Neuropsychological Profile Of Patients Research Articles

Characterizing cognitive subtypes in schizophrenia using cortical curvature

Cognitive deficits are a core symptom of schizophrenia, but research on their neural underpinnings has been challenged by the heterogeneity in deficits’ severity among patients.Here, we address this issue by combining logistic regression and random forest to classify two neuropsychological profiles of patients with high (HighCog) and low (LowCog) cognitive performance in two independent samples. We based our analysis on the cortical features grey matter volume (VOL), cortical thickness (CT), and mean curvature (MC) of N = 57 patients (discovery sample) and validated the classification in an independent sample (N = 52). We investigated which cortical feature would yield the best classification results and expected that the 10 most important features would include frontal and temporal brain regions. The model based on MC had the best performance with area under the curve (AUC) values of 76% and 73%, and identified fronto-temporal and occipital brain regions as the most important features for the classification. Moreover, subsequent comparison analyses could reveal significant differences in MC of single brain regions between the two cognitive profiles. The present study suggests MC as a promising neuroanatomical parameter for characterizing schizophrenia cognitive subtypes.

Neuropsychological profile of patients with infectious disease: characterization and comparison of patients with HIV, HTLV, and HCV.

Understanding the effect of the HIV, HTLV-1, and HCV viruses on cognitive aspects can help in the better characterization of dementia, as well as the best conducts to be suitable for rehabilitation. Thus, the present study aimed to characterize and compare the neuropsychological profile of 3 groups of patients with infectious diseases: HIV, HTLV, and HCV. The results of neuropsychological assessments and depression assessment of 325 people treated at a referral hospital for infectious diseases were analyzed, being 120 HIV carriers (74 (61.7%) men) with an average age of 47.5years (SD = 10.3), 65 patients with HTLV-1 (16 (24.6%) men) with a mean age of 49.9years (SD = 12.9), and 87 HCV patients (47 (54%) men) with a mean age of 55.5years (SD = 11.2). In addition, 54 people (26 (48.1%) men) with negative serology who made up the control group were evaluated. The results of the statistical evaluation of the sociodemographic factors of the four groups (HIV, HTLV-1, HCV, and control) showed that in addition to age, schooling was a significant factor among them and may have a strong influence on the performance of cognitive tests. The HTLV-1 group had the lowest neurocognitive performance and also the highest rate of depressive symptoms.

Resting state network dynamic reconfiguration and neuropsychological functioning in temporal lobe epilepsy: An HD-EEG investigation.

Temporal lobe epilepsy (TLE) is nowadays considered a network disorder impacting several cognitive domains. In this work we investigated dynamic network reconfiguration differences in patients with unilateral TLE compared to a healthy control group, focusing on two connectivity indices: flexibility and integration. We apply these indices for the first time to high-density EEG source-based functional connectivity. We observed that patients with TLE exhibited significantly lower flexibility than healthy controls in the Control, Default Mode and Attentive Dorsal networks, expressed in the delta, theta and alpha bands. In addition, patients with TLE displayed greater integration values across the majority of the resting state networks, especially in the delta, theta and gamma bands. Relevantly, a higher integration index in the Control, Attentive Dorsal and Visual networks in the delta band was correlated with lower performance in visual attention and executive functions. Moreover, a greater integration index in the gamma band of the Control, Somatomotor and Temporoparietal networks was related to lower long-term memory performance. These results suggest that patients with TLE display dysregulated network reconfiguration, with lower flexibility in the brain areas related to cognitive control and attention, together with excessive inter-network communication (integration index). Finally, the correlation between network integration and the reduced cognitive performance suggests a potential mechanism underlying specific alterations in neuropsychological profile of patients with TLE.

Neuropsychological Profiles of Patients with Progressive Apraxia of Speech and Aphasia.

