Neuropsychological Performance In Patients Research Articles

Are males more likely than females to develop schizophrenia?

This study was undertaken to determine whether the incidence of schizophrenia is equivalent for males and females. An attempt was made to identify every first-episode case of psychosis in a large Canadian city over a period of 2 1/2 years. A comprehensive referral network was established that included hospital and community settings where psychotic persons might appear. More than 300 potential subjects were identified, 175 of whom underwent a structured psychiatric interview and were assigned diagnoses according to five different diagnostic systems. The incidence of schizophrenia was two to three times higher among males than among females. Even though the use of different diagnostic systems yielded slightly different risk rates, the elevated risk for males remained consistent. There were no differences between the sexes in the incidence of affective psychosis. In comparison with schizophrenia, the incidence rates for mood disorders with psychotic features were sometimes lower and sometimes higher, depending on the diagnostic system used. The findings, coupled with reports in the past 10 years from other investigators, challenge the conventional belief that the incidence of schizophrenia is the same for the two sexes.

Frontal lobe function in amyotrophic lateral sclerosis: a neuropsychologic and positron emission tomography study.

In this study the regional cerebral glucose utilization and the neuropsychological performance of patients with amyotrophic lateral sclerosis (ALS) was investigated. Special attention was given to neuropsychological tests thought to mirror frontal lobe dysfunction. The regional cerebral glucose utilization was studied in 18 patients using high-resolution positron emission tomography. Clinically all patients displayed upper and lower motor neurone signs. In ALS patients glucose metabolism was significantly reduced in the frontal and in the entire cortex compared with controls; no changes were seen in the cerebellum. Comprehensive neuropsychological assessment of ALS patients compared to a pair matched control group revealed mild frontal dysfunction which in part significantly correlated with reduced glucose metabolism in the cortex and subcortical structures. We conclude that in patients with ALS, glucose consumption is decreased in parts of the brain other than the motor cortex accompanied by mild neuropsychological deficits based on the tests employed in this study.

The Relationship of High-Intensity Signals on Magnetic Resonance Images to Cognitive and Psychiatric State in Alzheimer's Disease

In Alzheimer's disease (AD), the relationship between white-matter changes on magnetic resonance images and behavior are unclear. Therefore, magnetic resonance images, cognition, and psychiatric state were assessed in patients with AD with depression (AD/DEP; n = 18) and without depression (AD; n = 45), older depressed patients (n = 12) and older normal individuals (n = 25). High-intensity signals in the cortex and subcortical regions were similar in number and proportions among all groups, even when hypertensive patients were excluded. No correlations to cognitive or psychiatric state were found. Periventricular signals were categorized using a 1- (absent) to 6- (thick, irregular caps and stripes) point scale. The categories were similar among groups except that patients with AD exhibited more category 5 changes than did normal subjects, neuropsychological performance was significantly worse in patients with AD who had category 5 and 6 changes when compared to those in category 1. These results suggest that periventricular changes may predict poor neuropsychological performance in patients with AD. However, neither deep white-matter lesions nor periventricular changes are useful for diagnostic purposes.

Neuropsychological impairment and factors predicting neuropsychological performance in patients scheduled for cardiopulmonary bypass surgery

Neuropsychological impairment and factors predicting neuropsychological performance in patients scheduled for cardiopulmonary bypass surgery

Electrophysiological and Neuropsychological Functions in Patients Treated with Interferon-β

The neurotoxicity of interferon-beta (IFN-beta) was assessed by performing electrophysiological examinations and neuropsychological tests on 22 patients with malignant hematological diseases before, during, and after IFN-beta treatment. IFN-beta (6 x 10(6) IU/m2) was infused i.v. for 6 h daily for 7 days on alternate weeks for a total of three cycles (induction therapy) and was then continued at the same dose, twice a week, for an additional 24 weeks (maintenance therapy). Twenty-one of the 22 patients were evaluable. There were no significant changes in EEGs, visual evoked potentials, sensory conduction central time or motor nerve conduction velocity of two long nerves in the 15-19 patients studied before and after induction therapy, nor in the 6-8 patients investigated at the end of maintenance therapy. Neuropsychological monitoring failed to disclose any IFN-induced deterioration in 21 patients tested before and at the end of induction therapy or in the 10 patients who were also studied at the end of maintenance therapy. Despite certain limitations in the patient follow-up, the results underline the good general tolerance of IFN-beta.

