首发精神分裂症及其健康同胞神经心理功能的比较

目的:探讨首发精神分裂症患者及其健康同胞神经心理功能差异。方法:采用范畴流利测验、连线测验(TMT)、数字符号编码测验和Stoop测验对在92例首发精神分裂症患者、56例健康同胞及62例健康对照者进行测评。结果:首发精神分裂症患者及其健康同胞所有神经心理测验成绩均差于健康对照组(P<0.05)。与健康同胞组比较,首发精神分裂症患者组除范畴流利测验外,其他神经心理测验成绩差异均有统计学意义(P<0.05)。结论:首发精神分裂症患者及其健康同胞存在认知损害,语义流畅性功能可能是精神分裂症的潜在内表型。     

奎的平和氯丙嗪对精神分裂症认知功能影响的双盲对照研究

目的 :探讨奎的平和氯丙嗪对精神分裂症患者认知功能的影响。方法 :40例精神分裂症患者随机均分为奎的平组和氯丙嗪组 ,在治疗前、治疗后 4、 6周作知识、算术、数字符号、数字广度 (顺、逆 )、木块拼图、瞬时逻辑记忆、视觉再生即刻和延迟、STROOPC测验、词汇流畅、TOH总分 ,计划时间、延迟逻辑记忆、WCST等神经心理测验 ,整个研究过程采用双盲双模拟法。为观察学习效应 ,12例健康者在相同间隔时间作神经心理测验。所得数据用SPSS10 0进行统计分析。结果 :治疗后 ,奎的平组大部分患者神经心理测验成绩提高而氯丙嗪组的测验结果变化不大 ,尤其在注意、执行功能方面。奎的平对精神分裂症患者认知功能的改善作用优于氯丙嗪 (P <0 0 5 )。结论 :奎的平对精神分裂症患者的注意和执行功能有改善作用而氯丙嗪不明显。     

35例精神分裂症患者神经心理学评估的对照研究

目的：用神经心理测验评估35例精神分裂症患者认知功能损害的特点。方法：采用多种神经心理测验评估35例精神分裂症患者（12例未用药，8例用药1周以内，15例用药1月以上）和20例健康对照组的学习、记忆、工作记忆、注意、信息处理速度、词语流畅、执行功能等认知功能。对未用药和用药1周以内的精神分裂症患者进行随访。结果：在成套神经心理测验的各个分测验中，精神分裂症患者（未用药、用药1周以内和用药1月以上）成绩均较正常人差[如韦氏数字符号得分未用药者（63．0&#177;13．8），正常对照组（87．10&#177;13．16），P〈0．001]。用药1月以上组的空间广度测验成绩优于未用药组[逆行得分成绩用药1月以上组（7．47&#177;1．81），未用药组（5．50&#177;1．73），P〈0．01；总分成绩用药1月以上组（15．33&#177;3．31），未用药组（12．42&#177;3．65）]。随访研究中，霍普金斯词汇学习测验一修订版、简易视觉空间记忆测验-修订版和视觉空间广度测验的随访成绩优于初测成绩[如空间广度测验的逆行得分初测成绩（5．7&#177;1．5），随访成绩（6．8&#177;1．0，P〈0．05）]。结论：精神分裂症患者存在大脑广泛的认知功能损害。非经典抗精神病药物治疗可能对精神分裂症患者的言语记忆、视觉空间记忆和视觉工作记忆有所改善。     

60岁以上老年人WMS结果分析

阿尔茨海默病 (ＡＤ)、脑血管病 (ＣＶＤ)以及其他神经系统疾病均能影响老年人的记忆功能。本文总结本院神经心理室 6 0岁以上老年人的韦氏记忆测验资料 ,分析上述疾病患者的记忆情况 ,通过与正常人进行比较 ,以了解这些疾病所产生的记忆损害状况和程度。1　对象与方法1.1　对象从 1991年 2月至 2 0 0 2年 1月 ,在我院神经心理室接受韦氏记忆量表 (ＷＭＳ -ＲＣ)测试的门诊和住院病人及部分正常老年人中年龄 6 0岁以上者共计394人。其中ＡＤ 198例 (5 0 .3% ) ,男性 113例 ,女性85例 ,平均年龄 71.2 4± 5 .6 7岁 ;ＣＶＤ 12 9例 (32 .7% ) …     

