated since the current study is naturalistic study.

Conclusions

Those with BAD in euthymic state suffer from cognitive dysfunction and some aspects of cognitive styles that may negatively interfere with their performance. Psychotherapeutic programs should consider these findings in their approaches for better impact on patients’ quality of life and overall treatment outcome.     

Exceptional Cognitive Ability: The Phenotype

Characterizing the outcomes related to the phenotype of exceptional cognitive abilities has been feasible in recent years due to the availability of large samples of intellectually precocious adolescents identified by modern talent searches that have been followed-up longitudinally over multiple decades. The level and pattern of cognitive abilities, even among participants within the top 1% of general intellectual ability, are related to differential developmental trajectories and important life accomplishments: The likelihood of earning a doctorate, earning exceptional compensation, publishing novels, securing patents, and earning tenure at a top university (and the academic disciplines within which tenure is most likely to occur) all vary as a function of individual differences in cognitive abilities assessed decades earlier. Individual differences that distinguish the able (top 1 in 100) from the exceptionally able (top 1 in 10,000) during early adolescence matter in life, and, given the heritability of general intelligence, they suggest that understanding the genetic and environmental origins of exceptional abilities should be a high priority for behavior genetic research, especially because the results for extreme groups could differ from the rest of the population. In addition to enhancing our understanding of the etiology of general intelligence at the extreme, such inquiry may also reveal fundamental determinants of specific abilities, like mathematical versus verbal reasoning, and the distinctive phenotypes that contrasting ability patterns are most likely to eventuate in at extraordinary levels.

伴迟发性运动障碍的慢性精神分裂症患者认知功能研究

目的:了解伴迟发性运动障碍(TD)的慢性精神分裂症患者认知功能的损害情况。方法:以82例伴TD的(TD组)、70例不伴TD的慢性精神分裂症患者(非TD组)为研究对象,两组一般情况相匹配,选用韦氏记忆测验(WMS)、威斯康星卡片分类测验(WCST)及连线测验(TMT)进行认知功能评定。结果:①两组在WMS方面比较无统计学差异。②两组在WCST方面比较,TD组错误应答数、选择错误率、错误思考时间、持续应答数及概念化水平百分数成绩均显著差于非TD组。③两组在TMT方面比较,TD组PartB耗时数显著长于非TD组,而两组PartA耗时数无显著差异。结论:伴TD的慢性精神分裂症病人存在明显的认知功能损害,且可能涉及额叶皮层。     

Cognitive function in outbred house mice after 22 weeks of drinking oxygenated water

Oxygen-enriched drinking water, which is increasingly sold worldwide, is claimed to "keep both the body and the mind healthy." However, currently there is no scientific evidence for such a statement. Therefore, we assessed the effect of 22 weeks of drinking oxygenated water on cognitive performance in healthy mice, using a spatial learning task and behavioral observations. Thirty-six female mice (age 3 to 6 months) received either hyperoxic or normal tap water (approximately 6.6 vs. 1.8 microg O(2) g(-1) day(-1), respectively) throughout the study period. Mice were weighed one to two times per month, and a blood sample was taken from the tail to determine the hematocrit. In addition, red blood cells were counted microscopically one and two months after the start of the experiment. Four weeks after the last blood sample (21 weeks after the start of the experiment), exploration behavior and locomotor activity were observed on a holeboard, and learning ability tests were performed using an elevated open maze. No significant differences were seen between groups for any of the parameters investigated. Thus, the study does not support the hypothesis that drinking oxygenated water improves cognitive function or hematological parameters in mice.     

