Recovery of short-term memory and psychomotor speed but not postural stability with long-term sobriety in alcoholic women

The authors assessed effects of extended abstinence on cognitive and motor function deficits previously observed in a group of alcoholic women (n = 43) initially tested after 15 weeks of sobriety. Alcoholic women were retested 1 and 4 years later, and control women were retested 3 years later. At Year 1, 14 of 23 returners had maintained sobriety, but they did not perform significantly better than relapsers; the group as a whole continued to show deficits relative to age norms. By Year 4, 13 of 14 returners had maintained sobriety for more than 30 months; as a group, these women had returned to normal levels on tests of memory and psychomotor speed but remained impaired in standing balance.     

A profile of neuropsychological deficits in alcoholic women

Neuropsychological deficits, most notable in executive, visuospatial, and functions of gait and balance, are detectable in alcoholic men even after a month of sobriety. Less well established are the severity and profile of persisting deficits in alcoholic women. The authors used an extensive test battery to examine cognitive and motor functions in 43 alcoholic women who were sober, on average, for 3.6 months. Functions most severely affected in alcoholic women involved visuospatial and verbal and nonverbal working memory processes as well as gait and balance. Areas of relative sparing were executive functions, declarative memory, and upper-limb strength and speed. The authors found that lifetime alcohol consumption was related to impairment severity on Block Design (Wechsler Adult Intelligence Scale-Revised, D. Wechsler, 1981) and verbal and nonverbal working memory, suggesting a dose effect of alcohol abuse. The alcohol-related deficits in working memory, visuospatial, and balance implicate disruption of prefrontal, superior parietal, and cerebellar brain systems.     

Cognitive disturbances and neuropsychological changes after surgical treatment in a cohort of 185 patients with idiopathic normal pressure hydrocephalus

Although idiopathic normal pressure hydrocephalus (iNPH) is considered a treatable dementia, there is still some controversy regarding the cognitive improvement in these patients. The main aims of this study were to analyze baseline cognitive status and to study the neuropsychological changes after surgical treatment in a sample of 185 consecutive iNPH patients. An additional aim was to identify the variables that influenced the cognitive outcome. Specific tests assessing memory, attention, visual scanning, executive functions (EFs), and motor speed were used before and 6 months after shunting. The cognitive domains most affected at baseline were memory, EFs, attention, and psychomotor speed. After shunting, significant differences in the group as a whole were found in all tests except Digits Forward and Trail Making Part B. However, less than 50% of patients showed a significant improvement when analyzed individually. Previous global cognitive status assessed by Mini-Mental State Examination baseline scores was the best predictor for the cognitive outcome.     

Effects of (DesGly9-Arg8) vasopressin on cognitive processes in alcoholic patients

The effect of intranasally administered (DesGly9-Arg8) vasopressin (DGAVP) on certain aspects of cognitive functions of alcoholic patients was studied. The investigation was carried out in 103 chronic alcoholic patients. None of the patients suffered from Korsakoff's syndrome, portal encephalopathy or brain damage of other etiology. The trial was double-blind, placebo controlled. Psychological testing, which included certain aspects of attention, short-term and long-term memory and spatial orientation, was carried out on the day before (baseline measurements), on the last day (II), and seven days after the last administration of DGAVP (III). No treatment effect of DGAVP was observed. The results show that investigations with humans are infinitely more complex than those with animals, since a number of physiological and socio-psychological factors must be controlled. In this study of alcoholics two such factors: 1) duration of abstinence and 2) adaptation to test situation were identified.     

Dysmorphology and microstructural degradation of the corpus callosum: Interaction of age and alcoholism

Chronic alcohol abuse is a ubiquitous health and societal problem, with a growing prevalence in the older population. Alcoholism is a source of substantial deterioration in brain tissue and has been consistently observed in vivo and postmortem in white matter. To quantify the potential compounded effect of age and alcoholism, we used conventional structural MRI and diffusion tensor imaging (DTI) to examine the macrostructural and microstructural integrity of the corpus callosum, one of the most prominent white matter structures of the brain, in 131 adults, age 27-75 years. Compared with the 74 controls, the 40 alcoholic men and 17 alcoholic women, who were abstinent from alcohol for an average of 3 months, showed similar patterns and extents of callosal shrinkage, which was greatest in the genu and body and less prominent in the splenium. Microstructural integrity was measured with DTI as fractional anisotropy, an index of intravoxel orientational coherence of white matter fibers, and bulk mean diffusivity, an index of the amount of intravoxel water motility. The macrostructural shrinkage was accompanied by abnormalities in anisotropy and diffusivity of the microstructural environment of these callosal regions, indicative of disruption of structural constituents of local brain white matter. Correlational analyses revealed an age-alcohol interaction, where older alcoholics had smaller genu and splenium and higher diffusivity in these regions than younger alcoholics. Significant correlations between regional MRI and DTI measures and performance on working memory, visuospatial ability, and gait and balance provided evidence for the functional ramifications of the callosal abnormalities in the alcoholics. Thus, despite abstinence from alcohol, the interaction of age and recent alcoholism history exerted a compounded untoward effect on callosal macrostructure and microstructure.     