Effects of radiation therapy on neuropsychological functioning in patients with nasopharyngeal carcinoma.

Sixteen patients who had a nasopharyngeal carcinoma (NPC) who were treated with radiation therapy were followed up after a median duration of 5.5 years and given a battery of neuropsychological tests. Results were compared with a comparable group of newly diagnosed NPC patients awaiting radiation therapy. The irradiated group was significantly poorer in overall IQ, non-verbal memory recall, and reported a substantially greater number of memory related complaints. These results contrast with the complacent general assumption that radiation therapy has a negligible effect on adult functioning.

Cerebrospinal fluid somatostatin correlates with spectral EEG variables and with parietotemporal cognitive dysfunction in Alzheimer patients.

Somatostatin levels of the cerebrospinal fluid (CSF) were correlated with variables of quantitative EEG and with neuropsychological performance in patients with probable Alzheimer's disease. Low somatostatin levels of CSF correlated with decreased beta activity and with decreased mean frequency in the combined alpha and theta EEG range. In the subgroup of mild Alzheimer cases CSF somatostatin correlated positively also with alpha power, and the peak and the mean frequency, and negatively with theta power but not with delta activity. Furthermore, low somatostatin of the CSF correlated with neuropsychological tests assessing temporoparietal dysfunction. To our knowledge, this is the first study to indicate the correlation between spectral analysis results of the EEG and CSF somatostatin suggesting that the relationship between somatostatin and EEG variables is worthy of further studies.

Reduced short-term neuropsychological performance in patients with nonsmall-cell lung cancer treated with cisplatin and etoposide.

Reduced short-term neuropsychological performance in patients with nonsmall-cell lung cancer treated with cisplatin and etoposide.

Neuropsychological function in patients after subarachnoid hemorrhage.

Neuropsychological testing of 48 patients who had undergone operation for subarachnoid hemorrhage (SAH) due to aneurysm was performed. Before this, the patients had their level of neurological recovery classified by neurosurgeons (37 good outcome vs. 9 poor outcome). These clinical categories correlated well with the results of neuropsychological testing. The degree of psychological impairment was related to age. The mean duration between SAH and clipping of the ruptured aneurysm was 4.6 days (range, 1-16 days), and 59% had operations on or before Day 3 post-SAH. Of the 37 patients with good neurological outcome, 26 patients had good neuropsychological outcome (no more than mild deficit). Poor neuropsychological outcome was associated with age and anterior communicating artery aneurysms. The incidence of significant neuropsychological deficit was considerably less than in previous reports, and possible explanations are discussed.

Evaluation of information-processing speed and neuropsychological functioning in patients with myotonic dystrophy.

Patients with myotonic dystrophy (MD) were compared to a control group, matched to the patients in important demographic variables including IQ, on the Sternberg Memory Scanning procedure, to investigate the hypothesis of a selective change in speed of information processing in MD patients. The neuropsychological functioning of these MD patients was also compared to normative data to provide a descriptive picture of their abilities; these results were correlated to the factors of age of onset and duration of the disease. Finally, the MD patients were also compared to the defined control group on the neuropsychological measures. There was little evidence of selective slowness of information processing or particular deficit independent of overall IQ. Neuropsychologically, the MD patients as a group performed at the low average level. There was, however, a wide range of abilities, suggesting that MD patients are not a unitary group in terms of neuropsychological functioning. Age of onset of the disease was important, at least for certain results. Further research of the neuropsychological functioning of MD patients must account for the wide range of results, with more precise measures of actual onset of the disease and muscular weakness, in a longitudinal evaluation.

Neuropsychological Perspectives in Amyotrophic Lateral Sclerosis

Three aspects of neuropsychological functioning in patients with ALS are examined. Contrary to previous research, a new psychometric study of psychological adjustment suggested significant depression-distress in this population and related psychological disturbance differentially to signs of upper versus lower motor neuron involvement and to respiratory failure. An association between ALS and impaired neuropsychological functioning is discussed through an examination of the clinical and pathologic literatures. ALS appears to be a multisystem degenerative disease with a variety of expressions that may frequently include loss of cognitive-behavioral competency with progressive involvement of the prefrontal cortex and, in a few instances, profound dementia. Finally, the article describes an analysis of trends in psychological adjustment and in the perception of physical capability over the course of a pilot clinical trial.

