Neurocognitive Profile Of Patients Research Articles

Comparative effectiveness of aripiprazole and olanzapine on neurocognitive profile of patients with schizophrenia.

Schizophrenia causes significant neurocognitive impairment. Treatment with antipsychotics leads to improvement in psychopathology and neurocognitive functions. To see comparative effectiveness of aripiprazole and olanzapine on neurocognitive profile of patients with schizophrenia. This was a comparative, prospective, and interventional study. Patients with schizophrenia as per the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), were assessed on Brief Psychiatric Rating Scale (BPRS), Positive and Negative Syndrome Scale (PANSS), and neuropsychological tests at baseline. Patients were randomly assigned to aripiprazole (10-30 mg per day, orally) and olanzapine (5-20 mg per day, orally) groups on the basis of computer-generated random table number. Patients were reassessed at 10 weeks. A total of 40 patients completed the study duration of 10 weeks. At baseline, the majority of patients showed significant impairment in one or more domains of neurocognition. Both aripiprazole and olanzapine led to improvement in psychiatric symptoms as well as neurocognitive profile. Aripiprazole treatment leads to significant improvement in mental speed as compared to olanzapine. A highly significant decrease in the value of the Stroop effect indicates improvement (P = 0.000**) with aripiprazole and visual-spatial constructive ability (P < 0.001). The olanzapine group showed highly significant improvement in performance of category fluency (P < 0.01) and verbal fluency (P < 0.01). The study concludes that aripiprazole and olanzapine have strong potential to improve specific domains of neurocognitive profile.

Neurocognitive profile of patients with Complex Regional Pain Syndrome (CRPS)

Neurocognitive profile of patients with Complex Regional Pain Syndrome (CRPS)

FEATURES OF NEUROCOGNITIVE IMPAIRMENTS IN PATIENTS WITH MILD COGNITIVE DISORDER OF DIFFERENT ETIOLOGY

Introduction. Mild cognitive disorder (MCD) is a heterogeneous syndrome that involves problems with memory, speech, and thinking that are inconspicuous and do not affect the patient's independence and daily life. The article considers similarities and differences in the neurocognitive profiles of patients with mild cognitive disorders of various etiologies. Materials and methods. We examined 60 people: 30 subjects aged 50 to 83 years with a mild cognitive disorder of various etiologies and 30 relatively healthy individuals as the control group. All patients underwent a magnetic resonance imaging (MRI) examination of the brain. We used the psychometric method and the following scales: the Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment Scale (MoCA), the Frontal Assessment Battery (FAB), the Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-cog), the Clinical Dementia Rating (CDR); the results were analyzed using the method of statistical processing. Results. According to the results of neurocognitive testing, no significant differences were found in the total scores (p = 0.6209), in particular, using the MMSE scale in patients with non-anamnestic (nMCD) and anamnestic (aMCD) мild cognitive disorder and мild cognitive disorder (aMCD). However, patients with nMCD showed significantly lower results with subtests: "attention and calculation" (p = 0.0443). According to the MoCA scale, patients with nMCD had a higher score vs. patients with aMCD (p = 0.0457), namely in the "delayed recall" subtests (p = 0.0102). Patients with nMCD had significantly lower results with the "attention and calculation" subtest (p = 0.0468). No significant differences were found between the groups of patients with MCD according to the results of testing with the FAB scale (p = 0.4778). According to some subtests of the ADAS-cog scale, patients with aMCD showed worse results with the "word recall" test (p = 0.0069) and "word recognition" (p = 0.0350). In patients with nMCD, lower scores were observed for the subtests "concentration and distractibility" (p = 0.0468), "number cancellation task" (p = 0.0217), and "passing the labyrinth" (p = 0.0015). Patients with aMCD showed significantly lower cognitive abilities than patients with nMCD. Consequently, patients with aMCD may be significantly at high risk of progression to Alzheimer's disease. Conclusions. After comparing the data of neurocognitive profiles, we established that in patients with anamnestic мild cognitive disorder, the clinical picture presented with a pronounced memory disorder, especially delayed recall, while the patients with non-anamnestic мild cognitive disorder were characterized by regulatory cognitive impairment (attention and calculation, reduced speed of thinking, impaired planning of activities). The MoCA and ADAS-cog scores had better diagnostic accuracy and specificity for the detection and differential diagnosis of mild cognitive disorders than the MMSE scale.