稳定期双相障碍认知功能及相关因素对照研究

目的探讨稳定期双相障碍患者认知功能损害特点及相关因素分析。方法对来我院门诊和住院部的符合ICD-10双相情感障碍,目前为缓解状态诊断标准的60例患者,和本院非临床工作人员或其他单位的60例正常者(对照组),采用蒙特利尔认知评价量表(MoCA)进行测试。结果①研究组总分(25.63±2.96)、视空间与执行功能(3.75±1.10)、记忆(3.05±1.36)、注意(5.18±0.75)与对照组存在明显差异(P0.05);②其中联合用药共38例(63.33%),出现认知功能障碍15例。单一用药22例(36.66%),出现认知功能障碍12例。两组认知功能损害无统计学差异;③病程≥24月与病程24月患者相比较,有统计学意义(χ2=6.613。P0.013)。结论稳定期双相障碍患者存在明显的注意、记忆和执行功能等认知功能损害,与病程的长短存在一定的相关性。     

精神分裂症患者的认知康复治疗进展

精神分裂症是一种发病原因不明的重性精神疾病,临床症状主要表现为思维、行为、感知觉以及情感等多个方面的功能障碍,还有不协调的精神活动,一般情况下,患者的意识较为清楚,保有基本正常的智能,但是还有一些患者会出现认知功能的损害,随着病情的反复发作进而加重,会导致患者出现精神残疾等情况,而有些患者在通过治疗后可以维持在基本痊愈或者是痊愈的状态下,维持基本的正常生活状态。     

精神分裂症患者认知功能的随访观察

目的探讨缺陷型、非缺陷型精神分裂症患者的认知功能的长期随诊特点。方法对1997年9月曾进行认知功能检查,持续住院的缺陷型22例和非缺陷型30例精神分裂症患者于4年后再次进行评定,同时采用简明精神病评定量表(BPRS)评定其症状。结果4年后精神分裂症患者仅非缺陷型的注意和计算明显降低,缺陷型患者的记忆因子明显降低外,其它各因子及总分无明显降低。结论精神分裂症患者的认知功能损害随病程进展并无明显加重趋势。     

Cognitive behavioural therapy with older people

Cognitive behavioural therapy (CBT) is a structured, brief psychological treatment approach with a wide range of applications, including the treatment of psychological disorders that accompany physical illness. Over recent years there has been an expansion in the use of CBT with older people. Knowledge of CBT helps doctors to understand the mechanisms of psychological disorders and to make appropriate referrals for treatment.     

认知训练和自我按摩对老年人认知功能的影响比较

目的:比较认知训练和自我按摩对于社区老年人认知功能的影响。方法:144名长沙市某社区老年人随机分为对照组、认知训练组和自我按摩组,除对照组外,认知训练组和自我按摩组分别接受为期6个月的认知训练和自我按摩训练干预。干预前后分别采用简明精神状态量表(MMSE)、韦氏记忆量表中国修订版(WMS-C)的图片回忆、联想记忆、理解记忆和背数四个分测验测量。结果:MMSE及记忆的四个分测验的时间主效应显著(P<0.05);不同的干预方法在MMSE得分及图片回忆、联想记忆、理解记忆得分变化上存在统计学差异(P<0.05);除图片回忆外,其余指标存在时间和干预方法之间的交互作用(P<0.01)。进一步组间多重比较显示:在MMSE和图片回忆、联想记忆和理解记忆得分上,认知训练组和自我按摩组与对照组间差异均有统计学意义(P<0.01);但认知训练组与自我按摩组间无统计学差异(P>0.05)。结论:认知训练和自我按摩均可有效改善老年人的认知功能,还不能认为这两种干预方法哪种更有效。     

脑白质疏松对急性缺血性卒中患者认知功能的影响

目的 探讨脑白质疏松（LA）对急性缺血性卒中患者认知功能的影响。方法 选择2016年3月~2017年2月我院收治的起病14 d内的首发急性缺血性卒中患者,共91例,所有患者完成MRI检查,依据头颅MRI是否存在LA,分为LA组74例,无LA组17例。并对脑白质疏松严重度进行评分,卒中后3个月进行认知功能评估,认知功能评定采用MoCA量表和MMSE量表。结果 LA组整体认知功能（MMSE、MoCA评分）及视空间执行功能、语言功能、记忆功能评分低于无LA组,差异有统计学意义（P＜0.05）,其他领域认知功能比较,差异无统计学意义（P＞0.05）,LA严重度与MMSE、MoCA评分呈负相关,Spearman相关系数分别为r =-0.25、-0.28,P值分别为0.02、0.01。LA组中轻度LA患者（LA评分≤3分）30例,与无LA组比较,二者整体认知功能、视空间执行功能、命名、注意、语言、抽象、记忆及定向功能比较,差异无统计学意义（P＞0.05）。Logistic回归分析显示脑白质疏松的严重程度是急性缺血性卒中后3个月痴呆的危险因素。结论 脑白质疏松影响急性缺血性卒中患者的整体认知功能及视空间执行功能、语言、记忆功能,且LA程度越重,对认知功能影响越大,但轻度的LA对认知功能影响不明显,LA严重度是急性缺血性卒中后3个月痴呆的重要危险因素。但本研究仅仅是一单中心横断面研究,缺乏LA对认知功能长期影响的资料,有必要开展长期随访的多中心研究对其进行进一步的阐述。     

