Delayed Story Recall Research Articles

Metabolic Syndrome Exacerbates Short-term Postoperative Cognitive Dysfunction in Patients Undergoing Cardiac Surgery: Results of a Pilot Study

The authors tested the hypothesis that patients with metabolic syndrome are more likely to develop short-term cognitive dysfunction after cardiac surgery with cardiopulmonary bypass. A prospective study. Veterans Affairs medical center. Fifty-six age- and education-balanced patients undergoing elective cardiac surgery with cardiopulmonary bypass (28 patients with and without metabolic syndrome in two separate groups) and 28 nonsurgical controls were enrolled. None. Recent verbal and nonverbal memory and executive functions were assessed using a psychometric test battery before and 1 week after cardiac surgery or at 1-week intervals in nonsurgical controls. Neurocognitive scores under the baseline condition were at least 1 z score (1 standard deviation) worse in surgical patients with compared without metabolic syndrome in all 3 cognitive areas (nonverbal and verbal recent memory and executive functions). Neurocognitive performance further deteriorated after surgery by at least 1 z score on 3 tests in the verbal memory modality (Immediate and Delayed Story Recall and Delayed Word List Recall). Overall cognitive performance (composite z score) after surgery was significantly (p = 0.03) worse in metabolic syndrome patients compared with those who did not have the disorder. The results indicate that short-term cognitive functions were more profoundly impaired in patients with metabolic syndrome undergoing cardiac surgery with cardiopulmonary bypass compared with their healthier counterparts.

Cognitive dysfunction in lower motor neuron disease: executive and memory deficits in progressive muscular atrophy

AimIn contrast with findings in amyotrophic lateral sclerosis (ALS), cognitive impairments have as yet not been shown in the lower motor neuron variant of motor neuron disease, progressive spinal muscular...

Memory performance in acute and weight-restored anorexia nervosa patients

Anorexia nervosa (AN), at the stage of starvation and emaciation, is characterized by abnormalities in cognitive function, including memory performance. It is unclear whether memory impairment persists or is reversible following weight restoration, and whether memory function differs between AN subtypes. The aim of the present study was to investigate general memory performance in currently ill and fully weight-restored patients of different AN subtypes. Memory performance was assessed using the Wechsler Memory Scale-Revised (WMS-R) in a total of 99 participants, including 34 restricting-type AN patients (AN-RESTR), 19 binge-eating/purging-type AN patients (AN-PURGE), 16 weight-restored AN patients (AN-W-R) and 30 healthy controls (CONTROL). Cognitive evaluation included a battery of standardized neuropsychological tasks for validating the findings on memory function. Deficits were found with respect to immediate and delayed story recall in currently ill AN patients irrespective of AN subtype. These deficits persisted in weight-restored AN patients. Currently ill and weight-restored AN patients did not differ significantly from healthy controls with respect to working memory or other measures of neuropsychological functioning. The findings suggest that impaired memory performance is either a stable trait characteristic or a scar effect of chronic starvation that may play a role in the development and/or persistence of the disorder.

Complex Mental and Physical Activity in Older Women and Cognitive Performance: A 6-month Randomized Controlled Trial

Several reports suggest beneficial impacts of either physical or mental activity on cognitive function in old age. However, the differential effects of complex mental and physical activities on cognitive performance in humans remain to be clarified. This randomized controlled trial evaluates a cognitive and a physical standardized 6-month activity intervention (3 x 1.5 h/wk) conducted in Berlin (Germany). Two hundred fifty nine healthy women aged 70-93 years were randomized to a computer course (n = 92), an exercise course (n = 91), or a control group (n = 76), of whom 230 completed the 6-month assessment. Group differences in change over a period of 6 months in episodic memory (story recall, possible range, 0-21; word recall, possible range, 0-16), executive control (working memory, ie, time quotient of Trail Making Tests B/A), and verbal fluency were evaluated by analyses of covariance (intention to treat) adjusting for baseline, fluid intelligence, and educational level. In contrast to the control group, both the exercise group, DeltaM (SD) = 2.09 (2.66), p < .001, and the computer group, DeltaM (SD) =1.89 (2.88), p < .001, showed improved delayed story recall. They maintained performance in delayed word recall and working memory (time measure) as opposed to the control group that showed a decline, DeltaM (SD) = -0.91 (2.15), p = .001, and DeltaM (SD) = 0.24 (0.68), p = .04, respectively. In healthy older women, participation in new stimulating activities contributes to cognitive fitness and might delay cognitive decline. Exercise and computer classes seem to generate equivalent beneficial effects.

