Cognitive function is not impaired in people with a long history of migraine: a blinded study

Little is known about the long-term consequences of migraine for cognitive functioning. This study compared older migraine patients with matched controls on four measures of cognitive ability, in a blinded design. Migraine patients and case-matched controls were recruited from the database records of a pre-existing study of ageing. Data were available from four tests of cognitive ability: verbal/arithmetic problem solving, spatial problem solving, processing speed, and vocabulary. There were no significant differences between the mean scores of migraine and control groups on any of the four cognitive tests. In addition, there were no significant differences between migraine and control groups in the effect of age on any of the four tests. A long history of migraine does not compromise scores on the four cognitive tests used in this study. These tests are predictive of memory and executive functioning in cognitive ageing, but it remains possible that lower-level cognitive processes, particularly as assessed by visual tasks, may be vulnerable to migraine.     

Reduced serotonin vascular sensitivity in ergotamine abusers

The action of ergotamine on the 5-hydroxytryptamine (5-HT) venous sensitivity was studied in ergotamine abuser and non-abuser migraine patients. Ergotamine abusers showed reduced 5-HT hand vein contraction during abuse, compared to seven days after ergotamine withdrawal. In non-ergotamine users, the 5-HT venoconstriction was not significantly modified 12 h after a single intramuscular ergotamine (0.25 mg) administration. Even the administration of ergotamine locally into the vein did not change the venospasm of 5-HT given acutely in the same vein. Therefore, it seems that the 5-HT antagonism does not contribute to the therapeutic effect of ergotamine during the migraine attack. Moreover, the reduced 5-HT responsiveness during ergotamine abuse may possibly be compatible with the chronic headache present in some abusers, the withdrawal headache attacks and the abuse itself.     

单纯性肥胖儿童应付方式特点与心理状况研究

目的探讨单纯性肥胖儿童的应付方式特点与心理健康状况。方法采用症状自评量表、应付方式问卷对64例单纯性肥胖儿童和64例正常儿童进行评定。结果肥胖组症状自评量表的躯体化、人际关系、抑郁、焦虑、敌对性、恐怖因子分显著高于正常组(P<0.05)。应付方式问卷肥胖组自责、幻想、退避因子分显著高于正常组(P<0.05)。症状自评量表因子与应付方式问卷因子中自责与人际关系、抑郁、焦虑、恐怖呈正相关(r=0.32～0.61,P<0.05);幻想与躯体化、抑郁、敌对呈正相关(r=034～0.44,P<0.05);退避与人际关系、敌对呈正相关(r=035～0.46,P<0.05)。结论单纯性肥胖儿童存在较多的心理问题,且多使用自责、幻想、退避等不成熟应付方式,其心理问题与不成熟应付方式有关。     

Acute hypoglycemia in humans causes attentional dysfunction while nonverbal intelligence is preserved

OBJECTIVE: Experimentally induced hypoglycemia in humans causes progressive but reversible cognitive dysfunction, but it is not known to what extent neuropsychological tests index abilities of cognitive functioning that are important in everyday life. This study examines the effects of acute insulin-induced hypoglycemia on attention and intelligence in nondiabetic humans. RESEARCH DESIGN AND METHODS: A hyperinsulinemic glucose clamp was used to achieve controlled euglycemia (4.50 [0.22] mmol/l) and hypoglycemia (blood glucose 2.59 [0.19] mmol/l) in 20 healthy volunteers. Subjects were studied on two occasions in a counterbalanced order. During each study condition, subjects completed parallel tests of cognitive function. Cognitive function was assessed by the Test of Everyday Attention and Raven's Progressive Matrices. RESULTS: Hypoglycemia induced a significant deterioration in tests sensitive to both visual and auditory selective attention. During hypoglycemia, attentional flexibility deteriorated and speed of information processing was delayed. Sustained attention was preserved and intelligence scores did not deteriorate during hypoglycemia. CONCLUSIONS: During hypoglycemia, a significant deterioration occurs in attentional abilities, whereas fluid intelligence is preserved. On the basis of these results, it can be surmised that many complex attention tasks relevant to everyday life are impaired during moderate hypoglycemia.     