Neuropsychological function and psychopathology in epilepsy.

Moehle, Bolter, and Long in 1984 did not replicate Hermann's 1981 finding of a relationship between psychopathology and the extent of deficits in neuropsychological functioning in patients with epilepsy. This note reviews additional studies on the relationship between psychopathology and neuropsychological function and interprets their findings in relation to the discussion and conclusions of Moehle, et al. The weight of the evidence supports the notion of an over-all relationship between deficits in neuropsychological function and psychopathology in epilepsy but further study is required.

Relationship of age and education to neuropsychological performance in patients with symptomatic carotid artery disease.

Reported the relationship between age, education, and performance on a battery of psychological and neuropsychological tests. Ss were 55 patients with symptomatic carotid artery disease (both TIA and completed stroke). Contrary to previous studies, there was no relationship between age and test performance, but there was a relationship between education and test performance. When the Ss were grouped according to level of education, the grade school group performed more poorly than both the high school and university groups on a variety of measures. These results were discussed in regard to their relation to previous studies and in the implications of these findings for clinical practice.

Longitudinal study of neuropsychological functioning in patients on chronic hemodialysis: A preliminary report

This study is part of a five-year project to investigate the long term effects of chronic hemodialysis on patients with end-stage renal failure. Previous research has associated hemodialysis with progressive dialysis encephalopathy (PDE), which is characterized by speech disturbances, cognitive impairment, myoclonus and behavioral changes. Little is known about the cause or the course of this syndrome except that is begins 14–36 months after treatment onset and usually culminates in death. The purpose of this study was to investigate neuropsychological (cognitive and behavioral) functioning in dialysis patients over a period of years. To date, 34 patients have been studied for 22 months utilizing a cross-sectional method comparing patients at different stages of treatment combined with a longitudinal method of repeated evaluations over time. Current findings show improved cognitive functioning during at least the first year of treatment and no evidence of cognitive deterioration in patients on dialysis for more than one year ( M = 4.3). These findings offer strong evidence that PDE is not necessarily a general phenomenon among patients on chronic hemodialysis.

Neuropsychological performances in patients treated with different antiepileptic drugs.

Twenty-six patients, suffering from various forms of epilepsy (2 with simple partial, 14 with complex partial, and 10 with generalized seizures) and treated with different drugs (10 with DPH, 10 with PB, and 6 with CBZ), underwent neuropsychological tests in order to evaluate: 1) Vigilance; 2) attention; 3) motor, sensory and adaptive (visuomotor) performances; 4) memory span, short-term and long-term memory, considering verbal as well as spatial aspects. The battery of tests was administered prior to treatment and when the drug plasmatic levels were within the ranges considered therapeutic. The results show that in the case of DPH there is an improvement of vigilance and adaptive performances but a worsening of attention and memory functions. With PB, only motor and adaptive performances improve; all other functions worsen. Finally, with CBZ, vigilance, attention, sensory performances and memory functions are unmodified while only motor and adaptive performances appear to improve.

Diphenylhydantoin serum levels, toxicity, and neuropsychological performance in patients with epilepsy.

The neuropsychological effects of diphenylhydantoin were assessed in 70 adults having primarily psychomotor and major motor seizures. All patients were stabilized on diphenylhydantoin alone, and assessment of this drug by gas-liquid chromatography provided a basis for dichotomizing the group into High and Low drug groups, both with and without toxic patients. In addition, patients showing signs of toxicity were contrasted with those not showing such signs. In each of these comparisons, control was maintained with respect to the variables of age, education, age at onset of disorder, and duration of disorder. Neuropsychological assessment was by means of the test battery originated by Halstead and developed by Reitan. Results showed that the High and Toxic Groups rather consistently did more poorly on all tasks than the Low and Nontoxic Groups. However, differences which were statistically significant appeared only in connection with tasks which had a heavy motor component. Possible reasons for the lack of statistically significant differences on the higher level mental tasks were presented.