首发精神分裂症重复神经心理测查系统分析

目的用重复神经心理测查系统探讨首发精神分裂症的认知功能损害特点。方法对53例首发精神分裂症患者和62例健康对照用重复神经心理测查系统（RBAN S）和Stroop色词测验进行检测。结果在Stroop色词测验中,病人组的成绩均比对照组差,且差异有统计学意义（P〈0.05）。在RBAN S测查中,病人组5个因子的成绩均比对照组差,且差异有统计学意义（P〈0.05）。结论首发精神分裂症患者可能存在比较严重的全面认知功能损害,范围比较广。     

精神分裂症患者的认知功能改变的研究

目的：探讨精神分裂症的认知功能损害特点。方法：对21例分裂样精神障碍，26例精神分裂症和22名健康对照组进行威期康星卡片分类测验，词汇流畅测验，联想学习，领悟，相似和数字广度测验，结果：在所有的神经心理测验中，分裂症样精神障碍组和精神分裂症组成绩均显著低于对照组（均P＜0．05），威期 星卡分分类测验与其它各项神经心理测验无明显的相关。结论：精神分裂症患者存在认知功能损害。     

综合戒酒远期疗效随访

本文就 1993年 3月至 1995年 5月在本院戒酒的 10 7例酒精依赖患者 ,经过系统呋喃唑酮厌恶疗法配合认知治疗至今届满 5年以上者获得其中 62例随访资料 ,分析报告如下 :临床资料 :62例男 ,符合ＣＣＭＤ -Ⅱ -Ｒ“酒精所致精神障碍”诊断标准[1] 。文化 :文盲 19例 ,小学 2 1例 ,初中 16例 ,高中 6例 ;职业 :农民 8例 ,渔民 3 2例 ,经商 8例 ,员工 13例 ,驾驶员 1例 ;婚姻 :已婚 5 0例 ,未婚 8例 ,离婚 4例 ;就诊年龄 3 7 1± 7 5岁 ,始饮年龄 19 5± 4 4岁 ,饮酒年数 17 3± 7 4年 ,酒精依赖期持续年数 6 9±3 7年 ,饮酒量 :日 3 12 8± 2 …     

脑电生物反馈治疗对慢性精神分裂症认知功能影响

目的:探讨脑电生物反馈治疗对慢性精神分裂症患者认知功能的影响。方法:对58例慢性精神分裂症患者在利培酮药物治疗的基础上,分别给予脑电生物反馈治疗(脑电生物反馈治疗组30例)及传统娱疗(传统娱疗组28例)。采用认知评估工具连线测验、简单视觉空间记忆测验(BVMT-R)、WMS-Ⅲ空间广度测验、霍普金斯词语学习测验(HVLT-R)、定步调听觉连续加法测验(PASAT)和威斯康星卡片分类测验(WCST-64)对治疗前及治疗8周后进行神经心理测试。采用阳性和阴性症状量表(PANSS)评定临床症状。结果:治疗前与治疗后PANSS评分两组间无显著差异(P0.05),两组在治疗前神经心理测验成绩无显著差异(P0.05)。治疗8周后,两组间各项神经心理测试比较:空间广度测验的顺行得分、持续错误数、完成分类数无显著差异(P0.05)。连线测验(t=2.10,2.07;P0.05),逆行得分(t=-2.52,P0.05),HVLT-R(t=-2.86,P0.01;t=-3.63,-10.35,P0.001),BVMT-R(t=-5.01,P0.001;t=-3.04,P0.01;t=-4.23,P0.001),PASAT(t=-20.65;P0.001),两组比较均有显著差异。结论:脑电生物反馈治疗对慢性精神分裂症的认知功能改善作用较传统娱疗组明显。     

首发精神分裂症患者认知功能与精神症状及疗效的关系

目的：探讨首发精神分裂症患者的认知和功能与精神症状及疗效的关系。方法：对１６４例首发精神分裂症患者随机给予氯丙嗪或氯氮平治疗;于治疗前分别作韦氏成人智力量表、韦氏记忆量表、铁槽铁钉测验、手指敲击测试、动作功能测验、手功能协调测验、连线测验Ａ和Ｂ、威斯康星卡片分类测验（ＷＣＳＴ）及词语流畅性测验１１项神经心理测查各一次,并作ＢＰＲＳ、ＳＡＮＳ、功能总体评定量表（ＧＡＦ）一次;治疗１２周末再评定１次上     

