Detection Of Neurocognitive Impairment Research Articles

Event-related evoked potential versus clinical tests in assessment of subclinical cognitive impairment in chronic hepatitis C virus

ContextChronic infection by hepatitis C virus causes impairment in neurocognitive function in up to 50% of patients which may not be detected by clinical tests.AimEarly detection of neurocognitive impairment in chronic hepatitis C patients and investigating the cognitive function in HCV patient by p300 and clinical test.Materials and methodsThe study included 60 patients with chronic hepatitis C and 30 healthy controls. Participants were subjected to a biochemical, hematological assessment, mini-mental state examination, Montreal Cognitive Assessment, P300, polymerase chain reaction (PCR), and fibroscan made for hepatitis C patients.ResultsThe digit span, attention, concentration, and memory were significantly lower in patients than controls. The delayed P300 peak latency and the reduction of its amplitude were significantly evident in patients with liver fibrosis than the controls and patients without fibrosis. These abnormalities were significantly higher with increasing the grade of fibrosis. All patients with cognitive impairment (reduced mini-mental state score) had abnormal P300-evoked responses. P300 could detect neurocognitive impairment in some patients with normal neurocognitive functions by clinical test. P300 had sensitivity (100%), specificity (59.26), positive predictive value (75%), negative predictive value (100%), and accuracy (81.67) in the detection of neurocognitive impairment in HCV patient.ConclusionPatients with chronic hepatitis C infection had significant impairment in their cognitive functions. This impairment increases with the increase in grade of hepatic fibrosis. P300 can detect minimal and subclinical impairment of cognitive function at early stages of chronic hepatitis with accuracy (81.67).Trial registrationPACTR on 19 march 2018 retrospectively. Identification number for the registry is PACTR201804003215168.

Comparison of screening tools for the detection of neurocognitive impairment in HAART-treated patients

Background : Neurocognitive impairment (NCI) and HIV-associated neurocognitive disorders (HAND) remain prevalent despite HAART. We examined sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and correct classification rate (CCR) of screening tools for the detection of NCI and HAND in HAART treated patients. Methods : We examined 101 unselected HAART-treated patients. Patients were administered the self-reported three questions (EACS Guidelines), the International HIV-Dementia Scale (IHDS), the Mini-Mental Status Examination (MMSE), and a comprehensive 6-domain (17-test) neuropsychological (NP) battery (120 minutes) that included, among others, the Digit Symbol (DS), the Trail Making Modalities (TM), and the Grooved Pegboard (GP) tests. NCI was defined according to the AAN criteria. HAND was diagnosed after exclusion of confounding conditions. Results : Our cohort was relatively healthy (mean CD4 count: 575 cells/mm 3 , undetectable plasma HIV RNA 85%). Prevalence of NCI and HAND were 39.6% (40 of 101) and 30.7% (31 of 101), respectively. Mean scores of IHDS (9.9 vs 10.8; p<0.001) and MMSE (26.8 vs 28.2; p=0.004) differed significantly between impaired and unimpaired patients, while mean three-questions scores (8.0 vs 7.0; p=0.23) did not. The three questions showed also poor sensitivity for the detection of both NCI (20%) and HAND (22%). The IHDS showed fairly good sensitivity (55%) and NPV (73.5%). Adding to the IHDS some easy to administer NP tests, i.e. TM, DS, and GP, resulted in an increase in sensitivity and NPV for the detection of NCI (table). Similar results were obtained regarding the detection of HAND (not shown in table). Conclusions : Both NCI and HAND are still very prevalent in HAART-treated patients. Among screening tools the self-reported three question show poor sensitivity. The IHDS performed better in terms of sensitivity, PPV, and NPV. Combinations of easy-to-administer NP tests with the IHDS resulted in increased sensitivity and NPV. Combining IHDS with one or two simple NP test may represent an improvement in the screening approach to the detection of both NCI and HAND. (Published: 11 November 2012) Citation: Abstracts of the Eleventh International Congress on Drug Therapy in HIV Infection Antinori A et al. Journal of the International AIDS Society 2012, 15 (Suppl 4):18286 http://www.jiasociety.org/index.php/jias/article/view/18286 | http://dx.doi.org/10.7448/IAS.15.6.18286

A comparison of screening batteries in the detection of neurocognitive impairment in HIV-infected Spanish speakers.

A substantial number of Spanish-speaking individuals from Mexico and Central America are now living in the United States. These individuals are at heightened risk for HIV infection and, due to late diagnosis and limited resources, for HIV-associated neurocognitive disorders (HAND). Early detection is key, yet adequate methods for detecting HAND in Spanish speakers, especially in resource-poor areas, remains problematic. Therefore, it is necessary to identify accurate yet efficient neurocognitive screening tools that are appropriate for use in resource-limited AIDS clinics serving Spanish-speaking patients. Twenty-one Spanish-speaking, HIV-positive adults who migrated from Mexico or Central America underwent neuromedical and neurocognitive evaluation in Spanish. The concordance of three neurocognitive screening measures (the HIV Dementia Scale [HDS], the Mini-Mental State Examination [MMSE], and the NEUROPSI) with a comprehensive neuropsychological battery was examined. In addition, accuracy in detecting neurocognitive impairment using standard and alternative cutoff scores was examined. The HDS and the NEUROPSI showed high correlation with the comprehensive neuropsychological battery. The HDS and the NEUROPSI also had the highest sensitivity (67% and 75%, respectively) and specificity (50% and 38%, respectively). Both measures also showed greater sensitivity than the MMSE to very mild forms of HAND. In this small sample of HIV-positive Spanish speakers from Mexico and Central America living in the United States, the HDS and the NEUROPSI demonstrated reasonable accuracy in detecting neurocognitive impairment, while the MMSE demonstrated very poor accuracy. The HDS and the NEUROPSI were equally sensitive in detecting mild HAND. Continued test development is required to capture this disorder, especially in resource-limited settings.

Detection of cognitive impairment with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) in adolescents with psychotic symptomatology

Cognitive impairment has been identified in the early phase of schizophrenia spectrum disorders, and is a major contributor to disease-related disability. While screening tools assessing cognitive impairment have been validated for adult schizophrenic populations, there is a need for brief, easily administered, standardized instruments that provide clinically relevant information for adolescents. This study examines the utility of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) in identifying and quantifying neurocognitive impairment in adolescents with schizophrenia spectrum disorders and other serious psychiatric illnesses. 112 adolescents, including 32 healthy subjects and 80 patients, were administered the RBANS. Patients with psychotic disorders demonstrated significant impairment on the RBANS total score compared to patients with other disorders and healthy controls, but this impairment appeared somewhat less severe than is typically reported for in adult patients with schizophrenia on this measure. The RBANS appears to be sensitive in the detection of neurocognitive impairment in a psychiatric population of adolescents with psychotic symptomatology, and may therefore have utility as a clinical screening instrument and/or neurocognitive outcome measure in this population.