中年2型糖尿病患者认知功能探讨

目的 通过心理测验，了解中年2型糖尿病(NIDDM)患的认知功能。方法 年龄、性别、化程度相匹配的INDDM患和对照组各60名，排除可能影响认知功能的各种神经、精神疾病、药物和酒精滥用，糖尿病人需排除曾有严重低血糖发作和酮症酸中毒，做韦氏记忆量表和威斯康星卡片分类测验。结果 2型糖尿病组认知测验成绩低于对照组，有显差异。结论 中年2型糖尿病患存在着认知功能损害。     

Working memory: a neuropsychologic and cerebral imagery approach

The working memory model proposed by Baddeley and Hitch has frequently been used in cognitive psychology and neuropsychological studies. This model consists of several interacting components, responsible for the storage and processing of the information stored in working memory. Many neuropsychological and functional imagery data are consistent with that formulation of working memory. Moreover, many cognitive tasks have been specifically designed to explore particular aspects of working memory functioning. Taken as a whole, these data confirm that the working memory model remains a useful theoretical framework to explore memory functioning both in normal subjects and in pathological conditions.     

Neuropsychological assessment of chronic non-malignant pain patients treated in a multidisciplinary pain centre.

The aim of the study was to investigate the influence of pain, sedation, pain medications and socio-demographics on cognitive functioning in chronic non-malignant pain patients. Chronic non-malignant pain patients (N=91) treated in a multidisciplinary pain centre were compared with age and sex matched healthy volunteers (N=64). Furthermore four subgroups of patients were examined: Group 1 (N=21) received no pain medications, group 2 (N=19) were in long-term oral opioid treatment, group 3 (N=18) were treated with antidepressants and/or anticonvulsants and group 4 (N=33) were treated with a combination of long-term oral opioids and antidepressants and/or anticonvulsants. Assessments comprised pain (PVAS) and sedation (SVAS), Continuous Reaction Time (CRT) testing for sustained attention, Finger Tapping Test (FTT) testing for psychomotor speed, Paced Auditory Serial Addition Task (PASAT) testing for information processing and working memory and Mini Mental State Examination (MMSE). CRT and FTT were impaired in the total patient sample. Treatment with opioids was associated with poorer performance of PASAT. High scores of PVAS and SVAS were associated with poor performance of PASAT and CRT, respectively. MMSE seems to be too insensitive for detecting the milder forms of cognitive impairment found in chronic non-malignant patients.     

Psychological interventions in multiple sclerosis: Improving cognition and quality of life

Multiple sclerosis is often associated with impaired cognitive functioning, of mainly attention, information processing speed, executive functions and memory. Cognitive alterations have direct functional consequences for quality of life, ranging from occupational activities to personal life and professional career. Additionally, there is a complex interplay between cognitive impairment and affective functions, such as depression or anxiety, which in turn has a negative impact on quality of life. Therefore, current work aims to reduce the impact of cognitive alterations on daily life rather than only defining their nature and severity. For this purpose, programs of cognitive rehabilitation have been increasingly used over the last decades. Although promising, their effects have not been studied widely and further works are needed to demonstrate their real daily-life efficiency and their effects over the long-term. Cognitive remediation must be integrated in a wider perspective rather than improve specific task performance, in which psychological care as well as the patient's feelings of being cared for and listened to remain essential. From this perspective, new approaches have developed in parallel. This extended review shows the potential benefit of cognitive-behavioral therapies, mindfulness or physical exercise on varied psychological functions in multiple sclerosis. Among others, these various therapies aim to help patients better conceive their cognitive functioning through their (neuro)psychological care and their daily life, hence improving their quality of life and self-esteem. They also aim to provide more appropriate long-term care by reconciling the quasi-systematic use of non-pharmacological approaches and follow-up clinical routine consultations with health care providers.     

