Neuropsychological Changes Research Articles

Features of anxiety and depressive disorders in woman during pregnancy

The phenomenon of pregnancy is one of the most important factors in the formation of a specific complex of anatomical-physiological, neuro-psychological, psychological and socio-psychological formations and changes of women, which are most often described in the literature by the term «maternal sphere of personality», «maternity» At the same time, the pregnancy in women and the phenomena caused by it are, firstly, the specific phase of gender and individual ontogeny, and secondly, multilevel, multidimensional education, causing the above specific changes in its gender status. Pregnancy and depression often go hand in hand. This condition affects about every tenth pregnant woman. According to recent research, sudden surges and changes in the hormonal background that accompany the entire pregnancy can really affect brain biochemistry, which in turn can lead to real clinical depression. If a woman had problems with conception or she was treated for infertility, the probability of her depression in her pregnancy increases by 10 times. Depression may be more likely to eclipse pregnancy and women who have suffered mental illness, anxiety, or depression before conception. This disorder may also occur in problematic relationships, as well as in situations where relatives have had a depression or mental illness, a woman has already had a miscarriage or her current pregnancy is a high-risk group. Depression during pregnancy has significant implications for pregnancy outcomes and maternal and child health. There is a need to identify which family, physical and mental health factors are associated with depression during pregnancy.

Fatigue in Ankylosing Spondylitis Is Associated With Psychological Factors and Brain Gray Matter

Background: Ankylosing spondylitis (AS) is a rheumatic inflammatory disease with unknown etiology, and fatigue is one of the main systemic symptoms of AS. The aim of the current study was to explore the mechanism of AS-associated fatigue (ASF) from multiple aspects, including neuropsychological changes.Method: A total of 120 AS patients and 78 age- and sex-matched healthy individuals were recruited into the study. Fatigue was assessed by the fatigue item of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Multidimensional Assessment of Fatigue (MAF) scale. Anxiety and depression were assessed by the Hospital Anxiety and Depression Scale (HADS). The cortical thickness and subcortical gray matter volume were assessed using a Philips Achieva 3.0 T TX MRI scanner.Result: Of the 120 AS patients, 103 (85.8%) reported varying degrees of fatigue. Among these fatigue cases, 33 (32.0%) were in the severe fatigue group (BASDAI-Fatigue ≥ 5), and 70 patients (68.0%) were considered to be in the mild fatigue group (BASDAI-Fatigue > 0 but <5). The BASDAI, ASDAS-CRP, HAD-A, and HAD-D scores of AS patients in the severe fatigue group were all significantly higher than those of patients in the mild fatigue and non-fatigue groups (all, P < 0.05). The structural equation model suggested that AS activity triggered the occurrence of fatigue by inducing psychological change. Finally, head MRI imaging found that the left thalamus volume in AS patients with severe fatigue was significantly larger than that in non-fatigue AS patients and healthy controls (both, P < 0.05).Conclusion: The study revealed neuropsychological factors involved in fatigue in AS.

Correlations of Neuropsychological and Metabolic Brain Changes in Parkinson's Disease and Other α-Synucleinopathies.