41例心衰患者CA-125测定的临床意义

糖类抗原 12 5 (ＣＡ - 12 5 )作为卵巢癌的肿瘤标志物已众所周知 ,但其与充血性心力衰竭 (ＣＨＦ)关系的报道少见。我们自 2 0 0 0年 5月对 4 1例ＣＨＦ患者进行ＣＡ - 12 5检测比较 ,旨在探讨其临床意义。对象和方法　　一、对象 :ＣＨＦ组 :4 1例 (男 2 6 ,女 15 ) ,平均年龄 6 7(40～83)岁。按ＮＹＨＡ心功能分级 ,Ⅱ级 12例 ,Ⅲ级 14例 ,Ⅳ级 15例 ,肿瘤患者均除外。对照组Ａ :急性心肌梗死 (ＡＭＩ) (不伴心力衰竭 ) 10例 (男 7,女 3) ,年龄 5 8～ 81岁 ;对照组Ｂ :健康成人 10例 (男 5 ,女 5 ) ,年龄 30～ 70岁。二、方法 :ＣＨＦ和…     

Role of executive functioning in verbal and visual memory

G. Tremont, S. Halpert, D. J. Javorsky, and R. A. Stern (2000) found that individuals with executive dysfunction were more impaired on less structured versus more structured verbal memory tasks. In the present study, the authors investigated the relationship between executive functions and memory in patients with a history of traumatic brain injury by examining the effect of executive functioning on more structured and less structured verbal and visual memory tasks at baseline and 1-year follow-up. Matched subgroups controlled for differences in severity of neuropsychological impairment unrelated to specific executive functions. The G. Tremont et al. (2000) findings were not replicated. Results showed that when acuteness and severity of injury were controlled, executive impairment played no significant role in performance on either more or less structured memory tasks. However, regardless of structure, executive functions played a role in visual memory performance, suggesting that visual memory may be a more fluid ability than verbal memory.     

Alcoholics' self-assessment of their neuropsychological functioning in everyday life

Self-reports of impairment in everyday cognitive and perceptuomotor functioning for the 6 months that preceded treatment were investigated in 60 male, middle-aged alcoholics and for a comparable time period in 60 nonalcoholic controls matched on age, education, and Shipley Vocabulary age. Alcoholics reported significantly more everyday impairment than did controls in memory, higher cognitive functions, language skills, and perceptual-motor function. Laboratory tests of neuropsychological performance revealed that the alcoholics were significantly poorer than controls on measures of memory, higher cognitive functions, and overall neuropsychological functioning, but test performances essentially were uncorrelated with self-reported everyday impairment and with self-reported levels of depression and anxiety. However, in both groups, measures of depression and anxiety were correlated significantly with self-perception of impairment. In alcoholics, quantity-frequency of drinking (QFI) was also correlated with reported impairment; chronicity was not. Multiple regression analyses indicate that in alcoholics, both quantity-frequency measures of alcohol intake and affective distress (depression, anxiety) made independent and roughly equal contributions to reported everyday impairment; in controls, only affective distress contributed significantly.     

Neuropsychological functioning in migraine headache, nonheadache chronic pain, and mild traumatic brain injury patients.

There are conflicting reports in the literature concerning the neuropsychological functioning of migraine headache patients. The finding in some studies that migraineurs performed more poorly than healthy controls led to the hypothesis that chronic migraine may result in subtle but persistent cerebral dysfunction. Reports describing acute and between-headache neurophysiological disturbances in migraineurs lent support to this hypothesis. To elucidate the cognitive status of these patients, we administered a brief neuropsychological battery to 60 individuals with migraine headache (HA), nonheadache chronic pain (PAIN), or mild traumatic brain injury (MTBI). The PAIN group was included to test the hypothesis that cognitive difficulty in migraineurs might result from the discomfort, depression, medications, etc. often associated with chronic pain, rather than from brain dysfunction. The MTBI patients were considered a useful comparison for the migraineurs because their level of impairment was also expected to be mild, at worst. A MANOVA, with three cognitive index scores as the dependent variables, revealed that the three groups differed significantly. Follow-up contrasts demonstrated that the MTBI group was significantly more impaired on the memory index compared to the HA and PAIN groups, which did not differ from each other. The use of two different normative-based cutoffs to identify individuals who were impaired on the test battery revealed that the frequency of impairment within the two groups of pain patients, but not the MTBI patients, was within normal limits. Thus, the results did not support a link between migraine headache and cognitive impairment.     