To characterize and compare the neuropsychological profiles of patients with primary progressive apraxia of speech (PPAOS) and apraxia of speech with progressive agrammatic aphasia (AOS-PAA). Thirty-nine patients with PPAOS and 49 patients with AOS-PAA underwent formal neurological, speech, language, and neuropsychological evaluations. Cognitive domains assessed included immediate and delayed episodic memory (Wechsler Memory Scale-Third edition; Logical Memory; Visual Reproduction; Rey Auditory Verbal Learning Test), processing speed (Trail Making Test A), executive functioning (Trail Making Test B; Delis-Kaplan Executive Functioning Scale - Sorting), and visuospatial ability (Rey-Osterrieth Complex Figure copy). The PPAOS patients were cognitively average or higher in the domains of immediate and delayed episodic memory, processing speed, executive functioning, and visuospatial ability. Patients with AOS-PAA performed more poorly on tests of immediate and delayed episodic memory and executive functioning compared to those with PPAOS. For every 1 unit increase in aphasia severity (e.g. mild to moderate), performance declined by 1/3 to 1/2 a standard deviation depending on cognitive domain. The degree of decline was stronger within the more verbally mediated domains, but was also notable in less verbally mediated domains. The study provides neuropsychological evidence further supporting the distinction of PPAOS from primary progressive aphasia and should be used to inform future diagnostic criteria. More immediately, it informs prognostication and treatment planning.

Acetylcholinesterase inhibitors and cognitive stimulation, combined and alone, in treating individuals with mild Alzheimer\u2019s disease

BackgroundsAcetylcholinesterase inhibitors (AChEI) and cognitive stimulation (CS) are the standard pharmacological and non-pharmacological treatments for Alzheimer’s disease (AD).AimsThe aim of this study was to investigate the effects of these treatments, alone or combined, on the neuropsychological profiles of patients with AD.MethodsForty participants were assigned to three groups receiving either only AChEI (n = 14), AChEI + CS (n = 15), or only CS (n = 11). Cognition was evaluated at baseline and after three months. Linear mixed-effects models were used to investigate differences among the treatments in terms of changes in the patients’ neuropsychological profiles.ResultsResults, although preliminary because of the small sample size, suggest that a general improvement was found in patients who received AChEI + CS and those who received only CS compared with those who received only AChEI. Interestingly, individuals who received only CS showed a significant improvement in immediate memory recall than those who received only AChEI. Furthermore, the group receiving AChEI + CS showed an improvement in delayed recall than the other two groups.DiscussionThe combination of AChEI and CS seems to have the greatest benefit for patients with mild AD. More interestingly, CS alone is more effective than AChEI alone, even in improving memory, considered to be the “lost” cognitive domain in AD.

Spatio-spectral relationships between pathological neural dynamics and cognitive impairment along the Alzheimer's disease spectrum.

IntroductionNumerous studies have described aberrant patterns of rhythmic neural activity in patients along the Alzheimer's disease (AD) spectrum, yet the relationships between these pathological features and cognitive decline are uncertain.MethodsWe acquired magnetoencephalography (MEG) data from 38 amyloid‐PET biomarker‐confirmed patients on the AD spectrum and a comparison group of biomarker‐negative cognitively normal (CN) healthy adults, alongside an extensive neuropsychological battery.ResultsBy modeling whole‐brain rhythmic neural activity with an extensive neuropsychological profile in patients on the AD spectrum, we show that the spectral and spatial features of deviations from healthy adults in neural population‐level activity inform their relevance to domain‐specific neurocognitive declines.DiscussionRegional oscillatory activity represents a sensitive metric of neuronal pathology in patients on the AD spectrum. By considering not only the spatial, but also the spectral, definitions of cortical neuronal activity, we show that domain‐specific cognitive declines can be better modeled in these individuals.

CASPR2-Related Morvan Syndrome: Autonomic, Polysomnographic, and Neuropsychological Observations.

