Common Cognitive Deficits Research Articles

Correlation between midline gait function performance and verbal fluency in patients with Parkinson's disease.

Verbal fluency impairments are among the earliest and most common cognitive deficits in Parkinson's disease (PD), yet more than one study has shown that as a group, verbal fluency performance is not always different between patients with PD and age-matched controls. Here we examined whether PD-related deficits in speech and language capabilities are detectable in patients who exhibit poor midline motor function, such as control of gait. We postulated that if phonemic verbal fluency (PVF) performance in PD is dissociable from other factors such as age in this patient subgroup, a low PVF will likely reflect a general cognitive-motor deficit attributable to Parkinsonian pathology. Thirty-one PD and thirteen controls were evaluated on PVF and the Metronome-Paced Square Step Test (MPSST), a complex sensorimotor task that challenges axial and midline function. The MPSST requires a patient to initiate and maintain a consecutive series of diagonal and midline cross-over steps during the test. We found that despite similar PVF performance between groups, the vast majority of controls but not patients completed the MPSST without any errors, and the odds of completing the MPSST without any errors was 15 times greater among control. More importantly, a significant amount of PVF variability was explained by MPSST performance in PD but not controls even after controlling for age and disease duration. Together, these results provide evidence that PVF performance in PD likely reflects a PD-specific process and suggests that the MPSST may be a more sensitive test of PD-specific pathology than PVF.

A Meta-Analysis of Autobiographical Memory Studies in Schizophrenia Spectrum Disorder.

Meta-analyses and reviews on cognitive disorders in schizophrenia have shown that the most robust and common cognitive deficits are found in episodic memory and executive functions. More complex memory domains, such as autobiographical memory (AM), are also impaired in schizophrenia, but such impairments are reported less often despite their negative impact on patients' outcome. In contrast to episodic memory, assessed in laboratory tasks, memories of past personal events are much more complex and directly relate to the self. The meta-analysis included 20 studies, 571 patients with schizophrenia spectrum disorder, and 503 comparison subjects. It found moderate-to-large effect sizes with regard to the 3 parameters commonly used to assess AM: memory specificity (g = -0.97), richness of detail (g = -1.40), and conscious recollection (g = -0.62). These effect sizes were in the same range as those found in other memory domains in schizophrenia; for this reason, we propose that defective memories of personal past events should be regarded as a major cognitive impairment in this illness.

Trouble déficitaire de l’attention et/ou trouble bipolaire ?

The attention deficit disorder and the bipolar disorder maintain a complex relation. Indeed, these two syndromes share numerous symptoms that engender numerous diagnostic difficulties. According to several studies, it seems that these two disorders are really different with significant differences at the functional and anatomical level. However, there are common cognitive deficits as well as relatively frequent co-morbidity which is necessary to know in order to adjust the treatment.

A pilot study examining functional brain activity 6months after memory retraining in MS: the MEMREHAB trial.

Cognitive impairment in individuals with multiple sclerosis (MS) is now well recognized. One of the most common cognitive deficits is found in memory functioning, largely due to impaired acquisition. We examined functional brain activity 6months after memory retraining in individuals with MS. The current report presents long term follow-up results from a randomized clinical trial on a memory rehabilitation protocol known as the modified Story Memory Technique. Behavioral memory performance and brain activity of all participants were evaluated at baseline, immediately after treatment, and 6months after treatment. Results revealed that previously observed increases in patterns of cerebral activation during learning immediately after memory training were maintained 6months post training.

Common Cognitive Deficits in Children With Attention-Deficit/Hyperactivity Disorder and Autism

Cognitive deficits in working memory (WM) are characteristic features of Attention-Deficit/Hyperactivity Disorder (ADHD) and autism. However, few studies have investigated cognitive deficits using a wide range of cognitive measures. We compared children with ADHD ( n = 49) and autism ( n = 33) with a demographically matched control group ( n = 79) on a multidimensional battery of cognitive ability. Results confirmed previous research that both groups were characterized by deficits in WM. However, results also suggest verbal WM measures were better predictors than nonverbal WM measures. In addition, measures of visual-motor integration are equally discriminating of children with ADHD and autism from a matched control group. In all, 81% discrimination accuracy was obtained using only WM and visual-motor integration measures. Demonstrated shared deficits in WM and visual-motor integration are explained based on proposed neurological mechanisms common across the two disorders. Clinical implications are discussed.