Cognitive impairment is a common feature in Parkinson's disease (PD) and other α-synucleinopathies as 80% of PD patients develop dementia within 20 years. Early cognitive changes in PD patients present as a dysexecutive syndrome, broadly characterized as a disruption of the fronto-striatal dopamine network. Cognitive deficits in other domains (recognition memory, attention processes and visuospatial abilities) become apparent with the progression of PD and development of dementia. In dementia with Lewy bodies (DLB) the cognitive impairment develops early or even precedes parkinsonism and it is more pronounced in visuospatial skills and memory. Cognitive impairment in the rarer α-synucleinopathies (multiple system atrophy and pure autonomic failure) is less well studied. Metabolic brain imaging with positron emission tomography and [18F]-fluorodeoxyglucose (FDG-PET) is a well-established diagnostic method in neurodegenerative diseases, including dementias. Changes in glucose metabolism precede those seen on structural magnetic resonance imaging (MRI). Reduction in glucose metabolism and atrophy have been suggested to represent consecutive changes of neurodegeneration and are linked to specific cognitive disorders (e.g., dysexecutive syndrome, memory impairment, visuospatial deficits etc.). Advances in the statistical analysis of FDG-PET images enabling a network analysis broadened our understanding of neurodegenerative brain processes. A specific cognitive pattern related to PD was identified by applying voxel-based network modeling approach. The magnitude of this pattern correlated significantly with patients' cognitive skills. Specific metabolic brain changes were observed also in patients with DLB as well as in a prodromal phase of α-synucleinopathy: REM sleep behavior disorder. Metabolic brain imaging with FDG-PET is a reliable biomarker of neurodegenerative brain diseases throughout their course, precisely reflecting their topographic distribution, stage and functional impact.

Predictive value of induced hyperammonaemia and neuropsychiatric profiling in relation to the occurrence of post-TIPS hepatic encephalopathy.

Hepatic encephalopathy (HE) occurs in 20-50% of patients after transjugular intrahepatic portosystemic shunt (TIPS) placement. Older age, HE history and severe liver failure have all been associated with post-TIPS HE but it remains difficult to identify patients at risk. The aim of the present pathophysiological, pilot study was to assess the role of induced hyperammonaemia and associated neuropsychological and neurophysiological changes as predictors of post-TIPS HE. Eighteen TIPS candidates with no overt HE history (56 ± 8yrs., MELD 11 ± 3) underwent neurophysiological [Electroencephalography (EEG)], neuropsychological [Psychometric Hepatic Encephalopathy Score (PHES) and Scan tests], ammonia and sleepiness assessment at baseline and after the induction of hyperammonaemia by an oral amino acid challenge (AAC). Pre-AAC, 17% of patients had abnormal EEG, 5% abnormal PHES, and 33% abnormal Scan performance. Post-AAC, 17% had abnormal EEG, 0% abnormal PHES, and 17% abnormal Scan performance. Pre-AAC, ammonia concentrations were 201 ± 73μg/dL and subjective sleepiness 2.5 ± 1.2 (1-9 scale). Post-AAC, patients exhibited the expected increase in ammonia/sleepiness. Six months post-TIPS, 3 patients developed an episode of HE requiring hospitalization; these showed significantly lower pre-AAC fasting ammonia concentrations compared to patients who did not develop HE (117 ± 63 vs. 227 ± 57μg/dL p = 0.015). They also showed worse PHES/Scan performance pre-AAC, and worse Scan performance post-AAC. Findings at 12months follow-up (n = 5 HE episodes) were comparable. In conclusion, baseline ammonia levels and both pre- and post-AAC neuropsychiatric indices hold promise in defining HE risk in TIPS candidates with no HE history.

Soroxchi after Traveling to South America: Cognitive and Neurobehavioral Changes in a Patient with Bilateral Globus Pallidus Lesions

Abstract Objective Soroxchi/Acute Mountain Sickness (AMS) is a condition that can result in cerebral and pulmonary hypoxia. Neuropsychological research on AMS is minimal and the long-term effects on cognition and behavior are unclear. AMS is associated with cognitive impairments in processing speed, attention, and executive functions as well as neurobehavioral symptoms. This case study delineates the neuropsychological and neurobehavioral changes secondary to bilateral globus pallidus (GP) lesions associated with AMS. Case Description Patient is a 51-year old, primarily Spanish-speaking, male of Mexican descent with 9 years of education, and who had traveled to La Paz, Bolivia (4,070 MASL) for work. Upon arrival, fatigue and dizziness led to hospitalization to treat acute pulmonary edema and hypoxia. Brain MRI revealed hyperintense bilateral GP lesions. Medical history was notable for hyperlipidemia. Psychiatric history was unremarkable. Neuropsychological assessment 4 months post-AMS revealed impairments in visuo-conceptual and speeded complex visuospatial abilities, executive functions, and confrontation naming. Cognitive improvements were noted in delayed recall of non-contextual verbal information and confrontation naming ten months post-AMS. Significant mood and personality changes were reported; patient endorsed anhedonia, fatigue, alexithymia, avolition, and sleep difficulties. Family described patient as depressed, apathetic, and socially withdrawn. Pharmacological and psychotherapy treatments were recommended and initiated. Diagnostic Impressions and Outcomes Findings were consistent with a diagnosis of Mild Neurocognitive Disorder. His family denied neurobehavioral improvements post interventions. Discussion This case study is the first to characterize the long-term neuropsychological and neurobehavioral changes following bilateral GP lesions secondary to AMS. Declines in visual-conceptual abilities reveal a new finding for this type of cerebral incident.