脑损伤患者语义启动效应的研究

目的探讨脑损伤患者语义启动效应的变化。方法对8例阿尔茨海默病(AD)患者、15例血管性痴呆(VD)患者、17例脑外伤(TBI)患者、24名正常青年人(青年组)、17名正常中老年人(中老年组)进行简易精神状态检查、临床记忆量表、加工分离程序测验,对所得数据进行统计学分析。结果AD组患者的意识性提取、自动提取成绩均显著低于青年组及中老年组(P<0.001);VD组、TBI组患者的意识性提取成绩均显著低于青年组及中老年组(P<0.001),自动提取成绩与青年组及中老年组的差异无显著性意义(P>0.05)。结论AD患者的外显记忆和语义启动效应损伤,VD和TBI患者的外显记忆损伤,语义启动效应均保留。     

Cognitive predictors of sentence comprehension in children with and without developmental language disorder: Implications for assessment and treatment

Abstract

Purpose: This paper summarises the clinical ramification of a large-scale study of the direct and indirect (mediated) influences of four cognitive mechanisms that are relevant to the comprehension of syntactic structure by school-age children with and without developmental language disorder (DLD).

Method: A total of 117 children with DLD and 117 propensity-matched typically-developing (TD) children completed sentence comprehension tasks and cognitive tasks related to fluid reasoning, controlled attention, speed of processing, phonological short-term memory (pSTM), complex working memory (cWM) and language knowledge in long-term memory (LTM).

Result: Results of confirmatory factor analysis (CFA) indicated that the most salient characteristics of cognitive processing in children with and without DLD were represented by a measurement model that included four latent variables: fluid reasoning, controlled attention, complex WM and language knowledge in LTM. Structural equation modelling (SEM) indicated that complex WM mediated the relationship between sentence comprehension and fluid reasoning, controlled attention and long-term memory for language knowledge.

Conclusion: Our research suggests that the most salient characteristics of cognitive processing in children with and without DLD can be condensed to four cognitive factors: fluid reasoning, controlled attention, complex WM and language knowledge in LTM. We suggest a few measures that clinicians can use to reliably assess these factors, and we summarise a functional intervention programme that is designed to promote the strategic organisation of information in ways that challenge verbal complex WM and LTM processes that support language comprehension and use.     

利培酮 奥氮平 奎硫平对康复期精神分裂症认知功能的影响

目的 探讨利培酮、奥氮平、奎硫平对康复期精神分裂症患者认知功能和社会功能的影响. 方法 将60例康复期精神分裂症患者随机分为三组,每组20例,分别口服利培酮、奥氮平、奎硫平治疗,观察12周.于治疗前及治疗12周末采用韦氏记忆量表、威斯康星卡片分类测验、连线测验、个人和社会功能量表、阳性与阴性症状量表及临床病情严重程度量表进行测评,并与60名健康体检者（对照组）进行对比分析. 结果 治疗前三组患者威斯康星卡片分类测验、连线测验及韦氏记忆量表的各项认知功能指标评分与对照组均有显著性差异（P＜0.05或0.01）;治疗后三组患者连线测验-B连线时间评分显著低于治疗前（P＜0.05或0.01）,而威斯康星卡片分类测验、连线测验-A连线时间、连线测验-A错误数、连线测验-B错误数及韦氏记忆量表记忆商评分与治疗前比较均无显著变化（P＞0.05）,且威斯康星卡片分类测验、连线测验-B错误数及韦氏记忆量表记忆商评分仍与对照组有显著性差异（P＜0.05或0.01）.治疗12周末,三组患者临床病情严重程度量表评分均较治疗前有显著下降（P＜0.05）;奎硫平组阳性与阴性症状量表总分减分值显著低于利培酮组和奥氮平组（P＜0.05）;三组不良反应均轻微. 结论 利培酮、奥氮平、奎硫平均能改善康复期精神分裂症患者的部分认知功能和社会功能,疗效相当,但短期内对执行功能及韦氏记忆量表记忆商无显著改善.     