Neuropsychological deficits and CT scan changes in elderly depressives

A number of computerized tests were used to study visual attention, memory and learning in elderly depressed patients. Impairment was found in approximately 70% of depressed patients and was seen particularly in memory and in measures of latency. Depressed patients showed equivalent impairment in short-term memory but less impairment in conditional associative learning compared to a group of patients with early dementia of the Alzheimer-type (DAT), matched for age and pre-morbid IQ. With respect to qualitative differences between depression and DAT, depressed patients showed a different pattern of errors and a consistently prolonged latency of response which was independent of delay in a delayed matching-to-sample test. On recovery from depression, although improvement was seen in most test scores, performance in measures of latency and in a number of tests of memory and learning failed to reach the level seen in a group of matched control subjects and approximately 35% of patients continued to show impairment. For the depressed patients, ventricular brain ratio (VBR) correlated with measures of slowing. In addition, in the 'recovered-depressives', VBR correlated with poor performance at high levels of task difficulty. These findings are discussed with respect to previous literature on the pattern of cognitive impairment and CT scan findings in depression.     

Effects of abstinence on the ability of clinical laboratory tests to identify male alcoholics

Quadratic discriminant analysis of 25 commonly ordered clinical laboratory tests resulted in correct classification of 100% of nonalcoholic inpatients (n = 41), 100% of medical ward alcoholics as alcoholic (n = 63), and 95% of alcoholism treatment program participants as alcoholic (n = 274). Admission laboratory values for a random sample of 138 additional alcoholism treatment program participants were used to correctly classify 96% of them as alcoholics. Repeat analysis of these same laboratory tests after some 27 days of hospitalization resulted in 94% of the 138 patients still being classified as alcoholic, even though significant improvements in individual hepatic and hematologic laboratory values were noted. Classification was not changed with reanalysis after long-term abstinence (7 or 24 months), suggesting widespread and persistent alcohol-related alterations in organ system functioning with chronic alcohol abuse. Quadratic discriminant analysis of laboratory tests is an effective means of identifying people with present or past alcohol abuse but is not yet of value in detecting compliance with a treatment goal of abstinence.     

Higher levels of plasma estradiol and testosterone in healthy elderly men compared with age-matched women may protect aspects of explicit memory

OBJECTIVE: To assess longitudinally the relationships between plasma levels of estradiol (E2) and free testosterone (T) and cognitive functioning in elderly men, women who use estrogen, and women who do not use estrogen. DESIGN: At two test times 18 months apart (time 1 and time 2), men (time 1, n = 31; time 2, n = 23), women who were using estrogen (time 1, n = 14; time 2, n = 10), and women who were not using estrogen (time 1, n = 41; time 2, n = 27), whose average age was 72.1 and 73.4 years at time 1 and time 2, respectively, were administered a battery of neuropsychological tests that measured verbal memory, visual memory, concentration and attention, language fluency, and semantic memory. Plasma levels of E2 and free T were assessed by radioimmunoassay. RESULTS: The men had higher free T levels than both groups of women at both test times. Although women who were using estrogen had higher E2 levels than those of the men and of the women who were not using estrogen, the men's E2 levels were also significantly higher than those of the women who were not using estrogen. Moreover, the women who were using estrogen and the men had higher Forward Digit Span scores compared with the women who were not using estrogen at both test times, and women who were using estrogen had higher Backward Digit Span scores than those who were not using estrogen. Both groups of women performed better than the men on the Category Retrieval Test (verbal fluency). The performance of women who were using estrogen on the Delayed Selective Reminding Test (long-term rote memory) improved over time compared with that of the men and of the women who were not using estrogen. CONCLUSIONS: These findings raise the possibility that higher E2 levels in elderly men and in women who use estrogen may protect against some declines in explicit memory with normal aging.     