Age-dependent brain volume and neuropsychological changes after chemotherapy in breast cancer patients.

This study investigated volumetric brain changes and cognitive performance in premenopausal and postmenopausal patients treated for early-stage breast cancer. Participants underwent elaborate neurocognitive assessments (neuropsychological testing, cognitive failure questionnaire, and high-resolution T1-weighted structural MRI) before and after chemotherapy. Volumetric brain changes were estimated, using longitudinal deformation-based morphometry, and correlated with cognitive changes. In total, 180 women participated in this study, of whom 72 patients with breast cancer had received adjuvant chemotherapy (C+), 49 patients did not receive chemotherapy (C-), and 59 healthy controls (HC). The population was categorized into two age groups: A young group who were premenopausal and younger than 52 years at baseline (n = 55C+/32C-/41HC), and an older group who were postmenopausal and older than 60 years (n = 17C+/17C-/18HC). Cognitive impairment occurred after chemotherapy in both young and older patients, although older patients showed more decline in processing speed (Trail making test b). White matter volume expansion was observed after chemotherapy, only significantly present in the younger subgroup of patients. In patients not treated with chemotherapy, diffuse gray and white matter volume reduction was observed. Less white matter expansion concurred with more cognitive decline (r > .349, p < .05). In conclusion, we found age-dependent cognitive decline and white matter volume changes in patients with breast cancer after chemotherapy, which could possibly be linked to neuroinflammatory processes. White matter expansion after chemotherapy, more pronounced in premenopausal patients, correlated with less cognitive decline. This suggests such expansion to be age-dependent, possibly caused by a protective response in the younger brain to chemotherapy-induced neurotoxicity.

Immunological and Neurometabolite Changes Associated With Switch From Efavirenz to an Integrase Inhibitor.

The biological mechanisms by which efavirenz (EFV) causes central nervous system (CNS) effects are unclear. The objective of this pilot study was to elucidate the mechanisms underlying these CNS effects by correlating well-described neuropsychological (NP) changes with neurometabolites and immunologic markers following switch off EFV. Two single-arm parallel switch studies among HIV-infected adults in Boston, USA, from 2015 to 2017. Twenty asymptomatic HIV-infected adults on EFV-containing regimens were switched to an integrase strand transfer inhibitor-based regimen for 8 weeks. NP assessments were conducted before and after switch and correlated with neurometabolite changes measured using magnetic resonance spectroscopy and immunological markers. All pre-EFV and post-EFV measures were evaluated using matched-paired analyses. NP testing demonstrated improvement in the domains of mood, cognition, and sleep off EFV. Magnetic resonance spectroscopy revealed decreases in the neurometabolite glutathione level (P = 0.03), a marker of oxidative stress after switch. Inhibitory neuronal activity as reflected by gamma-amino butyric acid levels increased (P = 0.03), whereas excitatory neurotransmitters glutamine + glutamate (Glx) and aspartate decreased (P = 0.04, 0.001). Switching off EFV was also associated with changes in inflammatory markers; plasma markers sCD14 (P = 0.008) decreased, whereas I-FABP and TNFRI levels increased (P = 0.05, 0.03). Cellular markers CD4 and CD8 HLA-DR-/CD38 subsets both increased (P = 0.05, 0.02). Even asymptomatic participants showed improvements in NP parameters when switched off EFV. These improvements were associated with decreased CNS oxidative stress and excitatory neuronal activity. Changes in immune activation biomarkers suggested overall decreased inflammation. EFV may exert CNS effects through oxidative and inflammatory pathways, providing insight into possible mechanisms of EFV neurotoxicity.