Morvan syndrome is characterized by central, autonomic, and peripheral hyperexcitability due to contactin-associated protein 2 (CASPR2) antibody. Our objective was to study the clinical spectrum, electrophysiologic, autonomic, polysomnographic, and neuropsychological profile in patients with CASPR2-related Morvan syndrome. Serum and CSF samples that were CASPR2 antibody positive from 2016 to 2019 were assessed. Among them, patients with Morvan syndrome diagnosed based on clinical and electrophysiologic basis were included. Fourteen (M:F = 10:4) patients with Morvan syndrome were included with age at onset of 37.1 ± 17.5 years. The clinical features were muscle twitching (12), insomnia (12), pain (11), paresthesias (9), hyperhidrosis (7), hypersalivation (6), double incontinence (3), spastic speech (2), dysphagia (2), behavioral disturbances (2), seizures (1), and cold intolerance (1). Neurologic examination revealed myokymia (12), hyperactive tendon reflexes (10), and tremor (6). EMG revealed neuromyotonia (12) and increased spontaneous activity (7). Autonomic function tests conducted in 8 patients revealed definite autonomic dysfunction (4), orthostatic hypotension (2), early dysfunction (1), and postural orthostatic tachycardia syndrome (1). Polysomnography findings in 6 patients revealed insomnia (3), absence of deep sleep (1), high-frequency beta activity (1), REM behavior disorder (1), and periodic leg movements (1). Neuropsychological evaluation showed subtle involvement of the left frontal and temporal lobe. Malignancy workup was negative. All patients were treated with steroids. There was complete neurologic resolution in follow-up with persistent neuropathic pain in 5 patients. This study has contributed to the growing knowledge on CASPR2-related Morvan syndrome. It is important for an increased awareness and early recognition as it is potentially treatable by immunotherapy.

The association of cognitive phenotypes with postoperative outcomes after epilepsy surgery in patients with temporal lobe epilepsy

IntroductionThe concept of cognitive phenotypes has been developed to categorize the heterogeneity of neuropsychological profiles in patients with temporal lobe epilepsy (TLE). This study examines the utility of cognitive phenotypes derived from clinical criteria in the prediction of postoperative outcomes. MethodsScores from 9 standardized neuropsychological tests were used to sample preoperative performance in 4 core domains (intellectual, memory, language, & executive function) in 445 patients with TLE (206 right: 236 left). Patients were grouped into 3 clinical phenotypes using clinical criteria: 1. intact cognition, 2. isolated memory and/or language impairment, and 3. widespread impairment. Patients who did not meet the criteria for these phenotypes were characterized as having a mixed profile phenotype. ResultsApproximately half of the sample had intact cognitive function, with one-quarter demonstrating isolated impairments in language and memory function. The remainder demonstrated widespread impairment or a mixed pattern of cognitive impairments. The clinically derived cognitive phenotypes were associated with demographic and clinical characteristics. Patients with widespread cognitive impairments had an earlier onset of seizures than those with other cognitive phenotypes. They also reported higher levels of depression. Higher levels of anxiety were reported in those with isolated memory/language impairments. Phenotypes were not associated with postoperative seizure outcome or postoperative declines in verbal memory or language function, but an intact phenotype was associated with a greater risk of decline in visual learning than right-sided surgery. ConclusionsDistinct cognitive phenotypes in TLE can be identified using clinical criteria and may reflect neurodevelopmental influences and mood in addition to progression of the disease. Phenotype may be a more powerful predictor of postoperative decline in visual memory than laterality of surgery.

MnSOD Ala16Val polymorphism in cognitive dysfunction in patients with epilepsy: A relationship with oxidative and inflammatory markers

ObjectiveThe objective of the study was to evaluate the neurocognitive profile and its relation with Ala16ValMnSOD polymorphism in epilepsy and if these clinical parameters are linked to oxidative stress and inflammatory markers. MethodsPatients with epilepsy (n = 31) and healthy subjects (n = 42) were recruited. A neuropsychological evaluation was performed in both groups through a battery of cognitive tests. Oxidative stress, inflammatory markers, apoptotic factors, and deoxyribonucleic acid (DNA) damage were measured in blood samples. ResultsStatistical analyses showed the association of MnSOD Ala16Val polymorphism with cognitive impairment, including praxis, perception, attention, language, executive functions, long-term semantic memory, short-term visual memory, and total memory in patients with epilepsy and Valine-Valine (VV) genotype compared with the control group. Compared with the controls and patients with epilepsy, Alanine-Alanine (AA), and Alanine-Valine (AV) genotype, the patients with epilepsy and VV genotype exhibited higher levels of tumor necrosis factor alpha (TNF-α), interleukin 1β (IL-1β), interleukin 6 (IL-6), activation of caspases 1 and 3 (CASP-1 and -3), and DNA damage. Our findings also showed higher carbonyl protein and thiobarbituric acid reactive substances (TBARS) levels as well as an increased superoxide dismutase (SOD) and acetylcholinesterase (AChE) activities in patients with epilepsy and VV genotype. ConclusionThis study supports the evidence of a distinct neuropsychological profile in patients with epilepsy, especially those with the VV genotype. Furthermore, our results suggest that oxidative and inflammatory pathways may be associated with genetic polymorphism and cognitive dysfunction in patients with epilepsy.

