Category Fluency Test Research Articles

Impaired sleep quality and cognition in patients of Parkinson's disease with REM sleep behavior disorder: a comparative study

ObjectivesThe present study was undertaken to evaluate the cognitive profile of Parkinson's disease (PD) patients with REM sleep behavior disorder (RBD) and to correlate with the clinical stage and polysomnographic variables. MethodsThe study included 25 PD patients who had RBD and 25 PD patients who based on two questionnaires were determined as not having RBD. These patients underwent overnight polysomnography (PSG) and neuropsychological assessment using a defined battery of tests. ResultsThe mean age of the patients with clinically probable RBD (RBD+) was 60.4 ± 8.2 years and PD patients without RBD (RBD-) was 57.3 ± 6.6 years (p = 0.14). The mean age at onset of the disease was 53.7 ± 9.4 years for RBD+ and 49.8 ± 7.8 years for RBD-patients (p = 0.12). The mean Unified Parkinson Disease Rating Scale (UPDRS) part III OFF score was 27.4 ± 11.1 for RBD+ and 32.7 ± 8.2 for RBD- (p = 0.06). The total sleep time of the patients was 4.3 ± 1.7 h with sleep efficiency of 53.8 ± 21.0%. Patients with RBD+ were found to have significant impairment in many neuropsychological tests compared to RBD-. ConclusionsRBD + patients had significant impairment in MMSE, category fluency test (FAS test), frontal assessment battery, attention (digit span backwards, Corsi span), verbal memory (story recall) and Rey's auditory verbal learning test. These patients also had poor sleep quality.

Effect of levodopa on handwriting tasks of different complexity in Parkinson's disease: a kinematic study.

Levodopa treatment does improve Parkinson's disease (PD) dysgraphia, but previous research is not in agreement about which aspects are most responsive. This study investigated the effect of levodopa on the kinematics of writing. Twenty-four patients with PD of less than 10years duration and 25 age-matched controls were recruited. A practically defined off state method was used to assess the levodopa motor response, measured on the Unified Parkinson's Disease Rating Scale PartIII. The kinematic features for six handwriting tasks involving different levels of complexity were recorded from PD patients in off and on states and from the control group. Levodopa is effective for simple writing activities involving repetition of letters, denoting improved fine motor control. But the same benefit was not seen for copying a sentence and a written category fluency test, tasks that carry memory and cognitive loads. We also found significant differences in kinematic features between control participants and PD patients, for all tasks and in both on and off states. Serial testing of handwriting in patients known to be at risk for developing PD might prove to be an effective biomarker for cell loss in the substantia nigra and the associated dopamine deficiency. We recommend using a panel of writing tasks including sentence copying and memory dependence. Dual-task effects may make these activities more sensitive to early motor deficits, while their weaker levodopa responsiveness would cause them to be more stable indicators of motor progression once symptomatic treatment has been commenced.

Frontal lobe dysfunction underlies the differential word retrieval impairment in adolescents with high-functioning autism.

There is substantial evidence of word retrieval impairment as indicated by poor performance on the category fluency test in autism spectrum disorder (ASD). However, little is known about the neural mechanisms underlying this impairment. Functional neuroimaging studies have shown that the lateral frontal cortex plays a key role in flexible word retrieval. Thus, we examined whether individuals with ASD exhibited altered frontal processing during the category fluency test using functional near-infrared spectroscopy (fNIRS). Twenty-two adolescents with high-functioning ASD (20 males) and 22 typically developing (TD) adolescents (16 males) aged 11-18 years were recruited. All underwent a category fluency paradigm, which required production of animal or means of transportation words for 1 min each although their frontal hemodynamic changes were recorded with fNIRS. We found that adolescents with ASD produced fewer animal but not transportation words (group-by-category interaction: P = 0.003), suggesting differential word retrieval impairment. In addition, unlike TD adolescents who exhibited activation primarily in lateral frontal regions during word production, adolescents with ASD had comparable activation across lateral and medial frontal regions. More importantly, this lack of lateral-medial distinction of activation, which was associated with poor word retrieval, differed significantly between groups only in the animal category (group-by-category interaction: P = 0.018). Thus, our findings implicate frontal lobe dysfunction in the impairment of differential word retrieval in adolescents with ASD. The relatively greater involvement of the medial frontopolar cortex might reflect the use of nonspecialized brain regions to compensate for the category-dependent difficulties with word retrieval in ASD. Autism Res 2019, 12: 600-613. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Using an optical imaging tool, we found that adolescents with autism had difficulties with producing semantically related words and exhibited frontal lobe dysfunction. Nonetheless, poor word production and altered brain processing was only seen when these adolescents were asked to produce words from a category of living things but not nonliving things (i.e., animals but not means of transportation). Category-dependent word retrieval problems and frontal lobe dysfunction might be two features of this disorder.