C-58 Reliable Change Index to Monitor Executive, Adaptive and Behavioral Functioning in Children with Perinatal Complications

Abstract Objective Research demonstrates that children with perinatal complications (i.e., extreme prematurity, hemorrhage, hypoxic-ischemic injury) are at increased-risk for behavior, executive functioning, and adaptive independence problems in their everyday life. The purpose of this study is to demonstrate the importance of monitoring for changes in these domains as these children reach school-age. Method The current study reviewed retrospective neuropsychological evaluations for a sample of 8 children (ages 5-10 years) evaluated in an outpatient neurodevelopmental follow-up program for children with perinatal complications. Re-evaluation was completed 1-2 years later. Children with the following standardized parent-report measures were included: Behavior Assessment System for Children (BASC-2,3), Behavior Rating Inventory of Executive Function (BRIEF, 2), and Adaptive Behavior Assessment System (ABAS-3). A reliable change index was calculated for each child to compare individual change in subscales/indices using gender/age standard error of measurement from test manuals. Results BRIEF subscale RCI values (≥ 1.96) indicated that most children showed increased problems with inhibition, shifting, working memory, and planning/organizational (range -13 to 13), whereas most showed improved emotional control (range -12 to 3). BASC indices revealed stability in behavioral and externalizing symptoms (range -3 to 2). ABAS RCI values indicated that children tended to improve across skills (range -19 to 27). Figures and tables will be displayed. Conclusions This study highlights the utility of RCI values in monitoring neuropsychological changes during the early school years, as this sample of children showed changes across several developing skills. Early identification of behavioral or adaptive deficits allows providers to make recommendations for clinical management and academic planning.

P1‐479: RELATIONSHIPS BETWEEN ALZHEIMER'S DISEASE BIOMARKERS ON SEMANTIC CUEING AND TOTAL RECALL IN THE FREE AND CUED SELECTIVE REMINDING TEST (FSCRT)

Semantic cueing (SC) can enhance performance on learning and recall tasks. SC may be a sensitive measure for detecting early neurocognitive changes in individuals with preclinical Alzheimer's disease (pAD). While free delayed recall is dependent on both the Papez circuit and distributed cortical networks, SC is especially sensitive to deficits in the Papez circuit that is affected early in AD. The present study examined SC in a series of cognitively normal subjects that had undergone structural MRI and CSF analyses for Aβ and tau in order to test the hypothesis that SC deficits can predict pAD. Inclusion/exclusion criteria included Mini-Mental Status Exam (MMSE) score of ≥26 (indicating intact global cognition), a Hachinski Ischemic Scale (HIS) score <4 (indicating low cerebrovascular risk), and no significant medical or neurologic disease that could cause cognitive deficits. The Free and Cued Selective Reminding Test (FCSRT), 3D-MPRAGE T1 sequences on MRI, and CSF were collected on 66 cognitively normal participants seen at the University of Kentucky Alzheimer's Disease Center. Linear regression was used to examine relationships between SC recall, cortical thickness, and CSF. Participants had a mean MMSE score of 28.7 ± 1.8, age of 73.9 ± 5.7 years, an education of 16.6 ± 2.5 years, and were 52.9% female. None of these variables were significant predictors of pAD. While higher CSF Aβ levels were significantly associated with free recall (β=0.025, p=0.01), they showed no association with SC. In contrast, increased levels of CSF tau were significantly associated with decreased SC recall performance (β=0.001, p=0.002). The association of decreased CSF Aβ with free delayed recall but not SC suggests dysfunction in cortical and other brain regions, with relative sparing of the Papez circuit. In contrast, the present data demonstrates that SC is associated with both the presence of tau abnormalities in CSF and entorhinal cortex atrophy, which is indicative of active neurofibrillary tangle pathology. While SC recall does not appear to predict amyloid positivity, it appears to be associated with neuropsychological change early in the neurofibrillary tangle cascade. These results allow for the development of more effective neuropsychological assessments for individuals with preclinical Alzheimer's disease.