The Effect of Spousal Bereavement on Cognitive Functioning in a Sample of Older Adults

ABSTRACT Objective: This study examined the association between bereavement and cross-sectional differences in cognitive performance in a sample of older adults. Methods: Secondary cross-sectional data analysis was conducted on 211 participants from the MacArthur Battery dataset. Participants completed several cognitive tasks 6-months post-loss. Results: Hierarchical multiple regression results suggested that bereavement status was not associated with cognitive performance. However, the effect of bereavement on memory (immediate and delayed story recall) performance was moderated by age and gender where the younger participants and men who were bereaved performed worse compared to their non-bereaved counterparts. Discussion: Our results support the finding that bereavement is associated with poorer memory performance within certain subgroups (i.e., men and younger participants). We discuss findings in light of theories of stress and cognitive aging.

Correlation between cognitive functions and syndromes of traditional Chinese medicine in amnestic mild cognitive impairment

To explore the correlation between the cognitive functions and syndromes of traditional Chinese medicine (TCM) in amnestic mild cognitive impairment (aMCI), and to provide evidence for clinical syndrome differentiation treatment. Six hundred subjects from Dongzhimen Hospital and seven communities in Beijing, aged between 40 and 85 years, accepted neuropsychological assessments, imaging and biochemical examinations, and syndrome differentiation, from whom 159 aMCI patients, 213 normal control (NC) subjects and 171 Alzheimer's dementia (AD) patients were screened out. Correlation between the cognitive functions and TCM syndromes in aMCI patients was analyzed. Mini-Mental State Examination (MMSE) score in aMCI patients was closely correlated with kidney essence vacuity and deficiency of blood and qi (r = -0.11, r = -0.11; P = 0.003, P = 0.015). Delayed Word Recall (DWR) score was correlated with kidney essence vacuity (r = -0.20, P = 0.020). Instant Story Recall (ISR) and Delayed Story Recall (DSR) scores were respectively correlated with turbid phlegm blocking upper orifices (r = -0.11, r = -0.27; P = 0.021, P = 0.000). Language function was correlated with kidney essence vacuity and deficiency of blood and qi (r = -0.11, r = -0.13; P = 0.042, P = 0.007). Attention/calculation was also closely correlated with kidney essence vacuity and deficiency of blood and qi (r = -0.10, r = -0.21; P = 0.039, P = 0.010). Attention score of aMCI patients was correlated with excess of heat toxin syndrome (r = -0.29, P = 0.026). The memory decline of aMCI is correlated with kidney essence vacuity and turbid phlegm blocking upper orifices. Furthermore, turbid phlegm blocking upper orifices is correlated with episodic memory decline, which is closely related to AD. The aMCI patients with phlegm have the risk to progress into AD. Although other cognitive functions of aMCI remain relatively intact, the patients' language function, attention/calculation and the whole cognitive function may be worsen as the aggravation of kidney essence vacuity, deficiency of blood and qi, phlegm and heat toxin, and may eventually lead to multiple cognitive domains impairment, even dementia.