Impaired memory and general intelligence related to severity and duration of patients' disease in Type A posttraumatic stress disorder

Studies of short-term memory and general intelligence associated with duration and severity of posttraumatic stress disorder (PTSD) on observed Type A scores are rare. The authors' aim was to assess Type A behavior and identify subgroups of patients who performed most poorly on memory and intelligence tests and Type A scores related to the severity and duration of their disease. They administered nonverbal memory and intelligence tests to 30 men with PTSD and 20 men without PTSD who responded. During their initial contact with the participants, 2 experts assessed 3 major coronary-prone characteristics (hyperalertness, tight facial musculature, and explosive speech). They found significant differences between the PTSD and control groups in total Type A scores. Those with the most severe PTSD performed most poorly on visual retention tests and showed the highest scores on self-reported and subjective diastolic blood pressure reactivity during magnetic resonance imaging. In the PTSD group, high error scores on the visual retention test predicted Type A behavior and low scores on the picture memory block design tests predicted high Type A scores. A significant positive correlation was found between Type A and clinician-assessed subjective distress, whereas the correlations were significantly negative between picture memory and Type A behavior Suppressed fear is commonly associated with PTSD; decades of research on Type A behavior have isolated fear as a crucial factor in cardiovascular disease.     

The relation between cognitive functioning and self-reported sleep complaints in nondemented older adults: results from the Bronx aging study

Self-reported sleep complaints and current cognitive functioning were assessed in 375 nondemented participants ages 75 to 85 years (134 men and 241 women) as part of enrollment in the Bronx aging study, an ongoing longitudinal community-based study of cognitive aging. This study only reports on the baseline data collected from 1980 to 1983. Sleep complaints were common, occurring in about 25% of the sample. Furthermore, after controlling for depression, use of hypnotic medication, physical morbidity, age, and education, participants who reported longer sleep onset latencies performed significantly worse on measures of verbal knowledge, long-term memory and fund of information, and visuospatial reasoning. Participants who reported longer sleep durations did significantly worse on a measure of verbal short-term memory. These results suggest that perceived sleep is related to select objective cognitive abilities even when accounting for commonly recognized mediating variables, such as depression, medical comorbidity, age, or use of hypnotic medication. Given the restricted range of this nondemented sample, these results may underestimate the relation between cognitive abilities and sleep.     

A randomized controlled trial of estrogen treatment in men with mild cognitive impairment

This randomized, placebo-controlled, cross-over study investigated whether estrogen treatment would have a beneficial effect on tests of verbal memory in men with mild cognitive impairment (MCI). Forty-three men newly diagnosed with MCI were administered a battery of neuropsychological tests before randomly receiving 12 weeks of treatment with estrogen or placebo followed by a 12 week cross-over treatment. A significant improvement in the total score, and in two subscale scores of the Buschke Selective Reminding Test occurred following estrogen treatment compared to both pretreatment and post-placebo scores (p < 0.05). However, benefit occurred only in the men who had received estrogen for 12 weeks following 12 weeks of placebo. Although these findings tentatively suggest that treatment with estrogen may improve verbal memory in men with MCI, the fact that the improvement occurred only in the group that received estrogen following 12 weeks of placebo and the absence of improvement on every test of verbal memory administered suggests that these findings need to be replicated using a larger sample size.     

Cerebral changes on MRI and cognitive function: the CASCADE study

The aging, non-demented brain undergoes several physiological changes, some of which may affect cognitive function. The goal of the present study was to examine the associations between subcortical and periventricular white matter hyperintensities (WMHs), cortical and subcortical atrophy, and cognitive function (episodic memory, word fluency, attention, and perceptual, cognitive, and motor speed). This was done within a European collaborative study, Cardiovascular Determinants of Dementia (CASCADE), in which magnetic resonance imaging (MRI) was performed on community-dwelling individuals. The study includes 1254 persons from eight European study centers, ranging between 64 and 76 years of age (M 69.4+/-3.3; 55% men). When demographics (age, education, and sex), study center, and concurrent brain changes had been adjusted for, periventricular WMHS predicted lower performance in word fluency and the Stroop test (time), and subcortical atrophy predicted lower performance in motor speed and the Stroop test (errors). The findings are consistent with findings from lesion and functional neuroimaging studies.     