Alteraciones neuropsicológicas asociadas al consumo de la Dextro-metil-anfetamina en adolescentes mexicanos

la ingesta de metanfetamina origina una reacción química con la dopamina segregada en las estructuras de la vía mesolímbica, produciendo alteraciones en los procesos conductuales, emocionales y cognitivos. el objetivo de este trabajo fue identificar los cambios neuropsicológicos asociados al consumo de en estudiantes de educación media superior y superior, en fase inicial de tratamiento, con consumos controlados. es un estudio comparativo con la participación de 170 adolescentes evaluados en los ámbitos neuropsicológicos (NEUROPSI), personalidad (NEO-FFI) y regulación emocional (DASS-21). la evaluación de las dimensiones cognitivas por el NEUROPSI revelan diferencias estadísticamente significativas entre los dos grupos. el consumo de parece producir una serie de daños neuropsicológicos acentuados, como consecuencia de una sintetización menos pura que ataca determinadas regiones y sistemas cerebrales. Los cambios emocionales demuestran tener vínculos con la conducta y a la vez con el aspecto neuropsicológico, generando cambios que llevan a una inadecuación social por parte de los consumidores.

The reduction of astrocytes and brain volume loss in anorexia nervosa\u2014the impact of starvation and refeeding in a rodent model

Anorexia nervosa (AN) is an often chronic, difficult to treat illness that leads to brain volume reductions in gray and white matter. The underlying pathophysiology is poorly understood, despite its potential importance in explaining the neuropsychological deficits and clinical symptoms associated with the illness. We used the activity-based anorexia model (ABA), which includes food reduction and running wheel access in female rats to study brain changes after starvation and refeeding. Longitudinal animal MRI and post-mortem brain sections confirmed a reduction in the mean brain volumes of ABA animals compared to controls. In addition, the mean number of astrocytes was reduced by over 50% in the cerebral cortex and corpus callosum, while the mean number of neurons was unchanged. Furthermore, mean astrocytic GFAP mRNA expression was similarly reduced in the ABA animals, as was the mean cell proliferation rate, whereas the mean apoptosis rate did not increase. After refeeding, the starvation-induced effects were almost completely reversed. The observation of the astrocyte reduction in our AN animal model is an important new finding that could help explain starvation-induced neuropsychological changes in patients with AN. Astrocyte-targeted research and interventions could become a new focus for both AN research and therapy.

Indications and expectations for neuropsychological assessment in epilepsy surgery in children and adults.

In our first paper in this series (Epilepsia 2015; 56(5): 674-681), we published recommendations for the indications and expectations for neuropsychological assessment in routine epilepsy care. This partner paper provides a comprehensive overview of the more specialist role of neuropsychological assessment in the pre and postoperative evaluation of epilepsy surgery patients. The paper is in two parts. The first part presents the framework for the mandatory role of neuropsychologists in the presurgical evaluation of epilepsy surgery candidates. A preoperative neuropsychological assessment should be comprised of standardised measures of cognitive function in addition to wider measures of behavioural and psychosocial function. The results from the presurgical assessment are used to: (1) establish a baseline against which change can be measured following surgery; (2) provide a collaborative contribution to seizure characterization, lateralization and localization; (3) provide evidence-based predictions of cognitive risk associated with the proposed surgery; and (4) provide the evidence base for comprehensive preoperative counselling, including exploration of patient expectations of surgical treatment. The second part examines the critical role of the neuropsychologist in the evaluation of postoperative outcomes. Neuropsychological changes following surgery are dynamic and a comprehensive, long-term assessment of these changes following surgery should form an integral part of the postoperative follow-up. The special considerations with respect to pre and postoperative assessment when working with paediatric populations and those with an intellectual disability are also discussed. The paper provides a summary checklist for neuropsychological involvement throughout the epilepsy surgery process, based on the recommendations discussed.