Neurocognitive profiles of patients with first-episode and recurrent depression: a cross-sectional comparative study from China

BackgroundAccumulating evidence has shown that cognitive deficits are prevalent among patients with major depressive disorder (MDD). However, the pattern and extent of cognitive deficits in patients with first-episode and recurrent depression remain unclear. MethodsObjective measures of cognitive function were assessed in 433 first-episode of depression (FED) patients, 206 recurrent major depression (RMD) patients during the acute phase and 287 healthy controls (HCs). Five domains of cognition (speed of processing, attention, verbal learning, visual learning and execution function) were assessed by seven neuropsychological tests. Neuropsychological data were transformed into T scores according to the Chinese norm. ResultsBoth FED and RMD patients displayed deficits of mild-to-medium severity across all cognitive domains and their subtests, relative to HCs (Cohen's d = 0.12-0.62). Among MDD patients, RMD patients exhibited poorer verbal learning (Cohen's d = 0.17) and visual learning (Cohen's d = 0.21) than FED patients. ConclusionsMDD patients in the acute phase exhibited broad cognitive impairments, and there were significant differences in verbal and visual learning between FED and RMD patients. Our findings indicate that more attention should be paid to the domains of verbal and visual learning in future screening assessments and targeted interventions.

Neurocognitive profile of patients with X-linked dystonia-parkinsonism.

X-linked dystonia-parkinsonism (XDP) is a debilitating movement disorder endemic to the Panay Island, Philippines. Most studies focus on motor symptoms, hence we reviewed the neurocognitive profile of XDP patients. Neurocognitive testing of XDP patients focused on five domains: general intellectual functioning, episodic memory, language, attention and executive function, and affect. Twenty-nine genetically confirmed patients were included. Twenty-six (89.6%) had impairments in one or more domains, while only three had no impairment in any domain. Attention and executive function was the most commonly affected domain (n = 23, 79.3%). Deficits in general intellect, episodic memory, attention and executive function and affect were seen in our subset of XDP patients. The striatal pathology affecting the frontostriatal circuitry mandating these cognitive processes is mainly implicated in these impairments. The results of our study provided further evidence on the extent of cognitive impairment in XDP using a select battery of neurocognitive tests.

A Study to Assess the Neurocognitive Profile of Patients with OCD and Depression

Background: The present study was conducted to assess the neurocognitive profile of patients with OCD and depression. Subjects &amp; Methods: It comprised of patients of OCD (42) and depression (42) of both genders. An equal number of healthy control was also recruited. VAIS and performance tests of intelligence (BSS) were recorded. Results: Group I had 22 males and 20 females, group II had 18 males and 24 females and group III had 21 males and 21 females. The value for VAIS and performance tests of intelligence (BSS) parameters such as information were 94.2, 96.4 and 98.3 in all groups respectively, digit span was 103.4, 102.5 and 105.6 in all groups respectively, arithmetic was 95.8, 96.2 and 8.4 in all groups respectively, comprehension was 102.4, 104.5 and 107.3 in all groups respectively, verbal quotient was 105.2 in group I, 103.6 in group II and 10.6.7 in group III respectively. Block design was 9.12, 10.2 and 10.4 in all groups respectively, pass along test was 9.4, 9.8 and 10.2 in all groups respectively and the performance quotient was 102.2, 103.5 and 10.5.7 in all groups respectively. The difference was non-significant (P&gt; 0.05). Conclusion: Neuropsychological/cognitive parameters in patients with OCD, depression and healthy control were comparables.

Using network analysis to explore cognitive domains in patients with unipolar versus bipolar depression: a prospective naturalistic study.

Despite growing evidence in the field of cognitive function in mood disorders, the neurocognitive profiles of patients with unipolar and bipolar depression still need further characterization. In this study, we applied network analysis, hypothesizing this approach could highlight differences between major depressive disorder (MDD) and bipolar disorder (BD) from a cognitive perspective. The cognitive performance of 109 patients (72 unipolar and 37 bipolar depressed outpatients) was assessed through the Montreal Cognitive Assessment (MoCA), and a series of clinical variables were collected. Differences in cognitive performance between MDD and BD patients were tested using non-parametric tests. Moreover, a network graph representing MoCA domains as nodes and Spearman's rho correlation coefficients between the domains as edges was constructed for each group. The presence of mild cognitive impairment was observed in both MDD and BD patients during depression. No statistical significant difference was found between the two groups in terms of overall cognitive performance and across single domains. Nonetheless, network analytic metrics demonstrated different roles of memory and executive dysfunction in MDD versus BD patients: in particular, MDD network was more densely interconnected than BD network, and memory was the node with the highest betweenness and closeness centrality in MDD, while executive function was more central in BD. From a network analytic perspective, memory impairment displays a central role in the cognitive impairment of patients with unipolar depression, whereas executive dysfunction appears to be more central in bipolar depression. Further research is warranted to confirm our results.