Clinical and neuropsychological profile of patients with dementia and chronic traumatic encephalopathy

ObjectiveTo determine whether subjects with chronic traumatic encephalopathy (CTE) and dementia have distinct clinical features compared to subjects with pathologically confirmed Alzheimer’s disease (AD).MethodsAmong 339 subjects assessed for CTE in...

The Newly Normed SKT Reveals Differences in Neuropsychological Profiles of Patients with MCI, Mild Dementia and Depression.

The SKT (Syndrom-Kurztest) is a short cognitive performance test assessing deficits of memory and attention in the sense of speed of information processing. The new standardization of the SKT (2015) aimed at improving its sensitivity for early cognitive decline due to dementia in subjects aged 60 or older. The goal of this article is to demonstrate how the neuropsychological test profile of the SKT can be used to provide valuable information for a differential diagnosis between MCI (mild cognitive impairment), dementia and depression. n = 549 patients attending a memory clinic (Nuremberg, Germany) were diagnosed according to ICD-10 and tested with the SKT. The SKT consists of nine subtests, three for the assessment of memory and six for measuring attention in the sense of speed of information processing. The result of the SKT test procedure is a total score, which indicates the severity of overall cognitive impairment. Besides the summary score, two subscores for memory and attention can be interpreted. Using the level of depression as a covariate, statistical comparisons of SKT test profiles between the three patient groups revealed that depressed patients showed more pronounced deficits than MCI patients in all six attention subtests. On the other hand, MCI patients displayed significantly greater mnestic impairment than the depressed group, which was indicated by significant differences in the memory subscore. MCI and dementia patients showed similar deficit patterns dominated by impairment of memory (delayed recall) with MCI patients demonstrating less overall impairment. In sum, the SKT neuropsychological test profiles provided indicators for a differential diagnosis between MCI and beginning dementia vs. depression.

Cognitive outcomes following laser interstitial therapy for mesiotemporal epilepsies.

To provide a review of cognitive outcomes across a full neuropsychological profile in patients who underwent laser interstitial thermal therapy (LiTT) for mesiotemporal epilepsy (mTLE). We examined cognitive outcomes following LiTT for mTLE by reviewing a consecutive series of 26 patients who underwent dominant or nondominant hemisphere procedures. Each patient's pre- and postsurgical performance was examined for clinically significant change (>1SD improvement or decline on standardized scores), with a neuropsychologic battery that included measures of language, memory, executive functioning, and processing speed. Presurgical performance was largely consistent with previous research, where patients suffering from dominant hemisphere epilepsies demonstrated deficits in verbal learning and memory, whereas patients with nondominant hemisphere scored lower on visually mediated tests. Case-by-case review comparing presurgical to postsurgical scores revealed clinically significant improvement in both dominant and nondominant patients in learning and memory and other aspects of cognition such as processing speed and executive functioning. Of the few patients who did experience clinically significant decline following LiTT, a greater proportion had undergone dominant hemisphere procedures. Compared with the outcome literature of dominant open anterior temporal lobectomies (ATLs), where postsurgical decline has been documented in up to 40%-60% of cases, our LiTT case series exhibited a much lower incidence of postoperative language or verbal memory decline. Moreover, promising rates of postoperative improvements were also observed across multiple cognitive domains. Future studies exploring cognitive outcomes following LiTT should include comprehensive neuropsychological findings, rather than only select domains, as clinically significant change can occur in areas other than those typically associated with mesiotemporal structures.

