Attention Matrix Research Articles

Cognitive phenotyping of post-infectious SARS-CoV-2 patients

BackgroundSARS-CoV-2 infection entails neuroinvasive, neuroinflammatory, and treatment-related features accounting for cognitive deficits in COVID-19-recovered patients. Although screening for such dysfunctions in this population is considered clinically relevant, contributions to cognitive phenotyping including premorbid and disease-related confounders are scarcely represented. This study thus aimed at describing the cognitive outcome at the function-/domain-level of post-infectious SARS-CoV-2 patients being already at risk (RCD +) or not (RCD −) for cognitive decline.MethodsFifty-four COVID-19-recovered individuals were classified as either RCD + or RCD − according to medical records. The Mini-Mental State Examination (MMSE), Addebrooke Cognitive Examination-Revised (ACE-R), Frontal Assessment Battery (FAB), and Attentive Matrices (AM) were administered (N = 54, 34, 28, and 28 patients, respectively).ResultsPrevalence of defective (cutoff = 24.89) MMSE scores was 24.3% in RCD + patients and 5.9% in the RCD − group. ACE-R-total below cutoff scores were less frequent (RCD + : 5.4%; RCD − : 5.9%). Abnormal performances at the FAB an AM were respectively detected in 18.9% and 8.1% of RCD + patients and 0% and 11.8% of the RCD − group. Within the ACE-R subtests, those assessing orientation, attention, and fluency were the most frequently impaired in both groups. Disease-related variables were mostly unassociated with cognitive measures.DiscussionBoth RCD + and RCD − COVID-19-recovered individuals might show cognitive deficits within the dysexecutive-inattentive and amnesic spectrum. Non-instrumental, executive/attentive dysfunctions are predominant in this population and can be detected by both screening and domain-specific psychometric tests—although the latter might be more sensitive in RCD − patients.

The visuospatial pattern of temporal lobe epilepsy

PurposeUnlike temporal lobe lesions, temporal lobe epilepsy (TLE) has no definite effects on visuospatial functions. This retrospective study evaluated these functions in patients with TLE, aiming to clarify their relationships to TLE laterality and magnetic resonance imaging (MRI)-detected brain lesions. MethodsThe Raven Colored Progressive Matrices (RCPM), Attentive Matrices (AM), Trail Making Test A (TMTA), Street Completion Test (SCT), Rey Complex Figure Copying (RCFC) and Delayed Reproduction (RCFDR), and Corsi Blocks Span (CBS) and Supraspan Learning (CBSSL) were used to assess different visuospatial functions in 198 patients with TLE and 90 healthy subjects. ResultsIn 169 patients (83 left), MRI revealed focal temporal lobe lesions [unilateral mesial temporal lobe sclerosis (MTLS) in 88 cases]. The patients with left or right TLE obtained normal scores on the RCPM, AM, TMTA, SCT, and RCFC, but their scores were significantly low on the CBS, CBSSL, and RCFDR. The patients with MTLS obtained lower scores in comparison with the controls and the patients without lesions, whereas those with other lesions obtained low scores only on the CBSSL and those without lesions performed normally. ConclusionsTemporal lobe epilepsy does not affect nonmemory visuospatial functions but significantly impairs visuosopatial memory and learning. This pattern is independent of TLE laterality, in keeping with a modality-specific memory model. On the contrary, the type of temporal lobe lesion is relevant to the severity of impairment.

12-month effects of incretins versus SGLT2-Inhibitors on cognitive performance and metabolic profile. A randomized clinical trial in the elderly with Type-2 diabetes mellitus.