Common and specific cognitive deficits in schizophrenia: relationships to function.

The goals of the present study were to assess the interrelationships among tasks from the MATRICS and CNTRACS batteries, to determine the degree to which tasks from each battery capture unique variance in cognitive dysfunction in schizophrenia, and to determine the ability of tasks from each battery to predict functional outcome. Subjects were 104 schizophrenia patients and 132 healthy control subjects recruited as part of the CNTRACS initiative. All subjects completed four CNTRACS tasks and two tasks from the MATRICS battery: Brief Assessment of Cognition in Schizophrenia Symbol Coding and the Hopkins Verbal Learning Test. Functional outcome was also assessed in the schizophrenia subjects. In both the patient and control groups, we found significant intercorrelations between all higher order cognitive tasks (episodic memory, goal maintenance, processing speed, verbal learning) but minimal relationships with the visual task. For almost all tasks, scores were significantly related to measures of functional outcome, with higher associations between CNTRACS tasks and performance-based measures of function and between one of the MATRICS tasks and self-reported functioning, relative to the other functioning measures. After regressing out variance shared by other tasks, we continued to observe group differences in performance among task residuals, particularly for measures of episodic memory from both batteries, although these residuals did not correlate as robustly with functional outcome as raw test scores. These findings suggest that there exists both shared and specific variance across cognitive tasks related to cognitive and functional impairments in schizophrenia and that measures derived from cognitive neuroscience can predict functional capacity and status in schizophrenia.

Does it help to train attention in dyslexic children: pilot case studies with a ten-session neurofeedback program

Abstract Neurofeedback is a biofeedback training of electroencephalogram (EEG) activity through operant conditioning where an individual is trained to increase or inhibit the brain activity in specific frequency ranges. Studies have demonstrated its efficacy to reduce inattention, impulsivity and hyperactivity in children with attention deficit hyperactivity disorder (ADHD), with the mostly used training protocols on modulation of θ/β ratio. Given the comorbidity and common cognitive deficits between ADHD and developmental dyslexia, this study aimed to explore the effects of θ/β neurofeedback on cognitive deficits in Chinese dyslexic children. In the present case study, a multiple-baseline design was adopted, and the effects of training were investigated from both neurophysiological and neuropsychological levels. Four dyslexic children completed 10 weekly sessions of θ suppression and β enhancement neurofeedback training in the sensorimotor cortex. Pre- and post-assessments consisted of neurophysiological measures, neuropsychological assessments, and parental reports. Neurofeedback training reduced θ/β ratios in all participants. All participants also improved in measures of auditory vigilance and phonological awareness.

A Meta-Analysis of Mentalizing Impairments in Adults With Schizophrenia and Autism Spectrum Disorder

Mentalizing has been examined both in autism spectrum disorder (ASD) and schizophrenia (SCZ) primarily by either cognitive-linguistic (referred to as verbal) or emotion recognition from eyes (referred to as visual) mentalizing tasks. Each type of task is thought to measure different aspects of mentalizing. Differences in clinical features and developmental courses of each disorder may predict distinct patterns of mentalizing performance across dis orders on each type of task. To test this, a meta-analysis was conducted using 37 studies that assessed mentalizing either verbally or visually in adults with SCZ or ASD. We found that the estimated effect sizes of impairments in verbal and visual mentalizing tasks for both clinical groups were statistically large and at a similar level (overall Hedges' g = 0.73-1.05). For each disorder, adults with SCZ showed a trend towards larger impairments on verbal (overall Hedges' g = 0.99) than on visual mentalizing task (overall Hedges' g = 0.73; Qbet = 3.45, p =.06, df =1). Adults with ASD did not show different levels of impairment on the verbal versus visual tasks (Qbet = 0.08, p =.78, df =1). These results suggest that both clinical groups share, at least in part, some common cognitive processing deficits associated with mentalizing impairments.