An animal model of human declarative (relational) memory and of its dysfunction

The present work was aimed at determining, both at the psychological and at the neurobiological levels, aspects of rodent memory that fall into line with human declarative memory which is known to be selectively impaired in amnesic subjects and during the course of ageing. The ability to compare and to contrast items in memory, and to support inferential use of memories in novel situations (flexibility), were considered to be the two key psychological features of human declarative memory that were altered by both hippocampal lesions and hippocampal dysfunction. Adult and aged mice were trained on learning tasks using two-stage paradigms, the aim of which was to assess memory performance through these two psychological aspects in the same subjects. Results suggest that ageing specifically impairs the ability to both compare and contrast items in memory (declarative/relational memory based on complex associations), without altering memory based on simple S-R associations (procedural memory). Hippocampal lesions in adult mice produced the same dissociation between relational memory (impaired) and procedural memory (spared). Pharmacological experiments showed that, depending on the drug used, the relational memory deficit of aged mice may be selectively reversed (i.e. without changes in procedural memory) and that the behavioural efficacy of certain treatments was shown to parallel their potency in re-establishing normal (i.e. adult) levels of hippocampal plasticity-related mechanisms. Together with previous findings, these results suggest that the storage and use of relational representations would critically depend on the plasticity of hippocampal synapses, which via their connections with cortical areas, would support the storage of associations between perceptual, behavioral and cognitive events.     

Memory deficits in depression

Despite clinical reports of impaired memory functioning of depressed persons, the results of empirical studies in this area have been equivocal. The present study was designed to address a number of the methodological shortcomings of these earlier investigations, examining potential depressionassociated deficits in sensory and short-term memory processing in a single sample of subjects. Twenty depressed and 20 nondepressed subjects participated in two tasks, each examining one of these aspects of memory. The results of this study suggest that whereas sensory memory is intact in depressed individuals, short-term memory processing is impaired. More specifically, the depressed subjects experienced difficulty with the retention of material, likely owing to impaired rehearsal ability. The results of this study are discussed with respect to their implications for cognitive models of depression, and suggestions for future research in this area are offered.The authors wish to thank two anonymous reviewers for their helpful comments on an earlier version of this paper.     

Long term effects of oral sustained release morphine on neuropsychological performance in patients with chronic non-cancer pain

Morphine is increasingly used in patients with chronic non-cancer pain, but a major concern associated with chronic use relates to possible cognitive side-effects. The aim of this long-term prospective study was to evaluate the cognitive impact of oral sustained release morphine in patients with non-cancer pain. A battery of neuropsychological tests to explore attention, psychomotor speed and memory was administered. The effects of morphine on pain, quality of life, mood, subjective memory impairment and side-effects were also investigated. Evaluations were performed at baseline in patients free from opioids and then after 3, 6 and 12 months. Twenty-eight patients were included: 18 received oral sustained morphine (range 40-140 mg/day), ten patients stopped morphine prematurely because of side-effects or insufficient pain relief and were followed as a control group. There was no impairment of any neuropsychological variable over time in the morphine treated patients in comparison with the control group. Two measures of information processing speed - the Stroop interference score and the digit symbol test were improved at 6 and 12 months and there were significant correlations with the pain relief and improvement of mood. Self-reported memory impairment improved notably in responders to morphine. Morphine induced persisting effects on pain, and to a lesser extent on quality of life and mood. The visual analog scale score for side-effects increased at 12 months and essentially consisted of gastrointestinal disorders. This study demonstrates that 12 months treatment with oral morphine does not disrupt cognitive functioning in patients with chronic non-cancer pain and instead results in moderate improvement of some aspects of cognitive functioning, as a consequence of the pain relief and concomitant improvement of well-being and mood.     

Reductions in 'Ross Information Processing Test-Geriatric' information processing and 'A Quick Test of Cognitive Speed' processing speed in Alzheimer's disease: which lead and which follow?

Our objective was to obtain preliminary evidence for an order of emergence of measurable reductions in cognitive-linguistic abilities and processing/naming speed. A total of 22 patients with mild-to-moderate Alzheimer's disease (AD) or mild cognitive impairment and 22 age- and sex-matched controls participated. Ross Information Processing Test-Geriatric (RIPA-G) evaluated functional information processing and A Quick Test of Cognitive Speed (AQT) measured naming speed (s) for familiar single-dimension (e.g. colors, forms) and dual-dimension (e.g. color-form combinations) visual stimuli. Patient age was not a significant factor. Means for RIPA-G information processing were in the normal range. AQT means for most perceptual-speed (e.g. form naming) and all cognitive-speed measures (e.g. color-form naming) were in the atypical/pathological range. Correlations between information processing and processing speed were moderate, negative and mostly nonsignificant. RIPA-G memory and organization identified that about a third of patients performed below the normal range. AQT dual-dimension naming identified that all 19 patients with mild-to-moderate AD performed in the atypical range (i.e. slower than +2 SD of the mean). The findings provide preliminary evidence that reductions in perceptual and cognitive speed precede reductions in cognitive-linguistic abilities and functional information processing in mild-to-moderate AD. AQT can assess short-term changes in cognitive functioning and monitor intervention. RIPA-G can provide broad-based functional measures at baseline and over the longer term. The combined use of AQT and RIPA-G can provide health professionals with broadly based clinical information, relevant for making team-based rehabilitation, living and other decisions for patients with AD.     