Semantic network function captured by word frequency in nondemented APOE ε4 carriers.

Accurate identification of the earliest cognitive changes associated with Alzheimer's disease (AD) is critically needed. Item-level information within tests of category fluency, such as lexical frequency, harbors valuable information about the integrity of semantic networks affected early in AD. To determine the potential of lexical frequency as a cognitive marker of AD risk, we investigated whether lexical frequency of animal fluency output differentiated APOE ε4 carriers from noncarriers in a cross-sectional design among older African-American adults without dementia. We analyzed animal fluency performance using mean number of items and mean lexical frequency among 230 cognitively normal African Americans with and without the APOE ε4 allele. Lexical frequency was higher in APOE ε4 carriers than noncarriers when analyzed as a mean score and within time bins. In contrast, we found no group difference in the number of items produced. Lexical frequency was particularly sensitive to ε4 status after the first 10 s of the 60-s animal fluency task. Our results suggest that psycholinguistic features may hold value as a cognitive biomarker for identifying people at high risk of AD. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Prediagnostic markers of idiopathic Parkinson’s disease: Gait, visuospatial ability and executive function

BackgroundIdiopathic Parkinson’s disease (IPD) has a long preclinical phase. Research questionThis study assesses data on prediagnostic markers of IPD from a longitudinal, natural history study of aging. MethodsParticipants were selected from the database of the Baltimore Longitudinal Study of Aging, and included 10 prediagnosed IPD cases (eight men and two women) and 30 age and sex matched healthy controls. Patients with prediagnosed IPD had already had an assessment for IPD 2.6 ± 1.3 years (range 1.0–5.3 years) before the actual diagnosis, including: gait speed (six-meter corridor walk), spatio-temporal gait parameters using Vicon motion capture, balance, upper-limb motor skills, neuropsychological profile, and non-motor symptoms. ResultsPrediagnosed IPD cases compared to controls had slower gait speed (Δ=-0.13 m.s−1, p = 0.03) due to shorter step length (Δ=−5 cm, p = 0.004), worse visuospatial ability (card rotation test, Δ=-42, p = 0.0001) and worse executive function (category fluency test, Δ=-2.6, p = 0.04). SignificanceOur findings identify dimensions that merit further study as prediagnostic markers of Idiopathic Parkinson’s disease to identify patients who might benefit from future neuroprotective therapy in order to delay, or prevent, clinical manifestations.

Driving Cessation and Cognitive Dysfunction in Patients with Mild Cognitive Impairment.

Although driving by adults with cognitive impairment is an important public health concern, little is known about the indicators of driving cessation in patients with mild cognitive impairment (MCI). We aimed to investigate the prevalence of driving cessation in patients with MCI and the predictive value of cognitive performances for driving cessation. Patients with MCI were recruited in the Seoul National University Bundang Hospital; they met following inclusion criteria. Age range of 51–80 years, Clinical Dementia Rating scale score of 0.5, and ever car drivers including former and current drivers. All participants underwent comprehensive standardized cognitive assessments and information on driving status was obtained via an interview using a systematic questionnaire. The median age of the 135 participants was 72 years, and 54 participants (40%) were women; 93 patients (68.9%) were current drivers and 42 (31.1%) were former drivers. In univariate analysis, former drivers showed poorer performances in digit span backward and categorical fluency tests than current drivers. In multivariate logistic regression analysis, a poor digit span backward test score was significantly related with driving cessation (odds ratio: 0.493, 95% confidence interval: 0.258–0.939). In patients with MCI, poor performance in the digit span backward test, which represents impaired working memory capacity, was associated with a higher probability of driving cessation.