Cognitive regulation of negative affect in schizophrenia and bipolar disorder

Schizophrenia (SZ) and bipolar disorder (BD) exhibit common cognitive deficits that may impede the capacity for self-regulating affect. We examined the use of particular cognitive strategies for regulating negative affect in SZ and BD, and their associations with levels of mood symptomatology. Participants were 126 SZ, 97 BD, and 81 healthy controls (HC) who completed the Cognitive Emotion Regulation Questionnaire (CERQ), the Depression Anxiety Stress Scales (DASS) and the Hypomanic Personality Scale (HPS). Patients with SZ and BD reported more frequent rumination, catastrophising and self-blame, and less use of putting into perspective, relative to HC. Additionally, SZ patients were more likely to engage in other-blame, compared to HC. The most consistent predictors of symptomatology for SZ were self-blame and catastrophising, while for BD were rumination and reduced positive reappraisal. These findings demonstrate maladaptive use of cognitive strategies to self-regulate negative affect in SZ and BD, resembling those reported previously for unipolar depression. The ineffective use of adaptive cognitive reframing strategies in both patient groups may reflect the impact of their shared cognitive deficits, and requires further investigation. Remediation of cognitive capacities contributing to ineffective self-regulation may facilitate reduced mood symptomatology in SZ and BD.

High spatial and angular resolution diffusion-weighted imaging reveals forniceal damage related to memory impairment

IntroductionDiffusion tensor imaging (DTI) measures in patients with multiple sclerosis (MS), particularly those measures associated with a specific white matter pathway, have consistently shown correlations with function. This study sought to investigate correlations between DTI measures in the fornix and common cognitive deficits in MS patients, including episodic memory, working memory and attention. Materials and MethodsPatients with MS and group age- and sex-matched controls underwent high-resolution diffusion scanning (1-mm isotropic voxels) and cognitive testing. Manually drawn forniceal regions of interest were applied to individual maps of tensor-derived measures, and mean values of transverse diffusivity (TD), mean diffusivity (MD), longitudinal diffusivity (LD) and fractional anisotropy (FA) were calculated. ResultsIn 40 patients with MS [mean age±S.D.=42.55±9.1 years; Expanded Disability Status Scale (EDSS)=2.0±1.2; Multiple Sclerosis Functional Composite (MSFC) score=0.38±0.46] and 20 healthy controls (mean age±S.D.=41.35±9.7 years; EDSS=0.0±0; MSFC score=0.74±0.24), we found that FA, MD and TD values in the fornix were significantly different between groups (P<.03), and patient performance on the Brief Visuospatial Memory Test-Revised (BVMT-R) was correlated with DTI measures (P<.03). DiscussionThese results are consistent with findings of axonal degeneration in MS and support the use of DTI as an indicator of disease progression.

Outcomes of neuropsychological interventions of stroke

The reported prevalence of cognitive deficits within the first month of stroke ranges widely from 10% to 82%, depending primarily on the criteria used to define cognitive impairment and on the selected patient population. These cognitive defects progress toward impairment over a course of time if left untreated. Among the most common cognitive deficits are the attentional, the visuoperceptual, the memory and executive function deficits. As these impairments are being increasingly recognized in the scientific communities, more and more studies are being devoted to the outcomes of various therapies for these disorders. In this review, we focus on the outcomes of various therapies for these cognitive disorders over time. We reviewed all the possible medical databases using key words for individual cognitive deficit treatment outcomes. All the possible studies including randomized controlled trials, pre-post design studies, case series and single case reports were included in this study. On the basis of present literature review, we conclude that the evidence is definitively positive only for outcomes of attentional and visuoperceptive skill deficits. On the other hand, there have been very few studies to conclude for effectiveness of various therapies for memory and executive function outcomes.

Histamine H3 receptor antagonists/inverse agonists on cognitive and motor processes: relevance to Alzheimer's disease, ADHD, schizophrenia, and drug abuse

Histamine H3 receptor (H3R) antagonists/inverse agonists possess potential to treat diverse disease states of the central nervous system (CNS). Cognitive dysfunction and motor impairments are the hallmark of multifarious neurodegenerative and/or psychiatric disorders. This review presents the various neurobiological/neurochemical evidences available so far following H3R antagonists in the pathophysiology of Alzheimer's disease (AD), attention-deficit hyperactivity disorder (ADHD), schizophrenia, and drug abuse each of which is accompanied by deficits of some aspects of cognitive and/or motor functions. Whether the H3R inverse agonism modulates the neurochemical basis underlying the disease condition or affects only the cognitive/motor component of the disease process is discussed with the aim to provide a rationale for their use in diverse disease states that are interlinked and are accompanied by some common motor, cognitive and attentional deficits.