Reduced thalamic volume in first-episode non-affective psychosis: correlations with clinical variables, symptomatology and cognitive functioning

Structural studies have inconsistently shown the presence of thalamic volume differences in patients with schizophrenia. However, only a few studies have examined the relation between thalamic structure and clinical and cognitive variables in early phases of the illness. Thalamic volumes in right-handed minimally treated first episode patients with non-affective psychosis (N=61) relative to those of right-handed healthy comparison subjects (N=40) were measured. Thalamic volumes in the right and left hemispheres and total thalamic volume were automatically segmented and analyzed using BRAINS2. Analysis of covariance was used to control for intracranial volume. Clinical symptoms were assessed by total scores of BPRS, SAPS and SANS. The relationship between three cognitive dimensions (verbal learning and memory, speed processing/executive functioning and sustained attention/vigilance), and thalamic volume was evaluated. The impact of the duration of untreated illness, untreated psychosis and prodrome period in thalamic morphometry was also explored. Right, left, and total thalamic volumes of the patients with non-affective psychosis were significantly smaller than those of the healthy subjects. Larger thalamic volumes were associated with an earlier age of onset, a poorer cognitive functioning and a more severe negative symptomatology. Thalamic volumetric differences between patients with non-affective psychosis and healthy controls are already present at early phases of the illness. However, further investigations are warranted to fully clarify the relationship between those structural anomalies and clinical and cognitive outcomes.     

脑中风患者心理应激、干预与康复

目的:探讨生活事件、心理应激与脑中风发生、发展的关系;心理治疗干预在脑中风康复中的作用。方法:110例急性脑中风患者分为干预组52例,采用药物 心理治疗干预(音乐电疗、心理疏导、放松训练);非干预组58例,予以单纯药物治疗。正常对照组80例。治疗前对所有被试者行生活事件量表(LES)Derogatis90项症状自评量表(SCL-90)测试,脑卒中患者行神经功能缺损量表判定。治疗后只测SCL-90及神经功能缺损分值,并行治疗前后及组间比较。结果:脑中风患者治疗前LES、SCL-90评分明显高于对照组(P<0.01),治疗后干预组SCL-90各因子分明显低于非干预组(P<0.05);治疗后神经缺损评分较治疗前降低,以干预组明显(P<0.01),与非干预组比较差异显著(P<0.05)。心理障碍程度与神经功能缺损程度呈正相关(r=0.238)。结论:生活事件、心理因素是脑中风的主要诱发因素,其并发症、继发症的发生、发展与心理应激相关;及时、正确地治疗处理中风患者的情绪障碍是中风康复的重要环节。     

Integrative group-based cognitive rehabilitation efficacy in multiple sclerosis: a randomized clinical trial

Purpose: This study aimed to determine the efficacy of the integrative group-based cognitive rehabilitation programme, REHACOP, on improving cognitive functions in multiple sclerosis (MS).

Methods: Fourty-two MS patients were randomized to the treatment programme REHACOP (n?=?21) or waiting list control condition (n?=?21). The REHACOP group received cognitive rehabilitation in group format for three months focused on attention, processing speed, learning and memory, language, executive functioning, and social cognition. Patients completed a neuropsychological assessment at baseline and follow-up, which included tests of attention, processing speed, working memory, verbal memory, verbal fluency, and executive functioning. Repeated measures multivariate analysis of covariance (MANCOVA) was used to determine the efficacy of the cognitive rehabilitation programme.