Neurocognitive predictors of financial capacity across the dementia spectrum: Normal aging, mild cognitive impairment, and Alzheimer’s disease

Financial capacity is a complex instrumental activity of daily living critical to independent functioning of older adults and sensitive to impairment in patients with amnestic mild cognitive impairment (MCI) and Alzheimer's disease (AD). However, little is known about the neurocognitive basis of financial impairment in dementia. We developed cognitive models of financial capacity in cognitively healthy older adults (n = 85) and patients with MCI (n = 113) and mild AD (n = 43). All participants were administered the Financial Capacity Instrument (FCI) and a neuropsychological test battery. Univariate correlation and multiple regression procedures were used to develop cognitive models of overall FCI performance across groups. The control model (R2 = .38) comprised (in order of entry) written arithmetic skills, delayed story recall, and simple visuomotor sequencing. The MCI model (R2 = .69) comprised written arithmetic skills, visuomotor sequencing and set alternation, and race. The AD model (R2 = .65) comprised written arithmetic skills, simple visuomotor sequencing, and immediate story recall. Written arithmetic skills (WRAT-3 Arithmetic) was the primary predictor across models, accounting for 27% (control model), 46% (AD model), and 55% (MCI model) of variance. Executive function and verbal memory were secondary model predictors. The results offer insight into the cognitive basis of financial capacity across the dementia spectrum of cognitive aging, MCI, and AD.

An explanation on guiding principles of clinical research on mild cognitive impairment (protocol)

In order to provide the "guiding principles of clinical research on mild cognitive impairment (MCI) (protocol)" edited by Beijing United Study Group on MCI of the Capital Foundation of Medical Developments (CFMD) with evidence support, clinical criteria, subtypes, inclusion and exclusion of MCI, and use of rating scales were reviewed. The authors suggested that MCI clinical criteria and new diagnosis procedure from the MCI Working Group of the European Alzheimer's disease Consortium (EADC) may better reflect the heterogeneity of MCI syndrome. Diagnostic rating scales including Clinical Dementia Rating (CDR), Global Deterioration Scale (GDS), Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) and Instrumental Activities of Daily Living (IADL) are very useful in definition of MCI but can not replace its clinical criteria. Absence of major repercussions on daily life in patients with MCI was emphasized, but the patients may have minimal impairment in complex IADL. According to their previous research, the authors concluded that highly recommendable neuropsychological scales with cut-off scores in the screening of MCI cases should include Mini-Mental State Examination (MMSE), logistic memory test such as Delayed Story Recall (DSR), executive function test such as Clock Draw Test (CDT), language test such as Verbal Category Fluency Test (VCFT), etc. And finally, the detection of biological and neuroimaging changes, including atrophy in hippocampus or medial temporal lobe in patients with MCI, was introduced.

Methadone vs. buprenorphine/naloxone during early opioid substitution treatment: a naturalistic comparison of cognitive performance relative to healthy controls

BackgroundBoth methadone- and buprenorphine-treated opioid-dependent patients frequently show cognitive deficits in attention, working memory, and verbal memory. However, no study has compared these patient groups with each other during early opioid substitution treatment (OST). Therefore, we investigated attention, working memory, and verbal memory of opioid-dependent patients within six weeks after the introduction of OST in a naturalistic setting and compared to those of healthy controls.MethodsThe sample included 16 methadone-, 17 buprenorphine/naloxone-treated patients, and 17 healthy controls matched for sex and age. In both groups buprenorphine was the main opioid of abuse during the recent month. Benzodiazepine codependence, recent use, and comedication were also common in both patient groups. Analysis of variance was used to study the overall group effect in each cognitive test. Pair-wise group comparisons were made, when appropriateResultsMethadone-treated patients, as a group, had significantly slower simple reaction time (RT) compared to buprenorphine/naloxone-treated patients. In Go/NoGo RT methadone patients were significantly slower than controls. Both patient groups were significantly debilitated compared to controls in working memory and verbal list learning. Only methadone patients were inferior to controls in story recall. In simple RT and delayed story recall buprenorphine/naloxone patients with current benzodiazepine medication (n = 13) were superior to methadone patients with current benzodiazepine medication (n = 13). When methadone patients were divided into two groups according to their mean dose, the patient group with a low dose (mean 40 mg, n = 8) showed significantly faster simple RT than the high dose group (mean 67 mg, n = 8).ConclusionDeficits in attention may only be present in methadone-treated early phase OST patients and may be dose-dependent. Working memory deficit is common in both patient groups. Verbal memory deficit may be more pronounced in methadone-treated patients than in buprenorphine/naloxone-treated patients. In sum, to preserve cognitive function in early OST, the use of buprenorphine/naloxone may be more preferable to methadone use of, at least if buprenorphine has been recently abused and when benzodiazepine comedication is used. Longitudinal studies are needed to investigate if the better performance of buprenorphine/naloxone-treated patients is a relatively permanent effect or reflects "only" transient opioid switching effect.