Photobiomodulation improves the frontal cognitive function of older adults.

The frontal lobe hypothesis of age-related cognitive decline suggests that the deterioration of the prefrontal cortical regions that occurs with aging leads to executive function deficits. Photobiomodulation (PBM) is a newly developed, noninvasive technique for enhancing brain function, which has shown promising effects on cognitive function in both animals and humans. This randomized, sham-controlled study sought to examine the effects of PBM on the frontal brain function of older adults. Thirty older adults without a neuropsychiatric history performed cognitive tests of frontal function (ie, the Eriksen flanker and category fluency tests) before and after a single 7.5-minute session of real or sham PBM. The PBM device consisted of three separate light-emitting diode cluster heads (633 and 870nm), which were applied to both sides of the forehead and posterior midline, and delivered a total energy of 1349J. Significant group (experimental, control)×time (pre-PBM, post-PBM) interactions were found for the flanker and category fluency test scores. Specifically, only the older adults who received real PBM exhibited significant improvements in their action selection, inhibition ability, and mental flexibility after vs before PBM. Our findings support that PBM may enhance the frontal brain functions of older adults in a safe and cost-effective manner.

Multidelay multiparametric arterial spin labeling perfusion MRI and mild cognitive impairment in early stage Parkinson's disease.

Mild cognitive impairment (MCI), a well-defined nonmotor manifestation of Parkinson's disease (PD), greatly impairs functioning and quality of life. However, the contribution of cerebral perfusion, quantified by arterial spin labeling (ASL), to MCI in PD remains poorly understood. The selection of an optimal delay time is difficult for single-delay ASL, a problem which is avoided by multidelay ASL. This study uses a multidelay multiparametric ASL to investigate cerebral perfusion including cerebral blood flow (CBF) and arterial transit time (ATT) in early stage PD patients exhibiting MCI using a voxel-based brain analysis. Magnetic resonance imaging data were acquired on a 3.0 T system at rest in 39 early stage PD patients either with MCI (PD-MCI, N = 22) or with normal cognition (PD-N, N = 17), and 36 age- and gender-matched healthy controls (HCs). CBF and ATT were compared among the three groups with SPM using analysis of variance followed by post hoc analyses to define regional differences and examine their relationship to clinical data. PD-MCI showed prolonged ATT in right thalamus compared to both PD-N and HC, and in right supramarginal gyrus compared to HC. PD-N showed shorter ATT in left superior frontal cortex compared to HC. Prolonged ATT in right thalamus was negatively correlated with the category fluency test (p = .027, r = -0.495) in the PD-MCI group. This study shows that ATT may be a more sensitive marker than CBF for the MCI, and highlights the potential role of thalamus and inferior parietal region for MCI in early stage PD.