Psychosocial variables associated with the exceptional survival of patients with advanced malignant disease

This study identified psychosocial variables associated with the exceptional survival of nine cancer patients diagnosed as terminal. During open-ended interviews, subjects described their behaviors and emotions following the onset of disease and articulated personal explanations for their survival. Despite the methodological limitations inherent in this type of research, the similarity of the subjects'' responses was compelling.     

女性精神分裂症患者认知功能损害危险因素

目的探讨女性精神分裂症患者认知功能损害的危险因素,提供治疗认知功能损害的依据。方法采用自编调查表、阳性与阴性症状量表(PANSS)、简易智能精神状态量表(MMSE)对100例女性精神分裂症患者调查,认知功能损害危险因素采用Logistic回归分析。结果认知功能损害发生率为72%,阴性症状是认知功能损害的危险因素(B=0.151,Exp(B)=1.163),文化水平是认知功能损害的保护因素(B=-0.282,Exp(B)=0.754)。结论阴性症状越重认知功能损害危险度越高,文化水平越高认知功能损害危险度越低。     

Cognitive Factors in Eyelid Conditioning

With instructions not to try to figure out the experiment nor to aid or inhibit their natural responses, Ss report even complex CS-UCS contingencies quite accurately after most single cue and differential eyelid conditioning experiments. These cognitions, however, are rarely related to the S's conditioning performance. With a less obvious discriminandum, grammaticality of simple adjective-noun phrases, accuracy of reporting the differential cue was enhanced significantly when high imagery nouns were employed, and Ss unable to report the discriminandum learned no conditioned discrimination. Only those “aware’Ss who gave the V-form of the eyelid CR topography showed conditioned discrimination that was significantly superior to that of “unaware’Ss. Many kinds of cognitions are conditioned in the eyelid experiments, and awareness of CS-UCS contingencies may be a necessary but certainly not a sufficient condition for learning to occur. Awareness of CS-CR contingencies is almost never reported and consequently is unrelated to conditioning performance. In eyelid conditioning, cognitions may be viewed as simply another class of responses that are conditioned. Feedback from other CRs may, or may not, influence the course of conditioning.     

Stomatin-like protein 2 expression is associated with clinical survival in patients with cervical cancer

Aims: To investigate the prognostic role of stomatin-like protein 2 (STOML2) in cervical cancer. Methods: The expression of STOML2 in 8 pairs of cervical cancer and adjacent normal cervical tissues were detected by Real-time PCR. Immunohistochemistry was performed to evaluation of STOML2 expression in 94 paraffin-embedded cervical cancer samples. The correlation between STOML2 expression and cervical cancer progression and prognosis was analyzed statistically. Results: STOML2 expression was upregulated in cervical cancer tissues compared with adjacent normal cervical tissues. Of the 94 cervical cancer cases, high STOML2 expression was detected in 54 cases (57.4%). STOML2 expression was significantly related to tumor stage (P = 0.013) and tumor size (P = 0.025). Moreover, patients with high expression of STOML2 had a significant shorter overall survival and recurrent free survival time compared with those with low STOML2 expression in cervical cancer (P = 0.001 and P = 0.017, respectively). Multivariate analysis revealed that STOML2 was an independent prognostic factor (P = 0.022) for the overall survival in cervical cancer. Conclusion: Our study showed STOML2 was correlated to progression in cervical cancer, and implicated it as a potential predictive factor for the prognosis of cervical cancer.