Are neuropsychological impairments in children with early-treated phenylketonuria (PKU) related to white matter abnormalities or elevated phenylalanine levels?

This study aimed to enhance our understanding of neuropsychological functioning in children with early-treated phenylketonuria (PKU) and assess the relative impact of white matter abnormalities (WMA) and neurotransmitter deficiencies on cognitive functions in this population. The study consisted of 33 children with early-treated PKU and 34 healthy control children aged between 7 to 18 years. All children had a neuropsychological evaluation that included measures of general intelligence, attention, processing speed, memory and learning, executive function, and academic achievement. Children in the PKU group also had a magnetic resonance (MR) brain scan. When compared with the control group, the PKU group exhibited global cognitive impairment including lower IQ, attention problems, slow information processing, reduced learning capacity, mild executive impairments, and educational difficulties. Children in the PKU group with extensive WMA (n = 14) displayed significant impairments across all cognitive domains. Metabolic control correlated weakly to moderately with attention, executive, and memory/learning factors. Within the PKU group, regressions revealed that executive function and attention factors were independently related to severity of WM pathology and age, while the memory and learning factor was independently related to metabolic control and age. It is concluded that children with early-treated PKU exhibit a global pattern of impairment, with a particular deficit in processing speed. WM pathology extending into frontal and subcortical regions correlates with the greatest deficits and a profile of impairment consistent with diffuse WM damage. Our findings also offer some support for dopamine depletion in the prefrontal cortex, however adverse consequences as a result of norepinephrine and serotonin deficiencies should not be discounted.     

Memory and executive impairment in schizophrenia: comparison with frontal and temporal brain damage

BACKGROUND: Although poor neuropsychological test performance is well documented in schizophrenia, how closely it resembles that seen in patients with brain damage in terms of cognitive failures in daily life and stability over time has been little studied. METHOD: Thirty patients with chronic schizophrenia, 24 patients with frontal or temporal brain damage and 30 healthy controls were given a battery of memory and executive tests. Carers of the two patient groups also completed questionnaires rating memory and executive failures in daily life. Testing was repeated 6 weeks later. RESULTS: The schizophrenia and the brain-damaged patients were significantly impaired on most, but not all tests. The degree of carer-rated memory or executive failure was similar in the two groups, but the schizophrenia patients were rated as having significantly more executive failures than memory failures, whereas the brain-damaged patients showed the reverse pattern. Both groups of patients showed similar consistency of performance across sessions. CONCLUSIONS: Neuropsychological impairment in schizophrenia resembles that seen in patients with brain damage, not only in terms of overall severity, but also in terms of stability and the degree to which poor test performance translates into cognitive failures in daily life.     

Executive Function and Theory of Mind in 2 Year Olds: A Family Affair?

This study aimed to enhance our understanding of neuropsychological functioning in children with early-treated phenylketonuria (PKU) and assess the relative impact of white matter abnormalities (WMA) and neurotransmitter deficiencies on cognitive functions in this population. The study consisted of 33 children with early-treated PKU and 34 healthy control children aged between 7 to 18 years. All children had a neuropsychological evaluation that included measures of general intelligence, attention, processing speed, memory and learning, executive function, and academic achievement. Children in the PKU group also had a magnetic resonance (MR) brain scan. When compared with the control group, the PKU group exhibited global cognitive impairment including lower IQ, attention problems, slow information processing, reduced learning capacity, mild executive impairments, and educational difficulties. Children in the PKU group with extensive WMA (n = 14) displayed significant impairments across all cognitive domains. Metabolic control correlated weakly to moderately with attention, executive, and memory/learning factors. Within the PKU group, regressions revealed that executive function and attention factors were independently related to severity of WM pathology and age, while the memory and learning factor was independently related to metabolic control and age. It is concluded that children with early-treated PKU exhibit a global pattern of impairment, with a particular deficit in processing speed. WM pathology extending into frontal and subcortical regions correlates with the greatest deficits and a profile of impairment consistent with diffuse WM damage. Our findings also offer some support for dopamine depletion in the prefrontal cortex, however adverse consequences as a result of norepinephrine and serotonin deficiencies should not be discounted.     