Functional MRI activation patterns of cerebellum in patients with epilepsy and brain tumors

Function of cerebellum in control and coordination of motor function has been well established for several years. Recent functional magnetic resonance imaging (MRI) studies reveal activation of cerebellum with memory, speech and language tasks. We hypothesize that during every function in the brain signals are relayed to cerebellum. We seek to analyze cognitive, emotional and social functions of cerebellum in patients with brain tumors and epilepsy utilizing functional Magnetic Resonance Imaging. Fifty‐one consecutive adult patients who underwent functional MRI examination were retrospectively analyzed for various activation patterns involving cerebellum. The neuropsychological battery of tasks assessed motor, language, memory, visual and auditory functions. Cognitive ability of all participants was assessed by Montreal cognitive assessment (MOCA). Patterns were analyzed for specific lobes and locations in the cerebellum. We found that simultaneous cerebellar activation is a consistent finding with brain activation during every functional MRI task that we tested except visual task. The patterns of functional MRI cerebellar activation were similar in both patient subgroups and control subjects compared to previously described patterns in normal subjects. Clin. Anat. 32:1053–1060, 2019. © 2019 Wiley Periodicals, Inc.     

Cognitive, psychomotor and polysomnographic effects of trazodone in primary insomniacs

Trazodone is prescribed widely as a sleep aid, although it is indicated for depression, not insomnia. Its daytime cognitive and psychomotor effects have not been investigated systematically in insomniacs. The primary goal of this study was to quantify, in primary insomniacs, the hypnotic efficacy of trazodone and subsequent daytime impairments. Sixteen primary insomniacs (mean age 44 years) participated, with insomnia confirmed by overnight polysomnography (sleep efficiency ≤ 85%). Trazodone 50 mg was administered to participants 30 min before bedtime for 7 days in a 3-week, within-subjects, randomized, double-blind, placebo-controlled design. Subjective effects, equilibrium (anterior/posterior body sway), short-term memory, verbal learning, simulated driving and muscle endurance were assessed the morning after days 1 and 7 of drug administration. Sleep was evaluated with overnight polysomnography and modified Multiple Sleep Latency Tests (MSLT) on days 1 and 7. Trazodone produced small but significant impairments of short-term memory, verbal learning, equilibrium and arm muscle endurance across time-points. Relative to placebo across test days, trazodone was associated with fewer night-time awakenings, minutes of Stage 1 sleep and self-reports of difficulty sleeping. On day 7 only, slow wave sleep was greater and objective measures of daytime sleepiness lower with trazodone than with placebo. Although trazodone is efficacious for sleep maintenance difficulties, its associated cognitive and motor impairments may provide a modest caveat to health-care providers.     

Alcoholics anonymous and relapse prevention as maintenance strategies after conjoint behavioral alcohol treatment for men: 18-month outcomes

Ninety men with alcohol problems and their female partners were randomly assigned to 1 of 3 outpatient conjoint treatments: alcohol behavioral couples therapy (ABCT), ABCT with relapse prevention techniques (RP/ABCT), or ABCT with interventions encouraging Alcoholics Anonymous (AA) involvement (AA/ABCT). Couples were followed for 18 months after treatment. Across the 3 treatments, drinkers who provided follow-up data maintained abstinence on almost 80% of days during follow-up, with no differences in drinking or marital happiness outcomes between groups. AA/ABCT participants attended AA meetings more often than ABCT or RP/ABCT participants, and their drinking outcomes were more strongly related to concurrent AA attendance. For the entire sample, AA attendance was positively related to abstinence during follow-up in both concurrent and time-lagged analyses. In the RP/ABCT treatment, attendance at posttreatment booster sessions was related to posttreatment abstinence. Across treatment conditions, marital happiness was related positively to abstinence in concurrent but not time-lagged analyses.     

The benefits of cognitive training after a coronary artery bypass graft surgery

Cognitive deficits are frequent after coronary artery bypass graft surgery (CABG) in the elderly population. In fact, memory and attention deficits can persist several months after the surgery. Recent studies with healthy older adults have shown that memory and attention can be improved through cognitive training programs. The present study examined whether memory training (method of loci and story generation) and attentional training (dual-task computerized training) could improve cognitive functions in patients aged 65 years and older who underwent CABG surgery. Participants (n = 51) were assigned to one of three groups: (1) control group (tested at 1, 3 and 6 months after the surgery), (2) attention training followed by memory training, (3) memory training followed by attention training (groups 2 and 3: tested at 1, 2, 3 and 6 months after the surgery). The trainings took place between the 6th and 10th week following the surgery. The three groups were compared before and after each training program using attention and memory tests and neuropsychological tests. The results showed that attention and memory trainings lead to significant improvement in the cognitive domain that was trained. It thus seems that cognitive training can be a promising tool to enhance cognitive functions after a CABG surgery.     