One‐Year Postoperative Autobiographical Memory Following Unilateral Temporal Lobectomy for Control of Intractable Epilepsy

To examine the effects of temporal lobectomy (TL), particularly concerning its lateralization. Patients completed autobiographical memory tests, preoperatively and 1-year postoperatively. (a) right TL (RTL) patients recalled significantly more memories from the year after surgery than from the year before TL; (b) their pre to postoperative improvement on autobiographical memory scores was positively correlated to improvement of delayed story recall scores; and (c) 1 year after surgery, performance on recent personal memory recall was normalized for RTL patients only. We suggest that, in the absence of recurrent seizures, the relative integrity of the left hemisphere together with residual right hemisphere structures sustains postoperative autobiographical memory consolidation, at least 1 year postoperatively.

Declarative memory in unaffected adult relatives of patients with schizophrenia: A systematic review and meta-analysis

Despite evidence for diverse neuropsychological impairment in schizophrenia, verbal declarative memory has emerged as a core deficit in the disorder. Similar but less marked impairments have been demonstrated in unaffected biological relatives of patients with schizophrenia, but the nature and extent of the memory impairment in relatives compared to controls is unclear. We have conducted a systematic review and meta-analysis of the literature investigating declarative memory in unaffected biological relatives of schizophrenics and controls, with the aim of quantifying memory deficits in relatives. The standardised mean difference between groups was calculated for nine measures of declarative memory and two measures of intellectual ability, based on 21 studies of several hundred relatives of schizophrenics and controls. Unaffected relatives showed poorer performance relative to controls on all tests of memory examined. Small to moderate effect sizes, with overlapping 95% confidence intervals, were greatest on immediate (trial 1) list recall (0.65), followed by immediate (0.53) and delayed story recall (0.52). Verbal and general IQ showed smaller standardised mean differences as the latter tests, while the smallest standardised mean difference was shown on delayed visual recall (0.32). Results suggest greater deficits on tests of increasing memory load or which place demands on effective encoding processes but more studies with these tasks are needed. Investigation of sub-groups within these cohorts (e.g. age groups within or beyond the maximum age of risk) is recommended in order to identify deficits specific to the disease process.

Contribution of cannabis and MDMA ("ecstasy") to cognitive changes in long-term polydrug users.

Establishing whether cognitive changes follow long-term use of MDMA ("ecstasy") in humans has been difficult because of possible confounds with other drug use, particularly cannabis. Convincing evidence may be only obtained using experimental designs that account for such confounds. In the present study, cognitive/behavioural measures were used to investigate whether long-term MDMA use or long-term cannabis use is responsible for the changes sometimes observed in recreational MDMA users. Tests of attention and memory were administered to subjects who used both MDMA and cannabis, cannabis only, or neither drug. The main finding was that cannabis users, whether or not they also used MDMA, showed significantly impaired memory function on word free-recall and on immediate and delayed story recall compared to non-users. The findings highlight the importance of controlling for other drug use (particularly cannabis) when investigating persistent effects of MDMA in humans.

Oral amino acid load mimicking hemoglobin results in reduced regional cerebral perfusion and deterioration in memory tests in patients with cirrhosis of the liver.