Cognitive and Behavioral Disorders in Neurorehabilitation

Assessment and management of cognitive and behavioral issues in the neurorehabilitation of patients with brain injuries are extremely important. Because cognitive impairments can impede post-brain injury adaptive functioning, it is necessary to carefully assess the major neurocognitive functions to help determine potential obstacles to rehabilitation and to plan for effective interventions. Likewise, behavioral and emotional problems following brain injury, whether directly or secondarily caused by the injury, can hamper or undermine what may otherwise be an efficacious rehabilitative treatment plan. This article describes some of the most common cognitive, emotional, and behavioral deficits and provides practical suggestions about how to address them.

Comparative analysis of brain structure, metabolism, and cognition in myotonic dystrophy 1 and 2

Myotonic dystrophy type 1 and 2 (DM1/DM2) are multisystemic diseases with common cognitive deficits beside the cardinal muscular symptoms. We performed a comprehensive analysis of cerebral abnormalities to compare the neuropsychological defects with findings in different imaging methods in the same cohort of patients. Neuropsychological investigations, structural cerebral MRI including brain parenchymal fraction (BPF) and voxel-based morphometry (VBM), and (18)F-deoxy-glucose PET (FDG-PET) were performed in patients (20 DM1 and 9 DM2) and matched healthy controls, and analyzed using statistical parametric mapping (SPM2). DM1 and DM2 patients showed typical neuropsychological deficits with a pronounced impairment of nonverbal episodic memory. Both patient groups showed a reduction of the global gray matter (measured by BPF), which could be localized to the frontal and parietal lobes by VBM. Interestingly, VBM revealed a bilateral hippocampal volume reduction that was correlated specifically to both a clinical score and episodic memory deficits. VBM also revealed a pronounced change of thalamic gray matter. White matter lesions were found in >50% of patients and their extent was correlated to psychomotor speed. FDG-PET revealed a frontotemporal hypometabolism, independent of the decrease in cortical gray matter. All abnormalities were similar in both patient groups but more pronounced for DM1. Our results suggest that 1) some of the characteristic cognitive deficits of these patients are linked to specific structural cerebral changes, 2) decreases in gray matter and metabolism are independent processes, and 3) the widespread brain abnormalities are more pronounced in DM1.

Differential fractional anisotropy abnormalities in adolescents with ADHD or schizophrenia

Schizophrenia and Attention-Deficit/Hyperactivity Disorder (ADHD) are associated with similar deficits in working memory, attention, and inhibition. Both disorders also involve abnormalities of white matter integrity, possibly reflecting neural communication disruptions. There are likely some regional white matter abnormalities that underlie the common cognitive impairment, though also some regional abnormalities unique to each disorder. We used diffusion tensor imaging (DTI) to compare white matter integrity, as indicated by fractional anisotropy (FA), in adolescents with schizophrenia ( n = 15) or ADHD ( n = 14) and healthy controls ( n = 26). Schizophrenia patients had uniquely low FA, relative to the other two groups, in bilateral cerebral peduncles, anterior and posterior corpus callosum, right anterior corona radiata, and right superior longitudinal fasciculus. ADHD patients had uniquely high FA in left inferior and right superior frontal regions. Both clinical groups had lower FA than controls in left posterior fornix. The two disorders generally demonstrated distinct patterns of abnormal connectivity suggesting that common cognitive and behavioral deficits derive from distinct sources, though the posterior fornix may be involved in both disorders. Schizophrenia was associated with abnormally low FA in widespread circuitry indicative of general connectivity disruptions, whereas ADHD was associated with abnormally high FA in frontal networks that may indicate impaired branching of fibers.

Overlap of Autism and Seizures: Understanding Cognitive Comorbidity

This article introduces the concept of ‘cognitive comorbidity,’ which lays emphasis on common cognitive deficits that cut across different disorders. The concept is illustrated with the help of two commonly reported overlapping conditions (autism and epilepsy). It is further explained by concentrating on two important cognitive processes of facial emotional recognition and emotional memory, shown to be compromised in both conditions; and their underlying neural substrates. Cognitive comorbidity is then contrasted with ‘comorbidity,’ a term which is more commonly used for describing cognitive disorders. The paper closes by providing directions for rehabilitative and theoretical efforts that could be inspired by the newly introduced concept.