The Myth of High False-Positive Rates on the Word Memory Test in Mild TBI

This study was designed to replicate previous reports of elevated false-positive rates (FPR) on the Word Memory Test (WMT) in patients with mild traumatic brain injury (TBI) and to evaluate previous claims that genuine memory deficits and non-credible responding are conflated on the WMT. Data from a consecutive case sequence of 170 patients with mild TBI referred for neuropsychological assessment were collected. Failure rate on the WMT was compared to that on other performance validity tests (PVTs). The clinical characteristics and neuropsychological profiles of patients who passed and those who failed the WMT and other PVTs were compared. Base rate of failure was the highest on the WMT (44.7%), but comparable to that on other established PVTs (39.4–41.8%). The vast majority of patients (94.7%) who failed the WMT had independent evidence of invalid performance, refuting previous estimates of 20–30% FPR. Failing the WMT was associated with globally lower scores on tests measuring various cognitive domains. The neurocognitive profile of individuals with invalid performance was remarkably consistent across various PVTs. Previously reported FPR of the WMT were not replicated. Failing the WMT typically occurred in the context of failing other PVTs too. Results suggest a common factor behind non-credible responding that is invariant of the psychometric definition of invalid performance. Failure on the WMT should not be discounted based on rational arguments unsubstantiated by objective data. Inferring elevated FPR from high failure rate alone is a fundamental epistemological error.

Personality Traits and Physical Complaints in Patients With Acromegaly: A Cross Sectional Multi-Center Study With Analysis of Influencing Factors.

Objective: Acromegalic patients display a distinct neuropsychological profile and suffer from chronic physical complaints. We aimed to investigate in more detail these aspects in acromegalic patients, dependent on influencing factors like disease activity, age, sex, chronic medication, surgery, pituitary radiation, pituitary insufficiency and comorbidities.Design: Cross sectional, multicentric.Methods: 129 patients (M/W 65/64, 58.3 ± 12.7 years, 53/76 with active/controlled disease). Acromegalic patients completed the following inventories: NEO-FFI, IIP-D, and the Giessen Complaints List (GBB-24), after written informed consent. Age, sex, IGF-1 concentrations, comorbidities, treatment modalities and pituitary insufficiency were documented.Results: Acromegalic patients or specific patient-subgroups were more agreeable, neurotic, exploitable/permissive, introverted/socially avoidant, non-assertive/insecure, nurturant and less open to experience, cold/denying, domineering, compared to normal values from the healthy population (controls). Multivariable analysis demonstrated that these overall results were due to the specific patient subgroups as patients on chronic medication, with arthrosis and pituitary insufficiency. Disease activity was only associated with the trait nurturant. Higher scores for introversion were associated with arthrosis. Lower domineering was independent of any disease- or treatment related variable or comorbidity. The GBB inventory showed overall higher scores in patients, with higher scores for exhaustion and general complaints being associated with pituitary insufficiency, coronary heart disease and history of malignancy in the multivariable analysis. Joint complaints were independent of any disease- or treatment- related variable.Conclusions: We define new aspects of a distinct neuropsychological profile in patients with acromegaly, which are largely independent of disease activity. Chronic physical complaints are more pronounced in patients than in controls, with exhaustion and general complaints showing no association with disease activity.