Effects of HIV on executive function and verbal fluency in Cameroon

HIV-associated neurocognitive disorders (HAND) are frequently associated with impaired executive function and verbal fluency. Given limited knowledge concerning HAND in Sub-Saharan-Africa and lack of Cameroonian adult neuropsychological (NP) test norms, we administered four executive function [Halstead Category Test (HCT), Wisconsin Card Sorting Test (WCST), Color Trails-II (CTT2), and Stroop Color-Word-Interference (SCWT)] and three verbal fluency (Category, Action, and Letter Fluency) tests to 742 adult Cameroonians (395 HIV−, 347 HIV+). We developed demographically-corrected NP test norms and examined the effects of HIV and related variables on subjects’ executive function and verbal fluency. HIV+ subjects had significantly lower T-scores on CTT2 (P = 0.005), HCT (P = 0.032), WCST (P < 0.001); lower executive function composite (P = 0.002) and Action Fluency (P = 0.03) T-scores. ART, viremia, and CD4 counts did not affect T-scores. Compared to cases harboring other viral subtypes, subjects harboring HIV-1 CRF02_AG had marginally higher CTT2 T-scores, significantly higher SCWT (P = 0.015) and executive function (P = 0.018) T-scores. Thus, HIV-1 infection in Cameroon is associated with impaired executive function and some aspects of verbal fluency, and viral genotype influenced executive function. We report the first normative data for assessing executive function and verbal fluency in adult Cameroonians and provide regression-based formulas for computing demographically-adjusted T-scores. These norms will be useful for investigating HIV/AIDS and other diseases affecting cognitive functioning in Cameroon.

FUNDAMANT: an interventional 72-week phase 1 follow-up study of AADvac1, an active immunotherapy against tau protein pathology in Alzheimer\u2019s disease

BackgroundNeurofibrillary pathology composed of tau protein is closely correlated with severity and phenotype of cognitive impairment in patients with Alzheimer’s disease and non-Alzheimer’s tauopathies. Targeting pathological tau proteins via immunotherapy is a promising strategy for disease-modifying treatment of Alzheimer’s disease. Previously, we reported a 24-week phase 1 trial on the active vaccine AADvac1 against pathological tau protein; here, we present the results of a further 72 weeks of follow-up on those patients.MethodsWe did a phase 1, 72-week, open-label study of AADvac1 in patients with mild to moderate Alzheimer’s disease who had completed the preceding phase 1 study. Patients who were previously treated with six doses of AADvac1 at monthly intervals received two booster doses at 24-week intervals. Patients who were previously treated with only three doses received another three doses at monthly intervals, and subsequently two boosters at 24-week intervals. The primary objective was the assessment of long-term safety of AADvac1 treatment. Secondary objectives included assessment of antibody titres, antibody isotype profile, capacity of the antibodies to bind to AD tau and AADvac1, development of titres of AADvac1-induced antibodies over time, and effect of booster doses; cognitive assessment via 11-item Alzheimer’s Disease Assessment Scale cognitive assessment (ADAS-Cog), Category Fluency Test and Controlled Oral Word Association Test; assessment of brain atrophy via magnetic resonance imaging (MRI) volumetry; and assessment of lymphocyte populations via flow cytometry.ResultsThe study was conducted between 18 March 2014 and 10 August 2016. Twenty-six patients who completed the previous study were enrolled. Five patients withdrew because of adverse events. One patient was withdrawn owing to noncompliance. The most common adverse events were injection site reactions (reported in 13 [50%] of vaccinated patients). No cases of meningoencephalitis or vasogenic oedema were observed. New micro-haemorrhages were observed only in one ApoE4 homozygote. All responders retained an immunoglobulin G (IgG) antibody response against the tau peptide component of AADvac1 over 6 months without administration, with titres regressing to a median 15.8% of titres attained after the initial six-dose vaccination regimen. Booster doses restored previous IgG levels. Hippocampal atrophy rate was lower in patients with high IgG levels; a similar relationship was observed in cognitive assessment.ConclusionsAADvac1 displayed a benign safety profile. The evolution of IgG titres over vaccination-free periods warrants a more frequent booster dose regimen. The tendency towards slower atrophy in MRI evaluation and less of a decline in cognitive assessment in patients with high titres is encouraging. Further trials are required to expand the safety database and to establish proof of clinical efficacy of AADvac1.Trial registrationThe studies are registered with the EU Clinical Trials Register and ClinicalTrials.gov: the preceding first-in-human study under EudraCT 2012-003916-29 and NCT01850238 (registered on 9 May 2013) and the follow-up study under EudraCT 2013-004499-36 and NCT02031198 (registered 9 Jan 2014), respectively.