Clinical Effects of Frontal Behavioral Impairment: Cortical Thickness and Cognitive Decline in Individuals with Subjective Cognitive Decline and Amnestic Mild Cognitive Impairment.

Frontal behavioral impairment (FrBI) is commonly observed in various degenerative diseases and refers to various behavioral symptoms. We investigated the effects of the presence of FrBI on cortical thickness, and the longitudinal neuropsychological changes in people in the predementia stage. A total of 794 individuals completed neuropsychological tests and the Frontal Behavioral Inventory (FBI) Questionnaire, and underwent magnetic resonance (MR) scanning. Participants were analyzed and grouped into non-FrBI (FBI = 0) or FrBI (FBI≥1). Cortical thickness was measured on MR images using a surface-based method. In total, 281 people with subjective cognitive decline (SCD) and 513 with amnestic mild cognitive impairment (aMCI) were assessed for FrBI. Relative to people without FrBI, those with FrBI presented reduced cortical thickness in the frontal, anterior temporal and lateral parietal regions (p < 0.05, FDR corrected). People with FrBI developed Alzheimer's disease, rather than behavioral variant frontotemporal dementia, as observed over seven years. Mixed effects models reported that people with FrBI have greater cognitive decline than those with non-FrBI in multiple domains, including language, memory, and executive functions (p < 0.05, FDR corrected). Furthermore, while negative FrBI symptoms (e.g., deficit behaviors) were associated with greater declines in multiple domains, positive FrBI symptoms (e.g., disinhibition symptoms) were related to declines in visuospatial function and verbal memory. Finally, the occurrence of both types of symptoms correlated with multi-domain cognitive decline. FrBI predicted worse clinical outcomes, including reduced cortical thickness and cognitive decline, which are not necessarily specific to frontal dysfunction.

Ventricular volumetry and free-water corrected diffusion tensor imaging of the anterior thalamic radiation in idiopathic normal pressure hydrocephalus

Background and purposeThe pathophysiology of idiopathic normal pressure hydrocephalus (iNPH) has not been completely clarified. We investigated the brain structure in iNPH using automatic ventricular volumetry, single-tensor diffusion tensor imaging (DTI) and bi-tensor free-water (FW) imaging analyses while focusing on cognitive impairments before and after lumboperitoneal shunt surgery. Materials and methodsThis retrospective study included 12 iNPH patients with structural magnetic resonance imaging (MRI) and diffusion MRI (dMRI) on a 3T-MRI scanner who underwent neuropsychological assessments before and after shunting and 8 healthy controls. Ventricular volumetry was conducted on structural MRI datasets using FreeSurfer. Ventricular volume was compared pre- and postoperatively. Correlation analyses were performed between ventricular volume or volume change and neuropsychological scores or score change. Tract-based spatial statistics were performed using dMRI datasets for group analyses between iNPH and controls and between pre- and post-surgery iNPH patients and for correlation analyses using neuropsychological scores. Tract-specific analyses were performed in the anterior thalamic radiation (ATR), followed by comparison and correlation analyses. ResultsThe third ventricular volume was significantly decreased after shunting; its volume reduction negatively correlated with a neuropsychological improvement. Compared with controls, iNPH patients had lower fractional anisotropy and higher axial, radial, and mean diffusivities, and FW in the periventricular white matter including ATR, resulting in no difference in FW-corrected indices. Single-tensor DTI indices partially correlated with neuropsychological improvements, while FW-corrected indices had no correlations. ConclusionThird ventricle enlargement is possibly linked to cognitive impairment and FW imaging possibly provides better white matter characterization in iNPH.