The neuropsychological profiles of young psychosis patients with and without current cannabis use

ABSTRACTIntroduction: Evidence suggests that patients with psychosis who have a history of cannabis use, but currently abstain, demonstrate superior cognitive performance than patients who have never used cannabis. The present study aimed to determine the neurocognitive profiles of patients who are in adolescence or early adulthood, when both illness- and drug-onset typically occur.Methods: Subjects were 24 cannabis-using and 79 cannabis-naïve psychosis patients between 16 and 25 years of age. Patients and controls were administered a neurocognitive battery, indexing estimated pre-morbid intelligence, psychomotor speed, mental flexibility, verbal learning and memory, verbal fluency, sustained attention, motor and mental response, and visuospatial learning and memory.Results: While healthy controls outperformed both patient groups across most cognitive measures, no significant differences between cannabis-using and cannabis-abstinent patients were evident.Conclusion: Evidently although there may be a group of patients who are diagnosed with a non-affective psychosis disorder regardless of external factors (i.e. cannabis use), some may instead have their illness precipitated through cannabis use at a young age, presenting with unique cognitive and symptomatic repercussions later in life. These results demonstrate no cognitive differences between cannabis-using patients and abstinent patients at the time of illness-onset, providing partial support for an alternative pathway to schizophrenia through early cannabis use.

Distinguishing neurocognitive deficits in adult patients with NP-C from early onset Alzheimer\u2019s dementia

BackgroundNiemann-Pick disease type C (NP-C) is a rare, progressive neurodegenerative disease caused by mutations in the NPC1 or the NPC2 gene. Neurocognitive deficits are common in NP-C, particularly in patients with the adolescent/adult-onset form. As a disease-specific therapy is available, it is important to distinguish clinically between the cognitive profiles in NP-C and primary dementia (e.g., early Alzheimer’s disease; eAD).MethodsIn a prospective observational study, we directly compared the neurocognitive profiles of patients with confirmed NP-C (n = 7) and eAD (n = 15). All patients underwent neurocognitive assessment using dementia screening tests (mini-mental status examination [MMSE] and frontal assessment battery [FAB]) and an extensive battery of tests assessing verbal memory, visuoconstructive abilities, visual memory, executive functions and verbal fluency.ResultsOverall cognitive impairment (MMSE) was significantly greater in eAD vs. NP-C (p = 0.010). The frequency of patients classified as cognitively ‘impaired’ was also significantly greater in eAD vs. NP-C (p = 0.025). Patients with NP-C showed relatively preserved verbal memory, but frequent impairment in visual memory, visuoconstruction, executive functions and in particular, verbal fluency. In the eAD group, a wider profile of more frequent and more severe neurocognitive deficits was seen, primarily featuring severe verbal and visual memory deficits along with major executive impairment. Delayed verbal memory recall was a particularly strong distinguishing factor between the two groups.ConclusionA combination of detailed yet easy-to-apply neurocognitive tests assessing verbal memory, executive functions and verbal fluency may help distinguish NP-C cases from those with primary dementia due to eAD.

Neurocognitive profile of patients with nocturnal frontal lobe epilepsy

Neurocognitive profile of patients with nocturnal frontal lobe epilepsy

Neurocognitive profile of patients with early stages of HIV infection

HIV-associated neurocognitive disorders (HAND) may include neurological disorders of various severities such as AIDS dementia complex (ADC) also known as HIV dementia and HIV-associated dementia (HAD), HIV encephalopathy, and Mild Neurocognitive Disorder (MND). As it seems HIV-associated neurocognitive disorders are associated with a metabolic encephalopathy induced by HIV infection and fueled by immune activation of macrophages and microglia. Despite of a group, evidences have described presence of cognitive alterations in HIV patients at different stages of HIV infection so far; little is known about the neurocognitive state of patients at very early stages of HIV infection. Here, we explored the neurocognitive profile of a group of cases of HIV patients at very early stages of HIV infection. We have analyzed of three groups of subjects, thus, we have studied a group of patients with early HIV infection, a healthy control group and a group of patients with mild cognitive impairment due to neurodegenerative causes. Our results suggested that cognitive processes are sensitive to very early neuropathological changes in HIV infection. Noteworthy, our results also showed that neurocognitive profile of HIV patients differs from those cognitive alterations in patients with mild cognitive disorders associated to primary neurodegeneration. Together, our results point out that HIV infection generates neural changes even at early stages of infection. Furthermore, our results highlight the importance of a deep neurocognitive exploration at very early stages of HIV infection as this approach allow improve the accompaniment, clinical attachment and interventions.Disclosure of interestThe authors have not supplied their declaration of competing interest.