Fasting Glucose Variability in Young Adulthood and Cognitive Function in Middle Age: The Coronary Artery Risk Development in Young Adults (CARDIA) Study.

To determine whether intraindividual variability in fasting glucose (FG) below the threshold of diabetes is associated with cognitive function in middle adulthood beyond increasing FG. We studied 3,307 CARDIA (Coronary Artery Risk Development in Young Adults) Study participants (age range 18-30 years and enrolled in 1985-1986) at baseline and calculated two measures of long-term glucose variability: the coefficient of variation about the mean FG (CV-FG) and the absolute difference between successive FG measurements (average real variability [ARV-FG]) before the onset of diabetes over 25 and 30 years of follow-up. Cognitive function was assessed at years 25 (2010-2011) and 30 (2015-2016) with the Digit Symbol Substitution Test (DSST), Rey-Auditory Verbal Learning Test (RAVLT), Stroop Test, Montreal Cognitive Assessment, and category and letter fluency tests. We estimated the association between glucose variability and cognitive function test score with adjustment for clinical and behavioral risk factors, mean FG level, change in FG level, and diabetes development, medication use, and duration. After multivariable adjustment, 1-SD increment of CV-FG was associated with worse cognitive scores at year 25: DSST, standardized regression coefficient -0.95 (95% CI -1.54, -0.36); RAVLT, -0.14 (95% CI -0.27, -0.02); and Stroop Test, 0.49 (95% CI 0.04, 0.94). Findings were similar between CV-FG with each cognitive test score at year 30 and when we used an alternative measure of variability (ARV-FG) that captures variability in successive FG values. Higher intraindividual FG variability during young adulthood below the threshold of diabetes was associated with worse processing speed, memory, and language fluency in midlife independent of FG levels.

Altered white matter connectivity in patients with schizophrenia: An investigation using public neuroimaging data from SchizConnect.

Several studies have produced extensive evidence on white matter abnormalities in schizophrenia (SZ). However, optimum consistency and reproducibility have not been achieved, and reported low white matter tract integrity in patients with SZ varies between studies. A whole-brain imaging study with a large sample size is needed. This study aimed to investigate white matter integrity in the corpus callosum and connections between regions of interests (ROIs) in the same hemisphere in 122 patients with SZ and 129 healthy controls with public neuroimaging data from SchizConnect. For each diffusion-weighted image (DWI), two-tensor full-brain tractography was performed; DWIs were parcellated by processing and registering T1 images with FreeSurfer and Advanced Normalization Tools. White matter query language was used to extract white matter fiber tracts. We evaluated group differences in means of diffusion measures between the patients and controls, and correlations of diffusion measures with the severity of clinical symptoms and cognitive impairment in the patients using the Positive and Negative Syndrome Scale (PANSS), a letter-number sequencing (LNS) test, vocabulary test, letter fluency test, category fluency test, and trail-making test, part A. To correct for multiple comparisons, a false discovery rate of q < 0.05 was applied. In patients with SZ, we observed significant radial diffusivity (RD) and trace (TR) increases in left thalamo-occipital tracts and the right uncinate fascicle, and a significant RD increase in the right middle longitudinal fascicle (MDLF) and the right superior longitudinal fascicle ii. Correlations were present between TR of left thalamo-occipital tracts, and the letter fluency test and the LNS test, and RD in the right MDLF and PANSS positive subscale score. However, these correlations were not significant after correction for multiple comparisons. These results indicated widespread white matter fiber tract abnormalities in patients with SZ, contributing to SZ pathophysiology.

Correlations Between Cognitive Aspects and Quantitative EEG in Adults With Epilepsy.