This study tests the hypothesis that administration of an oral amino acid load mimicking hemoglobin in patients with cirrhosis of the liver causes deterioration in neuropsychological function and a reduction in regional cerebral perfusion. Eight overnight fasted, metabolically stable cirrhotic patients with no evidence of overt hepatic encephalopathy were studied prior to and 4 h after simulating an upper gastrointestinal bleed by oral administration of 75 g of a solution mimicking the amino acid composition of hemoglobin. Neuropsychological function was measured using a test battery. Peripheral venous blood was collected for the measurement of ammonia and amino acid concentrations. Regional cerebral perfusion was measured using a head SPECT scanner following intravenous administration of technetium-99m hexamethyl propylamineoxime. The amino acid solution resulted in significant deterioration in the immediate and delayed story recall tests. Ammonia concentration increased from a median of 87 (range 67-94) micromol/L to 105 (98-112) micromol/L at 4 h after the simulated bleed (p < 0.01). The concentration of almost all amino acids increased; only isoleucine levels decreased following the upper gastrointestinal bleed. SPECT analysis showed a significant reduction in cerebral perfusion after the simulated bleed in both temporal lobes, left superior frontal gyrus, and right parietal and cingulate gyrus. An oral amino acid load mimicking hemoglobin in cirrhotic patients produces hyperammonemia and hypoisoleucinemia and causes a significant deterioration in memory tests, probably due to a reduction in regional cerebral perfusion. The model of simulating the metabolic effects of an upper gastrointestinal bleed in patients with cirrhosis of the liver seems to be useful in studying the metabolism of hepatic encephalopathy.

Perception, attention, and working memory are disproportionately impaired in dementia with Lewy bodies compared with Alzheimer's disease

OBJECTIVETo test the hypotheses that visuoperceptual and attentional ability are disproportionately impaired in patients having dementia with Lewy Bodies (DLB) compared with Alzheimer's disease (AD).METHODSA comprehensive battery of neuropsychological tasks...

The effect of fatigue, sleep deprivation and onerous working hours on the physical and mental wellbeing of pre-registration house officers.

The potential deleterious effects of doctors' long and arduous shifts have received relatively scant attention. This study addressed the effect of a 32 h on-call shift on 16 pre-registration medical house officers in St. James's Hospital, Dublin. We assessed 5 psychological parameters (Tension-Anxiety, Depression-Dejection, Vigour-Activity, Fatigue-Inertia and Confusion-Bewilderment) as well as 5 simple tests of alertness and concentration both pre- and post-call. The doctors were randomly assigned to be tested either pre- or post-call. On average the doctors got 4.5 hours sleep during a 32 h shift. This long shift had an adverse effect on all the psychological parameters (p < 0.05) except Depression-Dejection. The total mood disturbance score, which has been shown to correlate well with general psychological well-being, deteriorated significantly after the 32 h shift, p < 0.005. Two of the simple tests of alertness and concentration (Trail-making test and Stroop Color-Word test) also showed a significant fall-off in performance with sleep deprivation, p < 0.05, although the remaining tests (Delayed Story Recall, Critical Flicker Fusion and Three Minute Grammatical Reasoning Test) were not significantly impaired by the 32 h shift. This study shows that prolonged periods of duty without sleep adversely affect junior doctors, both in their psychological well-being and in their ability to carry out simple tasks.

Effects of Causal Structure on Immediate and Delayed Story Recall by Children with Mild Mental Retardation, Children with Learning Disabilities, and Children without Disabilities

Children with mild mental retardation, children with learning disabilities, and children without disabilities read and recalled a story immediately and after a delay of 4 or 5 days. The effects of the story's causal structure on recall were compared for the three groups. Although children with mild mental retardation recalled less than the other groups, the effects of causal structure were similar across the three groups. At both retention intervals, all groups recalled content better if it was on the story's causal chain than if it was off the causal chain, and statements with many causal connections better than statements with few causal connections. All groups were sensitive to the causal structure of the story. The only notable difference was that the children with mild retardation forgot content on the causal chain somewhat faster than content off the causal chain, whereas the other two groups showed the reverse pattern.

Clinical and neuropsychological characteristics in familial and sporadic Alzheimer's disease: relation to apolipoprotein E polymorphism.