A retrospective review of the neurocognitive profile of patients with neuronopathic Gaucher disease in the UK: data from the GAUCHERITE study

A retrospective review of the neurocognitive profile of patients with neuronopathic Gaucher disease in the UK: data from the GAUCHERITE study

Problematic sexual behavior in young adults: Associations across clinical, behavioral, and neurocognitive variables.

A notable number of young adults struggle to control impulsive behavior, resulting in impairment and distress. Assessments of problematic sexual behavior (PSB) have noted clinical differences relative to other populations, but neurocognitive findings have varied. This analysis assesses the clinical presentation and neurocognitive profile of patients with PSB relative to participants without PSB symptoms. A total of 492 participants (18-29) were recruited for a study on impulsivity in young adults. Participants completed diagnostic, self-report, and neurocognitive measures which assessed several cognitive domains. PSB was defined as endorsing fantasies, urges, or sexual behavior that felt out of control or was causing distress. In the sample, 54 (11%) participants reported current PSB. This group was older, reported earlier sexual experiences and alcohol use, and lower quality of life and self-esteem. Comorbidity was greater in the PSB group, particularly for depression and alcohol dependence. The PSB group also showed differences in impulsivity, decision making, spatial working memory, problem solving, and emotional dysregulation. Results suggest associations between PSB psychosocial dysfunction, greater comorbidity, and neurocognitive differences. These associations suggest a more salient impact than typical sexual behavior. Furthermore, this study demonstrated several neurocognitive deficits in the PSB group which have found more mixed support previously.

Grey matter density decreases as well as increases in patients with classic galactosemia: A voxel-based morphometry study

Brain impairments have been observed in patients with classic galactosemia, an inherited metabolic disorder resulting in a particular neuro-cognitive profile. Neuroimaging studies showed abnormalities such as diffuse white mater (WM) abnormalities and grey matter (GM) atrophy. Our current study analysed grey matter density using voxel-based morphometry (VBM) and compared the brains of eight adolescent patients with classic galactosemia with eight healthy gender- and aged-matched controls. GM density differences were found in several regions. Decreased GM density was found in the patients in the bilateral putamen and bilateral occipital cortex. Increased GM density in the patients, on the other hand, was found in the bilateral inferior frontal and medial prefrontal cortex. The anatomical profile of the abnormalities is in line with the neuro-cognitive profile of patients with classic galactosemia, including motor dysfunction, speech and language difficulties and higher order cognitive problems. Less favourable GM densities in patients (either increased or decreased compared to controls) correlated with younger age, a worse visual working memory performance, and an older age at initiation of the galactose-restricted diet. To conclude, this explorative study is the first to analyse the GM using VBM in this population, and demonstrates a mixed profile of both increased and decreased GM density in these patients.

Feasibility and effectiveness of cognitive remediation in the treatment of borderline personality disorder

ABSTRACTSeveral studies have demonstrated that borderline personality disorder (BPD) is associated with neuropsychological deficits and there is evidence that the neurocognitive profile of patients with BPD may be related to the outcome of this disorder. The aim of this study was to investigate the feasibility and the effectiveness of a cognitive remediation intervention in patients with BPD. Thirty patients with a DSM-IV-TR diagnosis of BPD were assessed on clinical, neuropsychological and functional outcome measures at baseline and after 16 weeks of a computer-assisted cognitive remediation (CACR) intervention or treatment as usual (TAU). Patients who received CACR showed a greater improvement in working memory and psychosocial functioning measures than patients treated with TAU. Symptom severity was not significantly affected by CACR treatment. The findings of this pilot study suggest the feasibility and potential effectiveness on specific cognitive domains, but modest clinical usefulness of a computerised modality of cognitive remediation in the treatment of BPD.

Neurocognitive profile of patients with continuous flow left ventricular assist device.

The increase of severe heart failure and the consequent reduction of the organ availability for transplantation has led to, in recent years, the introduction of the LVAD as replacement therapy to heart transplantation. Severe Heart Failure patients show cognitive deficits in various domains especially in executive functions, memory and speed of proceedings, due to different neurophysiopathological processes including chronic hypoperfusion and subsequent damage to hippocampal and para-hippocampal cortical areas. It is also known that these deficits improve after heart transplantation. We carried out a literature review selecting studies that analyzed the cognitive changes in patients with severe heart failure after implantation of the Continuous Flow Left Ventricular Assist Device. According to the inclusion criteria, we selected four studies since 2005 that presented a comprehensive neurocognitive assessment. The results show that the cognitive profile, with the implantation of LVAD improves in memory and executive domains, and this improvements results stable in short-medium time. The effects would also be independent of the type of flow produced by the device (pulsatile vs continuous). We believe that further studies are required to explore the relationship between LVAD and cognitive function in severe heart failure.