PTSD and Combat-Related Injuries: Functional Neuroanatomy

PTSD and Combat-Related Injuries: Functional Neuroanatomy

Cognitive deficits in middle‐aged and older adults with bipolar disorder and cognitive complaints: Comparison with mild cognitive impairment

Cognitive impairment has been reported in elderly bipolar disorder (BD) patients, however, few studies have evaluated middle-aged and older BD patients using standardized cognitive assessments and none (to our knowledge) analysed middle-aged and older BD patients with recent cognitive complaints. The main objective of this study is to characterize the cognitive deficits of middle-aged and older patients with BD and compare them with the common age-related cognitive deficits observed in Mild Cognitive Impairment (MCI). For this retrospective study, a systematic search for all cases of BD patients submitted to a neuropsychological assessment from 1999-2007, at participant institutions, was performed, and cases were matched (1:2) by gender and age to a sample of MCI subjects. A total sample of 135 patients, 45 patients with the diagnosis of BD, clinically stable, mean age of 63.8 +/- 8.8 years, and 90 patients with the diagnosis of MCI, mean age of 64.2 +/- 8.4 years, was studied. Patients with MCI were more impaired in verbal memory, whereas BD patients showed more deficits in attention, motor initiative, calculation and verbal abstraction. Interestingly, discriminant analysis classified about half of the BD group as belonging to the MCI group. This BD subgroup showed deficits in episodic memory similar to MCI patients. Patients with BD and patients with MCI have distinct profiles of cognitive impairment. A subgroup of BD patients with recent cognitive complaints may actually suffer from concomitant incipient MCI, and this finding may have diagnostic and therapeutical implications.

Neuropsychological and behavioural disinhibition in adult ADHD compared to borderline personality disorder

Although attention-deficit/hyperactivity disorder (ADHD) is thought to be an inhibitory disorder, the question remains of how specific the inhibitory deficit is in adults and whether it distinguishes ADHD from borderline personality disorder (BPD), with which it shares several clinical features, particularly impulsiveness. The study assessed various motor and cognitive inhibitory functions (inhibition of prepotent, ongoing and interfering responses) in addition to working memory in adult ADHD patients with and without BPD, compared to subjects with BPD alone and controls. In addition, questionnaire data on various aspects of impulsiveness and anger regulation were assessed in all groups. ADHD patients performed worse than BPD individuals and controls in two inhibitory tasks: the stop signal task and the conflict module of the Attentional Network Task (ANT). In addition, they exhibited longer reaction times (RTs) and higher intra-individual variance in nearly all attentional tasks. The co-morbid group exhibited poor performance on the stop signal task but not on the conflict task. The BPD group barely differed from controls in neuropsychological performance but overlapped with ADHD in some behavioural problems, although they were less severe on the whole. Impaired inhibition is a core feature in adults with ADHD. In addition, slow RTs and high intra-individual variance in performance may reflect deficits in the regulation of activation and effort in ADHD patients. ADHD and BPD share some symptoms of behavioural dysregulation without common cognitive deficits, at least in the attentional realm.

Self-generated learning in people with multiple sclerosis

Memory impairment is among the most common cognitive deficits in people with multiple sclerosis (MS). To remediate this problem, recent research has evaluated the benefits of self-generated encoding. These nascent investigations reveal that people with MS who have mild memory impairment demonstrate a significant memory benefit from self-generated encoding compared with didactic learning. To extend prior research, the present experiment included MS patients with moderate-severe, rather than just mild, memory impairment. Additionally, the experiment evaluated whether self-generated encoding improves memory for activities of daily living instead of abstract words. Specifically, the experiment determined whether self-generated encoding enhanced memory for names, appointments, and object locations. In agreement with and extending prior research, MS patients remembered more information if it was self-generated rather than didactically presented, and this finding occurred despite moderate-severe memory impairment. Furthermore, compared with didactic encoding, self-generation enhanced recall of activities of daily living. Implications of these findings for cognitive rehabilitation and the nature of memory impairment in MS are discussed.