AimThe aim of the present study is to examine the effects on cognitive performance, anthropometric measures, and metabolic markers in 2 different treatments: Incretins vs sodium-glucose co-transporter-2 inhibitors (SGLT2-I).Materials and methodsA randomized controlled clinical trial was carried out on 39 elderly subjects (23 men and 16 women) with type 2 diabetes mellitus, with a mean age of 77.21±8.07 years. Body mass index (BMI) of 29.92±4.31 kg/m2 and a cognitive status measured by a Mini Mental State Examination (scores >27 points). The subjects were on a 3-month treatment with a maximal dose of metformin as a stable regime, with the addition of incretins (liraglutide at doses of up to 1.8 mg/d; vildagliptin at 100 mg/d; sitagliptin 100 mg/d; and linagliptin 5 mg/d), or SGLT2-I (canagliflozin 300 mg/d; empagliflozin 25 mg/d; and dapagliflozin 10 mg/d). Glucose control was monitored by fasting glucose and glycosylated hemoglobin. Cognitive performance (by way of Verbal Fluency Test, Attentive Matrices Test, and Babcock Story Recall Test), anthropometric measures, and plasma lipids were also evaluated.ResultsCognitive status did not change significantly during the 12 months of treatment in either group: Verbal Fluency Test: (SGLT2-I: P=1.00, incretins: P=0.598); Babcock Story Recall Test (SGLT2-I: P=0.391; incretins: P=0.351); and Attentive Matrices Test (SGLT2-I: P=0.679, incretins: P=0.901). SGLT2-I also resulted in a reduction in weight (−1.95 kg; P<0.05), in BMI (−0.69 kg/m2; P<0.05) and an increase in high-density lipoprotein cholesterol (+5.73 mg/dl; P<0.01).ConclusionPreliminary data show that patients treated with incretins and SGLT2-I have not suffered a reduction in cognitive performance during the 1 year of treatment. Metabolic outcome seemed to benefit, in particular, in patients who were treated with SGLT2-I.

Neurocognitive functions in inpatient suicide attempters and non-attempters: A comparison

IntroductionAccording to many studies, suicide attempters, compared to healthy general population, exhibit some neurocognitive deficits, which are considered promising endophenotype of suicidal behavior disorder. A similar pattern of impairment is widespread in individuals affected by psychiatric disorders.ObjectivesTo compare neurocognitive functions of hospitalized suicide attempters (A) with those of an inpatient group without history of suicidal behavior (NA), likewise affected by psychiatric disorders.AimsThe purpose of the study is to evaluate if neurocognitive impairment is associated to suicidal behaviors, regardless of underlying psychiatric diagnosis.MethodsThe whole sample is composed of 70 adult psychiatric inpatients (34 males, 36 females), divided into two groups (A and NA) of 35 patients with diagnosis of Psychotic, affective and personality disorders. Neurocognitive functions were assessed using Tower of London Test (TOL), Modified Wisconsin Card Sorting Test (MCST), Stroop Test (ST) and Attentional Matrices (AM). Differences between A and NA groups were analyzed using U-test of Mann–Whitney and cross tabulations, taking into account the three diagnostic areas.ResultsStatistically significant differences were found between A and NA with regard to the ability of categorization (MCST), planning, problem solving and inhibition of automatic response (TOL), which proved to be more preserved in A individuals. No significant differences were found on selective attention tasks (ST and AM).ConclusionsThese preliminary findings show statistically significant differences on executive functions between suicide attempters and psychiatric non-attempter individuals. Further research on larger samples is needed to investigate these associations.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Effects of different types of physical activity on the cognitive functions and attention in older people: A randomized controlled study

This study aimed to evaluate the effects of different types of exercise on cognition. Eighty participants, 32 males and 48 females, aged 66.96±11.73, volunteered for this study. The participants were randomly divided into the four following groups: Resistance Group (RG; n=20), involved in high intensity strength training; Cardiovascular Group (CVG; n=20), involved in high intensity cardiovascular training; Postural Group (PG; n=20) involved in low intensity training, based on postural and balance exercises; and Control Group (CG; n=20). Exercises were performed over the course of 12weeks. All participants were tested for their cognitive functions pre- and post-intervention using the following neurocognitive tests: the Attentive Matrices Test, Raven's Progressive Matrices, Stroop Color and Word Interference Test, Trail Making Test and Drawing Copy Test. Statistical analysis showed that the CVG group improved significantly in the Attentive Matrices Test and Raven's Progressive Matrices (both p=<0.05), whereas the RG group improved in Drawing Copy Test time (p=<0.05). These results confirm that different types of exercise interventions have unique effects on cognition. Cardiovascular training is effective in improving performance attentive and analytic tasks, whereas resistance training is effective in improving praxis. Further investigation is necessary to evaluate the combination of the two exercise types in order to ascertain if their respective effects can be summated when performed together.