Patterns of neuropsychological changes after general anaesthesia in young children: secondary analysis of the Mayo Anesthesia Safety in Kids study

BackgroundWe hypothesised that exposure to multiple, but not single, procedures requiring general anaesthesia before age 3 yr is associated with a specific pattern of deficits in processing speed and fine motor skills. MethodsA secondary analysis (using factor and cluster analyses) of data from the Mayo Anesthesia Safety in Kids study was conducted, in which unexposed, singly exposed, and multiply exposed children born in Olmsted County, MN, USA from 1994 to 2007 were sampled using a propensity-guided approach and underwent neuropsychological testing at ages 8–12 or 15–20 yr. ResultsIn the factor analysis, the data were well fit to a five factor model. For subjects multiply (but not singly) exposed to anaesthesia, a factor reflecting motor skills, visual-motor integration, and processing speed was significantly lower [standardised difference of –0.35 (95% confidence interval {CI} –0.57 to –0.13)] compared with unexposed subjects. No other factor was associated with exposure. Three groups were identified in the cluster analysis, with 106 subjects (10.6%) in Cluster A (lowest performance in most tests), 557 (55.9%) in Cluster B, and 334 (33.5%) in Cluster C (highest performance in most tests). The odds of multiply exposed children belonging to Cluster A was 2.83 (95% CI: 1.49–5.35; P=0.001) compared with belonging to Cluster B; there was no other significant association between exposure status and cluster membership. ConclusionsMultiple, but not single, exposures to procedures requiring general anaesthesia before age 3 yr are associated with a specific pattern of deficits in neuropsychological tests. Factors predicting which children develop the most pronounced deficits remain unknown.

EEG correlates of face recognition in patients with schizophrenia spectrum disorders: A systematic review

ObjectiveTo systematically assess EEG studies and evaluate neuropsychological changes of face recognition in the context of neutral face stimuli in individuals with schizophrenia spectrum disorders. MethodsA literature search was conducted using the PubMed database from inception to March 2018. Studies included in the review measured any event-related potentials, neural oscillations, or phase synchrony. ResultsA total of 113 articles were identified. Twenty-nine studies were included for the review. The majority of the studies focused on the N170 component. Smaller N170 amplitudes were consistently reported in schizophrenia patients compared to the healthy control group. Significant correlations between N170 amplitudes and social functioning scales were reported. Other results were quite inconsistent; however, group differences were more prominent for tasks with specific conditions. ConclusionsOlder patients with longer disease duration show more consistent neuropsychological correlations. Alterations of event-related potentials are likely to be linked to higher severity of symptoms. The N170 component seems to be the most promising event-related potential to be used for evaluation of present status and for dynamic control of cognitive impairments, social functioning, and rehabilitation effectiveness. SignificanceThis systematic review provides evidence of (1) neuropsychological alterations of face processing outside an emotional context, and (2) a potential role of N170 as a diagnostic and treatment monitoring biomarker.

Exploratory study of HRB signs, patterns, and right-left differences relating to spatial cognition following nonimpact mild traumatic brain injury

Sweeney and Johnson found that response time on the Tactile Form Recognition Test (TFR) of the Halstead-Reitan Test Battery (HRB) requiring speeded tactile- and visual-spatial recognition was deficient for Nonimpact mild traumatic brain injury (mTBI) individuals in comparison to Impact mTBI and No mTBI participants. A follow-up study by Sweeney and Slade noted that skills most sensitive to Deficient TFR performance of mTBI subjects involved tactile-spatial perception, with lateralization of inferior performances contralateral to cerebral regions known to specialize in the spatial skills required. The current study compared frequencies of HRB Pathognomonic Signs, atypical Score Patterns, and abnormal Right-Left Differences for Nonimpact mTBI groups that exhibited Deficient, Perfectly Normal, or Normal TFR performances. The only statistically significant finding was that the Deficient TFR group produced a disproportionately greater number of errors with the right hand relative to the left hand on Fingertip Number Writing Perception. Deficient TFR mTBI individuals were 5.29 times more likely to commit errors with the right hand on the Fingertip Number Writing Perception Test than Perfectly Normal and Normal TFR mTBI subjects. Tentative clinical markers of neuropsychological changes that appear to be associated with Nonimpact mTBI, based on a series of investigations, were provided.