Introduction. Cognitive impairment frequently occurs in adult patients with epilepsy (PWE), but its pathophysiological basis is not well known. This study assessed cognition and its correlations with quantitative EEG coherence (QEEG) of patients with epilepsy. Method. Eighty PWE seen consecutively in the clinic and 40 normal subjects (NC) were assessed by neurological evaluation, Mini Mental State Examination, immediate and delayed recall of 10 simple figures, phonemic verbal fluency (FAS), category fluency test (VF animals), clock drawing, and QEEG. The mean global inter- and intrahemispheric coherences for the delta, theta, alpha, and beta bands were calculated. Cognitive functions and QEEG coherence of the PWE and the NC were compared, and logistic regression analysis determined the factors associated with impaired cognitive functions in PWE. The significance level was set at P < .05. Results. Regression analysis showed that FAS impairment (14.5 ± 8.6 vs 24.3 ± 15.7, respectively) and delayed recall of figures in PWE (7.3 ± 2.07 vs 8.6 ± 1.48) differed significantly between the PWE and the NC (Nagelkerke R2 = 0.266). Absolute power was greater in all the frequency bands in PWE. Interhemispheric and intrahemispheric beta coherences in the theta frequency was higher in the PWE than in the NC. Logistic regression analysis showed a significant association between interhemispheric delta coherence and VF animal impairment (cutoff point of 12), and between an interhemipheric beta coherence with level of education and delayed recall of figures impairment (cutoff point of 7) (Nagelkerke R2 = 0.297). Other variables were not associated. Conclusions. There was cognitive impairment of PWE and it was significantly associated with QEEG, which suggests that QEEG measures may contribute to the understanding of physiopathological events and as a marker for cognitive alterations in epilepsy.

Free and cued selective reminding test predicts progression to Alzheimer\u2019s disease in people with mild cognitive impairment

IntroductionTo assess the diagnostic accuracy of the free and cued selective reminding test (FCSRT) for the development of Alzheimer’s disease (AD) in people with mild cognitive impairment (MCI).MethodsWe enrolled 187 consecutive MCI outpatients from a memory clinic that were evaluated at baseline and every 6 to 12 months through an extensive clinical and neuropsychological protocol. For each test, measures of diagnostic accuracy were obtained. To improve the overall specificity of the neuropsychological battery, we also used the diagnostic tests in parallel combination. The association between FCSRT indexes and AD was tested through proportional hazard regression models with other dementia subtypes as competing event. Laplace regression was used to model time-to-AD diagnosis as a function of FCSRT indexes.ResultsThe area under the curve of the FCSRT indexes ranged from 0.69 (95% CI: 0.62–0.76) to 0.76 (95% CI: 0.70–0.82). The specificity peaked up to 100% when we combined the category fluency test with the delayed total recall index of the FCSRT. Participants who tested positive at the FCSRT, as compared with those with negative tests, presented a twofold to fivefold higher risk of developing AD (median follow-up time 2.5 years; p < 0.001) and were diagnosed with AD 2–3 years earlier (p < 0.001).DiscussionThe FCSRT assessment suite shows the best predictive performance in detecting AD in people with MCI. These findings might help to reliably and timely identify people at higher risk of AD that is crucial both for properly selecting participants to clinical trials and to fine tune an effective and patient-centered care.

Evaluation of diffusion tensor imaging changes and neurocognitive effects of asymptomatic vitamin B12 deficiency.

Vitamin B12 plays an important role in the mechanisms which are responsible for myelinization in the central nervous system. It can particularly lead to hematological and neuropsychiatric symptoms when serum levels fall due to insufficient intake with diet or absorption problems. The purpose of this study was to show the cognitive effects in vitamin B12 deficiency cases that have not reached clinical symptom level using neuropsychological tests, and to show possible cerebral neuronal damage using diffusion tensor imaging (DTI) method. A total of 62 asymptomatic vitamin B12 deficiency patients and 40 healthy subjects were included in the study and both groups were subjected to Standardized Mini-Mental State Examination, Montreal Cognitive Assessment Test, Rey Auditory Verbal Learning Test, forward and backward digit span (WMS-R forward and backward), Visual Reproduction Subtest (WMS-III), Category Fluency Test, Trail Making (Trail A-B) (21) and Similarities (BENZ) tests. DTI examinations were performed on both groups. Patient group was determined to get lower scores in all neuropsychological tests compared to control group. In DTI examination, a significant decrease in FA values of bilateral hippocampus and a prominent increase in apparent diffusion coefficient (ADC) values were determined in the patient group compared to control group. In this study, it was determined that there was microstructural damage in the brain in the presence of vitamin B12 deficiency even in the asymptomatic period, and the patients revealed cognitive decline. In accordance with this result, early treatment of the easily diagnosed and treated vitamin B12 deficiency may prevent possible irreversible damage in the future.