Cognitive Demand and Reminders Effect on Time-Based Prospective Memory in Amnesic Mild Cognitive Impairment (AMCI) and in Healthy Elderly

Individuals with-Mild Cognitive Impairment (MCI) often complain of difficulty remembering to carry out intended actions. We investigated the relative efficacy of a different reminder in performing a time-based Prospective Memory (PM) task. The PM performance of 24 participants with amnesic Mild Cognitive Impairment (AMCI) has been compared with that of 24 healthy controls. As ongoing task, samples of the Attentive Matrices Test were used. In the PM task subjects were requested to write an “X” every three minutes during a 9 minutes period. Participants received the task consisting either in a low demand condition (checking number “5”) or in a high demand condition (checking numbers “1”, “4”, “9”). In order to be as punctual as possible, participants were asked to simultaneously write the “X” at task time expiration, using a digital clock. Time monitoring was recorded. Reminder occurring was manipulated in that participants could receive critical, accidental or completely absent reminder. As expected, high cognitive demand was negatively correlated with PM performance and time monitoring. Unexpectedly, all the participants did not benefit from the critical reminder. These findings demonstrated, from a behavioral perspective, that Working Memory (WM) and PM processes are not based on the same memory system and PM may require WM resources at high demand.

P-373 - Effects of cognitive rehabilitation in a sample with acquired brain injury: preliminary results

Introduction Acquired brain injury (ABI) refers to a lesion in a normal brain. Independently of its etiology - traumatic brain injury, ischemic or hemorrhagic cerebrovascular accidents, meningitis, cerebral tumors, etc. - there is a loss of cerebral functions that mediate and control the sensory motor system, cognitive and emotional functioning.Cognitive rehabilitation should be provided as part of the medical treatment after ABI to reduce its impact on the daily functioning of patients Objectives and aims The present study examined the effects of cognitive remediation in reducing cognitive deficits observed in patients with ABI, in neurocognitive domains such as attention and vigilance, executive functioning, speed of processing, verbal learning and memory, and working memory. Methods Patients (n = 11) were evaluated with “Bateria de Lisboa Avaliacao de Demencias”, Rey Complex Figure Test, Trail Making Test, Weschler Memory Scale, Wisconsin Card Sorting Test and Attentional Matrices. Non-Parametric Wilcoxon signed-rank test was performed to compare a single sample before and after cognitive remediation in patients with acquired brain injury. Results Cognitive remediation was associated with significant improvements across neurocognitive domains such as attention and vigilance, remote memory, cognitive flexibility and capacity to change between tasks, logic memory, short term visual memory, associative memory, long term visual memory, visual memory, working memory and executive functioning measured trough Wisconsin Card Sorting Test total number of errors, perseverative errors and percent conceptual level responses. Conclusions Cognitive remediation produces significant improvements in cognitive performance and, when combined with neuropsychological rehabilitation, also improves functional outcomes.