Neuropsychological profile of patients in the first episode of psychosis

Neurocognitive dysfunction in patients presenting psychotic symptoms for the first time has been repeatedly noted by researchers. However, there is still much diversity in data concerning the performance of these patients in specific cognitive domains and their degree of impairment. We used the Cambridge Neuropsychological Test Automated Battery (CANTAB), in order to administer a comprehensive battery of neuropsychological tests. A series of tests was selected measuring attention, memory, planning, inhibition, shifting ability, mental flexibility, working memory and visuospatial ability. The sample comprised 64 patients (37 male) with first episode of psychosis and 14 healthy individuals (9 male). Patients’ performance was lower in all cognitive domains, in relation to the performance of controls. More specifically, impairments in sustained attention (–.6 SD), memory (–.7 SD), planning (–.6 SD), working memory (–.7 SD), shifting ability (–.6 SD) and visuospatial ability (–.6 SD) were prominent. Also, patients presented a severe deficit in speed of processing (–.7 SD) and selective attention (–.6 SD). Our data confirms that patients in the first episode of psychosis present deficits in all cognitive domains. A more rigorous and thorough examination of specific subcomponents of cognitive abilities may be necessary in order to examine possible contributing factors as to specify the exact nature of cognitive deficits in first episode of psychosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Cognitive Decline in Patients with Anorexia Nervosa: Which Cognitive Domains are Most Vulnerable and Need to be Considered?

Objective: Besides physical complaints, patients with anorexia nervosa (AN) often suffer from cognitive problems. However, it is still a matter of debate whether a specific profile of cognitive disturbances underlies the disease, and if so, whether this profile contributes to the maintenance of the illness and also leads to the development of different subtypes of AN. The aim of the present study was to provide a more detailed knowledge on neuropsychological profiles in patients with AN using an extension of the Ravello Profile test-battery by working memory (WM) tests. Method: Twenty-nine AN patients and 20 healthy controls (HC) participated in the study. Neuropsychological performance was assessed by the Ravello Profile and WM tasks such as Digit Span and Corsi Blocks, 2- and 3-Back tasks, Symbol Digit Modalities Test, Paced Auditory Serial and Addition Task, as well as the Verbal Learning and Memory Test. Results: AN patients showed subtle cognitive problems on certain measures including WM performance. Compared to HC, the AN group showed significantly worse performance in verbal short-term and long-term memory, visuospatial WM, inhibition, and switching abilities, subserving successful self-regulation. Discussion: Our results speak in favour of relevance for WM decline in the context of AN. Therefore, tasks assessing visuospatial WM and information processing speed (IPS) should be added to existing test batteries such as the Ravello Profile.

Treatment-resistant Major Depressive Disorder with Psychotic Features is Associated with Impaired Processing Speed.

A proportion of patients with major depressive disorder (MDD) show cognitive impairment that is associated with treatment nonresponse and poorer functional recovery. A broader range of cognitive dysfunction has been found to be associated with treatment-resistant depression (TRD) and with the presence of psychotic symptoms. Thus far, the effects of psychotic symptoms on the neuropsychological profile of patients with treatment-resistant MDD have not been investigated. In the present study, 44 treatment-resistant MDD patients with (n=12) or without (n=32) psychotic symptoms-based on the Structured Clinical Interview (SCID I)-were compared with regard to their clinical status and performance in a neuropsychological test battery. The neuropsychological test battery assessed verbal skills, processing speed, executive functions and memory functions. Patients with psychotic TRD displayed lower performance in processing speed than non-psychotic patients. The group differences were not associated with the severity or pervasiveness of depressive symptoms. The duration of depression (from the onset of depressive symptoms) was longer in the group of non-psychotic TRD patients, but no other group differences with respect to sociodemographic characteristics, age at the onset of symptoms or symptom severity were found. The results imply that among individuals suffering from MDD, patients with the psychotic subtype who are unresponsive to standard pharmacological and psychosocial treatments have an increased vulnerability to cognitive dysfunction in the area of processing speed. Further research with larger sample size is warranted to determine whether these group differences persist after remission.

Comparison of neuropsychological profiles in patients with Alzheimer's disease and mixed dementia

ObjectsWe designed this study to extensively compare the neuropsychological profiles of Alzheimer's disease (AD) and mixed dementia (MD) in a large multicenter cohort of patients. Specifically, we performed subgroup analyses to examine group differences associated with dementia severity. MethodsA total of 1021 AD patients and 577 MD patients were included from the Clinical Research Center for Dementia of South Korea (CREDOS) Study. All patients underwent comprehensive neuropsychological and functional ratings, as well as complete physical and neurological examinations. To avoid floor confounds, only patients with Clinical Dementia Rating (CDR) scores of 0.5–2.0 were included. ResultsOverall, MD patients showed worse performance in frontal/executive function than those with AD. Stratification by dementia severity revealed a significant difference in global cognitive function scores between AD and MD patients only in the low severity groups (CDR 0.5). Also, MD patients showed worse performance in frontal/executive function domains in the CDR 0.5 groups whereas they had better performance in the memory domain in the CDR 1 groups than did AD patients. Additionally, AD patients showed better performance than MD patients with respect to activities of daily living at CDR levels 0.5 and 1. All differences had disappeared at the CDR 2 level of global dementia severity. ConclusionThis study suggests that there are significant differences in neuropsychological profiles between AD and MD patients, with the pattern of this difference varying distinctively according to dementia severity.