S171. ALTERED WHITE MATTER CONNECTIVITY IN PATIENTS WITH SCHIZOPHRENIA USING PUBLIC NEUROIMAGING DATA FROM SCHIZCONNECT

BackgroundSeveral studies have produced a large body of evidence for white matter abnormalities related to schizophrenia. The literature has yet to achieve a state of consistency and reproducibility, and reported low integrity of white matter tracts vary between studies. Whole brain image study with large sample size is needed to address this issue. We investigated white matter integrity in connections between regions of interests (ROI) in the same hemisphere in patients with schizophrenia and healthy controls with public neuroimaging data from SchizConnect (http://schizconnect.org).MethodsA final data set was consisted of 129 healthy controls and 122 schizophrenia patients. For each diffusion weighted image (DWI), a two-tensor full-brain tractography was performed, and DWI images were parcellated by processing and registering the T1 images with FreeSurfer and the Advanced Normalization Tools. We extracted a total of 36 tracts in the both hemisphere connecting ROIs in the same hemisphere with white matter query language. We compared means of diffusion measures between patients and controls, and evaluated correlations with Letter-number sequencing (LNS) test, Vocabulary test, letter fluency test, category fluency test, and trails A of the Trail Making Test (TMT). The Benjamini-Hochberg procedure with false discovery rate (FDR) of 0.05 was used to correct for multiple comparisons.ResultsWe found a significant RD and TR increase of the left thalamo-occipital tracts and the right uncinate fascicle (UF), and a significant RD increase of the right middle longitudinal fascicle (MDLF), and the right superior longitudinal fascicle (SLF) ii in schizophrenia. There were correlations between the TR in the left thalamo-occipital tracts and letter fluency test, and the RD in the right SLF ii and LNS test, which did not survive after correction for multiple comparisons.DiscussionThese results indicate widespread abnormalities of white matter fiber tracts in schizophrenia, contributing to the pathophysiology of schizophrenia.

Cognitive and clinical variables associated with interictal dysphoric disorder in patients with epilepsy

PurposeThe relationship between interictal dysphoric disorder (IDD) and cognitive impairment in adult patients with epilepsy (PWE) is poorly studied. MethodsThe Interictal Dysphoric Disorder Inventory (IDDI) with cognitive and clinical aspects was compared with Quality of Life in Epilepsy Inventory (QOLIE-31) and Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) scores of 117 PWE at significance level p<0.05. ResultsInterictal dysphoric disorder occurred in 25 (21.4%) PWE, and it was significantly associated with the presence of psychiatric disorders (PD) (α2; p=0.007), presence of major depressive episodes (p=0.03), lower educational level, older individuals, and those with a lower performance in the category fluency test (VF) (9.7±5.1 vs. 12.2±4.2; t-test; p=0.037). There was a negative correlation between QOLIE-31 and IDD. The predictive factors for the occurrence of IDD were the presence of PD (p=0.014) and lower performance in the VF (p=0.013). ConclusionThe occurrence of IDD was high. Interictal dysphoric disorder was found in different epileptic syndromes, and it was associated with the presence of PD, depressive episodes, lower performance in VF, and lower quality of life (QoL).