P-520 - Cognitive performance and cigarette smoking in patients with mood disorders

Introduction In patients with Schizophrenia an association between smoking and improvement in cognitive deficits was found. Patients with Major Depressive Disorder (MDD) and Bipolar Disorder (BD) have shown a high prevalence of smoking habit and cognitive deficits but only a few studies have investigated the effect of smoking on their cognitive functions. Objectives To study the effect of nicotine assumption on cognitive function in MDD and BD. Methods 50 inpatients with MDD and 50 with BD (Major Depressive Episode) underwent a neuropsychological test battery (Anna Pesenti test, Attentive Matrices, Rey-Osterrieth Complex Figure, Phonemic/Semantic Fluency tests, Token test) at the beginning of their hospitalization. Smoking habit (current, lifetime) was investigated by specific questionnaires. Factorial ANOVA models were applied, with cognitive test scores as dependent variables and smoking (smoker/non-smoker) and diagnosis (MDD/BD) as factors. Results Smokers showed significantly better performance in verbal memory (p Conclusions Animal models show that nicotine can increase the monoamine levels in brain areas involved in memory and language functions. Our results suggest that the positive effect of smoking on cognitive functions may contribute to increase the smoking habit in patients with Mood Disorders as a self-medication strategy.

Neuropsychological predictors of quality of life in focal epilepsy

Spontaneous complaints of outpatients with focal epilepsy often stress the relationship between cognitive deficits and Quality of Life (QOL). Consequently, the aim of the present study was to find the best neuropsychological predictors of QOL in individuals with focal epilepsy, in order to guide their ambulatory health care. A sample of 71 Portuguese patients was studied: 40 female, 47 married, with a mean age of 37.48 years (S.D. = 11.79, 16–62), mean education of 7.93 (S.D. = 4.05, 3–17), and focal epilepsy of moderate severity. A Socio-demographic and Clinical Questionnaire, the SF-36 v1, the Cognitive Functioning Scale from the ESI-55, a Seizure Control scale (items from the Liverpool Seizure Severity Scale), and several neuropsychological tests were used. Semantic Fluency was the only predictor of Physical Functioning, Role Functioning – Physical, and Mental Health; I.A. Test predicted Bodily Pain; and Attentive Matrices predicted General Health, Vitality, and Role Functioning – Emotional. The Mental Component of the SF-36 v1 was predicted by Attentive Matrices, and the Physical Component was predicted by Semantic Fluency. Cognitive Functioning was predicted by the Token Test. Social Functioning and Seizure Control presented no statistically significant correlation with the neuropsychological indicators used. These results underscore the importance of cognitive performance to the QOL of individuals with focal epilepsy, supporting the systematic screening of cognitive performance in this population. Additionally, they suggest cognitive rehabilitation has the potential to improve these individuals’ QOL.

Relation of sorting impairment to hippocampal damage in temporal lobe epilepsy

One hundred and twelve patients with left ( n=65) or right ( n=47) temporal lobe epilepsy (TLE), associated with mesial or lateral temporal lobe lesion, were compared to 53 patients with left ( n=30) or right ( n=23) frontal lobe epilepsy (FLE), in order to explore the contributions of hippocampal lesions and of memory deficits to sorting impairment. Thirty-six healthy subjects of similar age and education were controls. The Modified Wisconsin Card Sorting Test (MWCST) was used to explore sorting ability. The two-syllable word span and consistent long-term retrieval from the selective reminding procedure for word-list learning were used to evaluate memory. Raven's Coloured Progressive Matrices and Attentive Matrices served to control for abstract reasoning and attention. Left FLE patients and TLE patients with left hippocampal sclerosis were significantly impaired on MWCST, short-term memory, and word learning. TLE patients with other left hippocampal lesions were also impaired on MWCST, although not significantly so. Analysis of individual scores showed that 42% of TLE patients with left hippocampal sclerosis, 14% of TLE patients with other hippocampal lesions, 63% of left FLE patients, and 30% of right FLE patients were impaired on the MWCST. In patients with left hippocampal sclerosis, MWCST score was associated with the learning score provided by the selective reminding procedure and Raven's Coloured Progressive Matrices score, whereas in FLE patients, MWCST score was associated with Attentive Matrices score. These results suggest that only some TLE patients, i.e. those with hippocampal damage, may be expected to be impaired on card sorting. The impaired sorting ability of these TLE patients may be due to involvement of the hippocampal function in forming associations or in registering new information.