Neuropsychological functioning in stimulant-naive boys with hyperkinetic disorder

BACKGROUND: Although children with hyperkinetic disorder and/or attention deficit hyperactivity disorder (ADHD) show disordered executive neuropsychological functioning, the nature of these changes remains controversial. Additionally, impairments in non-executive neuropsychological functioning have been relatively unexplored. Here, the authors describe the neuropsychological functioning of a sample of stimulant drug-naive boys with hyperkinetic disorder on a battery of neuropsychological tasks sensitive to impairments of both executive and non-executive functions. METHOD: Seventy-five stimulant drug-naive boys meeting diagnostic criteria for ICD-10 hyperkinetic disorder were compared with 70 healthy developing controls matched for age but not IQ on computerized tests of neuropsychological functioning from the Cambridge Neuropsychological Test Automated Battery (CANTAB) and a Go/No-Go inhibition task. RESULTS: Boys with hyperkinetic disorder exhibited impairments on tasks with a prominent executive component--working memory, planning, strategy formation, attentional set-shifting and on a reaction time task. However, they were also impaired on tasks without prominent executive components--pattern and spatial recognition, spatial span, delayed matching to sample and paired associates learning. Contrary to predictions, no impairment was observed on the Go/No-Go inhibition task. CONCLUSIONS: Medication-naive boys with hyperkinetic disorder displayed a broad range of neuropsychological impairments. Deficits were demonstrated on tasks with and without prominent executive components. Impairments were not confined to tasks dependent upon frontostriatal functioning, cannot wholly be explained by deficits in inhibitory control, nor can they be attributed to intelligence or previous exposure to stimulant medication.     

Cortical synaptic density is reduced in mild to moderate human immunodeficiency virus neurocognitive disorder. HNRC Group. HIV Neurobehavioral Research Center

Dendritic and synaptic damage (without frank neuronal loss) may be seen in milder human immunodeficiency virus (HIV)-related cognitive disorders. Synapse volume estimates, performed by stereological methods, could enhance the ability to detect subtle neuronal changes that may accompany cognitive impairment in HIV infection. For the present study, synaptic density and neuronal number were assessed by combined stereology/confocal microscopy and these measures were then correlated with ante-mortem levels of cognitive performance in AIDS patients. Three-dimensional stereological measures showed a significant correlation between reduced synaptic density and poor neuropsychological performance. To evaluate the specificity of any observed associations, additional variables including viral burden, astrogliosis and number of calbindin-immunoreactive neurons were measured. Factor analysis of a set of neuropathological variables revealed two factors; one defined by synaptic density and volume fraction, calbindin pyramidal neuronal densities and viral burden; the second by astrocytosis and calbindin interneuron density. Only the first factor correlated significantly with neuropsychological functioning during life. It is concluded that a combination of factors including synaptic damage, specific neuronal loss and increasing viral load underlies HIV-associated cognitive impairment. As synaptic damage is potentially reversible, early diagnosis and treatment of mild cogntive disorders may improve functioning and prevent the progression of brain disease.     

Self- and informant reports of executive function on the BRIEF-A in MCI and older adults with cognitive complaints.

Amnestic mild cognitive impairment (MCI) is characterized by impaired episodic memory, although subtle executive problems have been noted on neuropsychological tests. Recent research also has described a group of healthy, non-depressed older adults with significant cognitive complaints (CC) but normal performance on neuropsychological testing. These individuals show structural and functional brain changes intermediate between those seen in MCI and healthy older adults without such complaints (HC). We evaluated executive functions in MCI and CC using the Behavior Rating Inventory of Executive Function-Adult version (BRIEF-A), a newly developed self- and informant report questionnaire in 29 patients with amnestic MCI, 28 CCs, and 30 demographically matched HCs. MCI and CC participants reported significant difficulties with selective aspects of executive functioning relative to HCs despite clinically normal performance on neuropsychological tests of this cognitive domain. Scores were generally in the pattern of MCI>CC>HC, and findings were most pronounced for working memory. Additionally, MCI and CC participants were more likely than their informants to report clinically meaningful executive problems, though informants identified a similar pattern of difficulty overall. Results failed to reveal strong relations between the BRIEF-A and standardized neuropsychological tests of executive function. Overall findings indicate that the BRIEF-A is sensitive to subtle executive changes in MCI and CC and suggest the need for research to determine if executive complaints are predictive of clinical course.