Neuropsychological Changes in Patients Undergoing Treatment of Unruptured Intracranial Aneurysms.

Evaluation of differences in neuropsychological outcomes in patients undergoing surgical clipping (SC) vs endovascular coiling (EC) for unruptured cerebral aneurysms is essential in guiding patients seeking treatment of asymptomatic cerebral aneurysms. To perform a prospective longitudinal analysis of neuropsychological outcomes in patients who underwent microsurgery or coiling for unruptured cerebral aneurysms. SC (50 patients), EC (35 patients), and healthy controls (43 individuals) were included. A detailed neuropsychological evaluation was performed at baseline and at 2 wk, 3 mo, 6 mo, and 12 mo. Student's t-test was utilized for comparing neuropsychological outcomes among the 3 groups. A mixed-effects model allowed for evaluation of neuropsychological outcome changes among the groups over time. Both the SC and EC groups had nonsignificant differences in procedure-related complications. SC patients had the greatest initial declines in short-term memory, fine motor control, and executive functioning; however, these patients also recovered to a greater degree in neuropsychological functionality. Over the next year, all groups achieved similar neuropsychological outcomes with no significant differences among groups. Whereas the initial decline in neuropsychological functioning was greater for SC patients, 1 yr after treatment there was no significant difference in neuropsychological outcome among the SC, EC, and healthy control groups.

Valproate-induced reversible atrophy and cognitive decline: a case

Background: Valproate (VPA) has been previously described to cause reversible cerebral atrophy and cognitive decline, but few cases are reported and neuropsychological data is lacking. We report a case of VPA induced encephalopathy in an 11-year-old girl with temporal lobe epilepsy, presenting with impaired cognition and sedation combined with cerebral atrophy.&#x0D; Methods: Cognitive capacity was assessed using Wechsler Intelligence Scales for Children IV (WISC), non-standardised word lists and visual reproduction. Brain magnetic resonance imaging (MRI) was performed prior to, during and post VPA therapy.&#x0D; Results: Our patient demonstrated average full-scale intelligence quotient, verbal comprehension, perceptual reasoning and working memory. There was a marked discrepancy in processing speed, which ranked low average (score – 80; 9th percentile). Difficulties with mental abstraction and manipulation were noted. Brain MRI (3T) demonstrated mild generalised parenchymal atrophy. Cessation of VPA resulted in dramatic improvement in clinical symptoms (1 month after cessation) and normalisation of brain MRI (11 months after cessation). Progress neuropsychological testing 13 months after cessation showed marked improvements in processing speed. &#x0D; Conclusion: This case provides an important reminder of this rare but importantly reversible syndrome with new information supporting the neuropsychological changes involved.

Clinical and neuroimaging heterogeneity of dementia with Lewy bodies

To study clinical characteristics of dementia with Lewy bodies (DLB) depending on neuropsychological, neuroimaging and concomitant cerebrovascular changes as well as on the character of disease onset. Forty-five patients with DLB (25 men and 20 women, men age 72.9±7.2 years, illness duration 2.9±2.2) were studied. The diagnosis was made according to international criteria (McKeith, et al, 2017). MRI, clinical/neurological examination and psychometric scales were used. Clinical, neuropsychological and neuroimaging results reveal the heterogeneity of DLB, which remains poorly investigated. An analysis of the clinical picture, cognitive profile, neuropsychiatric changes and MRI results identified three subtypes of DLB course: 1) typical; 2) with early psychotic manifestation; 3) atypical (mixed). This approach may improve the diagnosis of DLB, prognosis of disease course and treatment effectiveness.