Results: Group?×?Time interactions revealed significant improvements in the REHACOP group as compared with the control group for processing speed (p?=?0.011, n_p²?=?0.16), working memory (p?=?0.014, n_p²?=?0.15), verbal memory (p?=?0.025, n_p²?=?0.13), and executive functioning (p?=?0.024, n_p²?=?0.13), showing medium–large effect sizes.

Conclusions: Patients receiving REHACOP showed improvements in several cognitive domains. This preliminary study thus provides evidence supporting the efficacy of this integrative group-based cognitive rehabilitation intervention in MS. Future research should confirm these findings, examine the impact of the treatment on everyday life functioning and explore the presence of brain changes associated with cognitive rehabilitation.

• Implications for rehabilitation

• This study provides initial evidence for integrative group-based cognitive rehabilitation efficacy in MS patients through the implementation of the REHACOP cognitive rehabilitation programme.

• Patients received cognitive rehabilitation for three months (3 one-hour-sessions per week) focused on training attention, learning and memory, language, executive functioning, and social cognition.

• Patients attending REHACOP sessions showed medium to large and statistically significant improvements in processing speed, working memory, verbal memory, and executive functioning.

     

Relations of brain volumes with cognitive function in males 45 years and older with past lead exposure

We examined relations between brain volumes assessed by MRI and cognitive function in subjects in whom we have previously reported associations of cumulative lead dose with: (1) longitudinal declines in cognitive function; (2) smaller volumes of several regions of interest (ROIs) in the brain; and (3) increased prevalence and severity of white matter lesions. We used two complementary methods (ROI- [evaluating 20 ROIs] and voxel-wise) to examine associations between brain volumes and cognitive function using multiple linear regression. MRIs and cognitive testing were obtained from 532 former organolead workers with a mean (SD) age of 56.1 (7.7) years and a mean of 18.0 (11.0) years since the last occupational exposure to lead at the time of MRI acquisition. Cognitive testing was grouped into six domains of function (visuo-construction, verbal memory and learning, visual memory, executive functioning, eye-hand coordination, processing speed). Results indicated that larger ROI volumes were associated with better cognitive function in five of six cognitive domains, with significant associations observed for visuo-construction (15 of 20, p相似文献   

Characteristics of frontal activity relevant to cognitive function in bipolar depression: an fNIRS study

Memory shortness, verbal influence, and disturbed attention are a few of the cognitive dysfunctions reported by individuals of bipolar disorder in depression phase (BD-D). As neuroimaging modalities can investigate such responses, therefore neuroimaging methods can be used to assist the diagnosis of bipolar disorder (BD). Functional near-infrared spectroscopy (fNIRS) is a neural imaging method that is proved to be prominent in the diagnosis of psychiatric disorders. It is the desired method because of its feasible setup, high resolution in time, and its partial resistance to head movements. This study aims to investigate the brain activity in subjects of BD-D during cognitive tasks compared to the healthy controls. A decreased activation level is expected in individuals of BD-D as compared to the healthy controls. This study aims to find new methods and experimental paradigms to assist in the diagnosis of bipolar depression. Participants of BD-D and healthy controls (HC) performed four cognitive tasks including verbal fluency task (VFT), symbol working memory task (symbol check), attention task (spotter) and multiple cognitive task (code break). fNIRS was used to measure levels of oxy-hemoglobin (HbO) representing the brain activity. The generalized linear model (GLM) method was used to estimate the hemodynamic response related to the task. The wavelet transform coherence (WTC) method was used to calculate the intra-hemispheric functional connectivity. We also analyzed the correlation between hemodynamic response and scores of psychiatric disorders. Results showed decreased levels of HbO in BD-D groups compared to the HC, indicating lower activity, during the tasks except for spotter. The difference between BD-D and HC was significant during VFT, symbol check and code break. Group difference during symbol working memory was significant both in brain activity and connectivity. Meanwhile, the individual brain activity during working memory is more related to the illness degree. Lower activity in BD-D reflects unspecific dysfunctions. Compared with other cognitive tasks, the single-trial symbol-check task may be more suitable to help the diagnosis of bipolar depression.