Neurorehabilitation of alexia without agraphia - a case report

Introduction. Alexia without agraphia is an impairment of reading ability. Speech, auditory comprehension, repetition and writing are relatively intact. Due to a damage of the splenium of corpus callosum, alexia without agraphia is considered to be an interhemispheric disconnection syndrome. Case Report. We presented a 71-year-old male, with chronic hypertension, diabetes mellitus and dyslipidemia. The magnetic resonance imaging showed a lesion in the left medial temporal region, including the equilateral thalamus, posterior cingulate gyrus, splenium of corpus callosum, lingual occipital gyrus, and the tail of the hippocampus. Lacunar ischemia was found on the right side of cerebellum. The neuro-linguistic diagnostic protocol included the Mini Mental State Examination, Boston Diagnostic Aphasia Examination, Boston Naming Test and phonemic and category fluency tests. We have also designed a clinical protocol for color recognition assessment. The results showed a mild cognitive impairment related to the time and space orientation, delayed memory and reading. On the speech and language levels, a severe acquired alexia without agraphia was registered which was not associated with other language modalities. Conclusion. The neuro-linguistic tests and clinical techniques provide a rather reliable diagnostic criteria, which is the basis for neuro-rehabilitation. The rehabilitation protocol refers to training techniques: tactile-kinesthetic recognition of graphemes and application of various reading techniques, such as letter-by-letter reading, Multiple Oral Re-reading, melodic intonation therapy and oral reading technique in order to facilitate rehabilitation of reading.

Executive function in patients with schizophrenia based on socio-occupational impairment: A cross-sectional study.

Background:Executive dysfunction deficit is the functionally most important cognitive deficit noted in schizophrenia. There is a dearth of Indian literature on the subject. The current study aimed at studying these executive functions in patients with schizophrenia in remission.Methodology:Sixty outpatients with a diagnosis of schizophrenia as per international classification of diseases-10 criteria; in remission as measured by Positive and Negative Syndrome Scale scores were divided into two groups using the personal and social performance scale. The patients with and without socio-occupational impairment formed the two groups. All patients were administered the Wisconsin Card Sorting Test (WCST), Stroop test, Color Trails Test 1 and 2, Phonemic Fluency (Controlled Oral Word Association Test), and category fluency (animal names test) tests and the tower of London test to ascertain deficits in executive functions. The data obtained were subjected to statistical analysis.Results:The two groups were well matched. The group with socio-occupational impairment showed a lesser number of categories completed (P = 0.001), more perseverative errors (P = 0.001), and greater percentage of the same (P = 0.001) on the WCST. Statistically significant differences between both groups were observed for scores on phonemic fluency (P = 0.012) and category fluency (P = 0.049) tests as well as the Tower of London test (P = 0.021). They also showed differences on the Stroop test and Color Trail tests, but this was not statistically significant.Conclusions:Performance on executive function tests is significantly correlated with functional outcome. It is important that future studies explore the role of these tests as a marker of socio-occupational impairment in schizophrenia.

Cardiovascular risk factors and cognitive performance in aging.

ABSTRACT.Background.Atherosclerosis in cerebral blood vessels, especially those which compose the Circle of Willis, can lead to reduced supply of oxygen and nutrients to different cortical structures, affecting cognitive function.Objective:To analyze whether cardiovascular risk factors negatively influence cognitive performance in adults and elderly.Methods:One hundred twenty-nine participants of both sexes, aged over 50 years, without cognitive or functional impairment were included. Body mass index (BMI), hypertension (HTN), diabetes mellitus (DM), smoking history, plasma levels of total cholesterol, low density lipoproteins (LDL), high density lipoproteins (HDL) and very low density lipoproteins (VLDL) cholesterol, triglycerides, and glucose were the cardiovascular risk factors analyzed. Cognitive assessment was performed using tests of attention, working memory, category fluency and declarative memory.Results:Controlling for age and education, multivariate linear regression models revealed that higher concentrations of triglycerides, as well as total, LDL and VLDL cholesterol, were associated with poorer performance on the digit span and category fluency tests. Higher HDL concentrations were associated with higher scores on category fluency tasks. Furthermore, higher BMI was associated with poorer delayed recall performance.Conclusion:The findings revealed that cardiovascular risk factors may negatively impact cognitive performance in aging.