Cortical motor potential alterations in chronic fatigue syndrome.

Premovement, sensory, and cognitive brain potentials were recorded from patients with Chronic Fatigue Syndrome (CFS) in four tasks: i) target detection, ii) short-term memory, iii) self-paced movement, and iv) expectancy and reaction time (CNV). Accuracy and reaction times (RTs) were recorded for tasks i, ii, and iv. Results from CFS patients were compared to a group of healthy normals. Reaction times were slower for CFS patients in target detection and significantly slower in the short-term memory task compared to normals. In target detection, the amplitude of a premovement readiness potential beginning several hundred milliseconds prior to stimulus onset was reduced in CFS, whereas the poststimulus sensory (N100) and cognitive brain potentials (P300) did not differ in amplitude or latency. In the memory task, a negative potential related to memory load was smaller in CFS than normals. The potentials to self-paced movements and to expectancy and RT (CNV) were not different between groups. The findings in CFS of slowed RTs and reduced premovement-related potentials suggest that central motor mechanisms accompanying motor response preparation were impaired in CFS for some tasks. In contrast, measures of neural processes related to both sensory encoding (N100) and to stimulus classification (P300) were normal in CFS.     

Laboratory test changes in young abstinent male alcoholics

Data collected over time from an abstaining young alcoholic population were analyzed together with data from a nonalcoholic population, which served as a reference group. The laboratory tests of the abstaining alcoholics were measured at baseline (zero weeks), three weeks, and six weeks, while those of the nonalcoholic group were measured once, at baseline. The analysis attempts to reveal how abstinence from beverage alcohol consumption in an alcoholic population affects 25 commonly ordered laboratory tests over time and whether cigarette smoking mediates any observed effects. The primary findings of this detailed examination of clinical chemistries in abstaining alcoholics indicate that drinking and smoking have independent effects and that the effects of drinking persist even after six weeks of abstinence.     

The difference in patterns of motor and cognitive function in chronic fatigue syndrome and severe depressive illness

BACKGROUND: Chronic fatigue syndrome (CFS) and major depressive disorder (MDD) share many symptoms and aetiological factors but may have different neurobiological underpinnings. We wished to determine the profile of the biological variables disturbed in CFS and MDD, and identify any critical factors that differentiate the disorders. METHODS: Thirty patients with CFS, 20 with MDD and 15 healthy controls matched group-wise for age and sex were recruited. Subjects were given a detailed battery of motor and cognitive tests, including measures of psychomotor speed, memory and maximal voluntary muscle contraction in both the morning and evening that were balanced to avoid order effects. RESULTS: CFS patients generally performed worse on cognitive tests than healthy controls, but better than patients with MDD. Both patient groups had markedly impaired motor function compared with healthy controls. MDD subjects showed a significantly greater diurnal improvement in maximal voluntary contraction than healthy controls. CONCLUSIONS: Patients with CFS and MDD show similarly substantial motor impairment, but cognitive deficits are generally more marked in MDD. Diurnal changes in some functions in MDD may differentiate the disorder from CFS.     

Individual differences in aging: behavioral and neurobiological correlates

The goal of this experiment was to determine the correlations among different behavioral and neurobiological measures in aged rats. Aged Sprague-Dawley rats were given a battery of cognitive and sensorimotor tests, followed by electrophysiological assessment of sleep and biochemical measurements of various neurotransmitter systems. The behavioral tests included the following: Activity level in an open field; short-term and long-term memory of a spatial environment as assessed by habituation: spatial navigation, discrimination reversal, and cue learning in the Morris water pool; spatial memory in a T-maze motivated by escape from water; spatial memory and reversal on the Barnes circular platform task; passive avoidance; motor skills. Sleep was assessed by electrographic cortical records. The following neurotransmitter markers were examined: Choline acetyltransferase; the density of nicotinic, benzodiazepine and glutamine receptors in the cortex and caudate nucleus; endogenous levels of norepinephrine, dopamine, and serotonin in the cortex and hippocampus. The duration of bouts of paradoxical sleep was strongly correlated with several cognitive measures and selected serotonergic markers. This finding suggests that changes in sleep patterns and brain biochemistry contribute directly to deficits in learning and memory, or that the same neurobiological defect contributes to age-related impairments in sleep and in learning and memory.