EXPLORING COMORBID OBSESSIVE-COMPULSIVE DISORDER AND ALCOHOL USE DISORDER USING NEUROPSYCHOLOGICAL TOOLS: A PRELIMINARY ANALYSIS

abstract By investigating neuropsychological profiles in patients with obsessive-compulsive disorder (OCD) and OCD with alcohol use disorder (OCD+AUD), focusing on tasks of behavioural inhibition, attentional set-shifting and decision-making, we aimed to elucidate factors contributing to compulsive behaviour. Consenting patients (n=24) were recruited from outpatient clinics and attributed to DSM-IV OCD (n=14) or OCD+AUD (n=10) groups. Healthy controls with no relevant family history (n= 15) were identified through established databases and public advertisement. We used the Barratt Impulsiveness Scale (BIS) to assess behavioural impulsivity, the Stop-Signal Task for motor response inhibition, the Intradimensional-Extradimensional (ID-ED) Set-Shift Task for attentional flexibility and the Cambridge Gamble Task (CGT) for decision-making. Analysis of co-variance was used to test for group differences, controlling for depression (Montgomery-Asberg Depression Rating Scale) and anxiety (State-Trait Anxiety Inventory), for which both patient groups scored significantly higher (p When we co-varied for anxiety and depression, both patient groups showed poorer attentional flexibility on the ID-ED task than controls (p=.01, with large effect size). Motor response inhibition (SST) did not differ between groups, however the OCD+AUD group showed poorer attentional inhibition than both other groups on the attentional subscale of BIS (p=.001). The quality of CGT decision-making was also significantly poorer in the OCD+AUD group than in the pure OCD group and controls (p=.05). Interestingly, significantly higher (p Although our interpretations are limited by small sample size, it appears the impairment in decision-making, set-shifting and attentional impulsivity observed in OCD+AUD may be attributable to between-group differences in intelligence. There is some evidence that lower premorbid IQ may be linked with AUD, specifically in those patients with a strong family history of AUD. On the other hand, questions have been raised as to the validity of the NART as a specific measure of premorbid IQ in AUD. Future such studies should pay close attention to measuring to premorbid intelligence and its relationship with neurocognitive performance.

Clinical and neuropsychological features of Alzheimer's disease in the combination with cerebrovascular disease

To study clinical/neuropsychological and neuroimaging characteristics of Alzheimer's disease in the combination with cerebrovascular disease (CVD). Ninety patients with dementia, including 35 patients with AD, 35 patients with mixed dementia (MD) and 20 patients with vascular dementia, were examined. The character of dementia was established according to NINCDS-ADRDA and NINDS-AIREN criteria. The neuropsychological battery included Addenbrooke's Cognitive Examination (ACE-R), Montreal Cognitive Assessment scale (MoCA), fluency test and the visual memory test (SCT). Affective and behavioral disorders were assessed with the Cornell Depression Scale in patients with dementia and a short version of NPI-4 in AD patients. Focal and diffuse changes were assessed with MRI. Patients with MD were older, had more often pseudobulbar syndrome (74%), postural instability (66%), frontal gait disorders (57%), Neuropsychological profile of patients with MD had mixed amnestic-dysexecutive character and, depending on the severity of vascular pathology, was closer to AD or to vascular dementia. Neuroimaging changes of patients with MD were correlated with clinical manifestations. The authors propose the approaches to the differential diagnosis of MD that allow to determine the main directions of treatment more precisely and to predict disease course.