The neurocognitive profile of patients with major depression with and without cardiovascular risk factors compared to mild dementia patients

The neurocognitive profile of patients with major depression with and without cardiovascular risk factors compared to mild dementia patients

Enhanced working and verbal memory after lamotrigine treatment in pediatric bipolar disorder

To examine the treatment impact of lamotrigine on the neurocognitive profile of patients with pediatric bipolar disorder (PBD). Healthy controls (HC) (n = 24; mean age = 12.4 +/- 3.3 years) and unmedicated PBD patients with manic, mixed, or hypomanic episodes (n = 34; mean age = 13 +/- 3.1 years) were matched for IQ, age, sex, race, and socioeconomic status. A neurocognitive battery was administered at baseline and again after 14 weeks, during which PBD patients were treated with lamotrigine. Clinical symptoms improved with treatment in the patient group with significant change from baseline to follow-up on the Young Mania Rating Scale (p < 0.001) and the Children's Depression Rating Scale-Revised (p < 0.001). Global neurocognitive function improved with lamotrigine in PBD patients over time relative to that in HC, although overall performance remained impaired. Working memory and verbal memory significantly improved with treatment in patients, and deficits in these domains were no longer significantly impaired relative to HC at follow-up. Executive function significantly improved with treatment in the patient group but still lagged behind HC at follow-up. Performance on attention tests did not improve with treatment. There appears to be significant improvement in cognitive abilities in PBD patients treated with lamotrigine that is most prominent in the areas of working memory and verbal memory and that occurs along with mood stabilization.

The neuropsychology of the schizo-obsessive subtype of schizophrenia: a new analysis

Interest in the neuro-cognitive profile of patients with schizophrenia and co-morbid obsessive compulsive disorder (schizo-OCD) is rising in response to reports of high co-morbidity rates. Whereas schizophrenia has been associated with global impairment in a wide range of neuro-cognitive domains, OCD is associated with specific deficits featuring impaired performance on tasks of motor and cognitive inhibition involving frontostriatal neuro-circuitry. We compared cognitive function using the CANTAB battery in patients with schizo-OCD (n=12) and a schizophrenia group without OCD symptoms (n=16). The groups were matched for IQ, gender, age, medication, and duration of illness. The schizo-OCD patients made significantly more errors on a task of attentional set-shifting (ID-ED set-shift task). By contrast, no significant differences emerged on the Stockings of Cambridge task, the Cambridge Gamble Task or the Affective Go/NoGo tasks. No correlation emerged between ID-ED performance and severity of schizophrenia, OCD or depressive symptoms, consistent with neurocognitive impairment holding trait rather than state-marker status. Schizo-obsessives also exhibited a trend toward more motor tics emphasizing a neurological contribution to the disorder.ConclusionOur findings reveal a more severe attentional set-shifting deficit and neurological abnormality that may be fundamental to the neuro-cognitive profile of schizo-OCD. The clinical implications of these impairments merit further exploration in larger studies.

Extent, Profile and Specificity of Visuospatial Impairment in Obsessive-Compulsive Disorder (OCD)

Recent reviews on the neurocognitive profile of patients diagnosed with obsessive-compulsive disorder (OCD) have converged on the assumption that both visuospatial and especially nonverbal memory performance are impaired in OCD. However, as most prior studies have contrasted performance of OCD patients with healthy controls only, no inferences can yet be drawn about the specificity of these deficits to OCD. Further, the administration of complex and multifunctional tasks limit conclusions about clearly defined cognitive deficits. The present study compared 71 OCD patients to 30 healthy and 33 psychiatric control participants on a large battery of visuospatial and nonverbal memory tasks at two time-points. In addition, a visuospatial battery (VS battery), which assesses a wide range of elementary visuospatial functions, was administered. While OCD patients performed worse than healthy controls on some complex tasks (e.g., Block Design), no visuospatial component proved to be impaired specifically in OCD. OCD patients and controls performed similarly on parameters of nonverbal memory. Regarding organizational strategy, OCD patients performed worse than healthy (but not psychiatric) control participants on two out of three Rey-figure trials (copy and immediate). It is suggested that prior research overestimated the severity and significance of visuospatial and nonverbal memory impairment in OCD. The authors would like to thank Dr. Michael Rufer, Dr. Angelique Mundt and Jürgen Orthmann for help with recruitment. The study was supported by a grant of the German Research Foundation (MO 969/1-1).