Alzheimer's disease (AD) is a heterogeneous entity presenting as sporadic and familial disease. In familial AD, there is evidence for genetic linkage to a yet undefined gene on chromosome 14 in early-onset pedigrees and on chromosome 19 in late-onset pedigrees. In a few early-onset kindreds, there were mutations in the amyloid precursor gene on chromosome 21. There is an increased frequency of apolipoprotein E (ApoE) epsilon4 allele in patients with late-onset AD. We studied the clinical presentation and profile of cognitive deficits in 58 AD patients at the early stage of the disease. We divided the AD patients into subgroups of sporadic late-onset (SLO) (> or = 65 years), familial late-onset (FLO) (> or = 65 years), sporadic early-onset (SEO) (<65 years), and familial early-onset (FEO) (<65 years) patients and into three subgroups according to their ApoE genotype zero epsilon4, one epsilon4, and two epsilon4 alleles. The AD subgroups did not differ in the global clinical severity of dementia or the duration of the disease. SLO, FLO, SEO, and FEO subgroups did not differ in clinical characteristics such as occurrence of rigidity, hypokinesia, tremor, myoclonus, hallucinations, delusions, or epileptic seizures nor in the profile of deficits on tests assessing memory, language, visuospatial, executive, and praxic functions. The epsilon4++ allele frequency was 0.43 for all AD patients and did not differ across subgroups divided according to the familial aggregation and age of onset. Patients with two epsilon4 alleles had earlier age at onset of dementia than those with no epsilon4 allele (63 +/- 9 versus 68 +/- 9 years), but otherwise the clinical symptoms and signs were not related to the ApoE genotype. However, the AD patients with two epsilon 4 alleles had lowest scores on memory tests and differed significantly from those with one or zero epsilon4 allele in the delayed list learning (p<0.05) and from those with zero epsilon4 allele in the immediate and delayed story recall. In contrast, verbal functions were better preserved in two epsilon4 patients than in those with other ApoE genotypes. This study failed to confirm the earlier reports of severe aphasia, agnosia, and apraxia in familial AD patients, but the clinical phenotype was similar irrespective to the familial aggregation. However, AD patients with two epsilon4 alleles are characterized by more severe memory loss and earlier age of onset than those without the epsilon4 allele.

Anterograde but not retrograde memory loss following combined mammillary body and medial thalamic lesions

We report the first human case of combined mammillary body and medial thalamic lesions due to focal pathology. A patient presented with a multi-lobular lesion that affected the mammillary bodies, the medial thalamus and the brain stem. On neuropsychological testing, he showed significant anterograde memory impairment, with marked impairment on delayed story recall, but normal or only mildly impaired performance on retrograde memory tasks. Our findings corroborate the results of recent non-human lesion studies and indicate that some of the well-established features of the amnesic syndrome, such as severe retrograde amnesia, may not be due to primary diencephalic pathology. Significant retrograde amnesia may result from cortical pathology or from an interaction between cortical and subcortical pathology.

Vasopressin levels in CSF of Alzheimer patients: Correlations with monoamine metabolites and neuropsychological test performance

Concentrations of vasopressin (AVP) and monoamine metabolites (HVA, 5-HIAA, MHPG) in cerebrospinal fluid (CSF) were measured and compared with memory functions in patients with dementia of Alzheimer type (DAT) and control subjects. CSF concentrations did not differ between the DAT patients and the controls, or between patients with different degrees of dementia. There were no correlations between concentrations of vasopressin and monoamine metabolites in CSF or between the CSF measures and psychological test scores, except for a correlation between CSF HVA and immediate and delayed story recall. These data suggest that probable damage to the vasopressinergic and monoaminergic systems in DAT is not reflected in the CSF of patients in early stages of the disease, nor is a deficit in these systems or their interaction the primary cause of cognitive impairment in DAT.

Recall and recognition memory in patients with Alzheimer's and Parkinson's diseases.

Alzheimer's and Parkinson's diseases are associated with cognitive impairment, although the pattern of cognitive dysfunction is not identical. We investigated the recall and recognition memory of 18 patients with idiopathic Parkinson's disease (PD) and of 32 patients with probable Alzheimer's disease (AD). In the list-learning test using Buschke's selective reminding method, PD patients showed superior delayed recognition memory capability compared to AD patients, whereas immediate recall did not differ in the two groups. In the delayed story recall, PD patients were also able to benefit from rehearsal and probe more than AD patients. The results suggest that PD patients are able to bind information better into long-term storage than are AD patients. This may be due to better function in PD of the entorhinal cortex and hippocampus.