Sustained Attention In Patients Research Articles

Sustained attention in patients with mild traumatic brain injury

To demonstrate that two tests of sustained attention were sensitive to attention deficits in patients with mild traumatic brain injury (TBI). A cross-sectional study recruiting 51 patients with TBI and 51 matched controls. The Sustained Attention to Response Task (SART) and Monotone Counting Test. The patient groups performed significantly worse than the normal controls in both sustained attention tests. The SART performance was also correlated with pathology severity in the patient group in terms of loss of consciousness (r = 0.247, p = 0.05). A cut-off of less than 1 standard deviation (SD) gives optimal diagnostic information in terms of sensitivity in the present sample (0.61 for Monotone Counting Test; 0.75 for SART). These findings suggest that the SART and Monotone Counting Test are sensitive to patients with mild TBI. The SART-assessed sustained attention is also sensitive enough to detect attention impairment in this clinical group regardless of diagnosis and may provide clinicians with an alternative method of assessing sustained attention in these clinical groups.

Nicotine and Behavioral Markers of Risk for Schizophrenia: A Double-Blind, Placebo-Controlled, Cross-Over Study

We investigated the effect of nicotine on three behavioral markers of risk for schizophrenia: sustained attention (using the Continuous Performance Task (CPT)), antisaccade performance, and smooth pursuit. Smooth pursuit was investigated in two conditions, one in which attention was enhanced (monitoring target changes) and one in which attention was not enhanced (no monitoring). Patients with schizophrenia (n = 15) and controls (n = 14) were given a 14-mg nicotine patch in a double-blind, placebo-controlled, crossover design and plasma nicotine concentrations were monitored. Nicotine concentrations were similar in both groups. A Group × Drug interaction (p < .02) on CPT hits indicated that nicotine improved sustained attention in patients but not in controls. Nicotine significantly decreased antisaccade errors (p < .01) in both groups. A Drug × Monitoring condition interaction (p < .01) on pursuit gain indicated that nicotine significantly increased pursuit gain in the no-monitoring condition in patients and controls equally, but did not improve pursuit in the monitoring condition. Thus, improvement in pursuit may have been mediated via an effect on attention rather than by an effect on oculomotor function per se. In patients, the magnitude of improvement in attention on nicotine was correlated with the improvement on eye movement tasks. Thus, nicotine improves performance on both attention and oculomotor markers of risk for schizophrenia, possibly via common mechanisms.

Uso de potenciales relacionados con eventos para el diagnóstico y seguimiento de los trastornos subclínicos de la atención sostenida en la enfermedad cerebrovascular isquémica

Ischemic cerebrovascular disease causes cognitive disorders among survivors, which may range from vascular dementia to alterations of a sub clinical nature. These are not easily detected using conventional diagnostic tools. Some of the most frequent disorders after a cerebral infarction are those affecting sustained attention or vigilance. The event related potential (ERP) P300 or P3 could be a valuable diagnostic indicator of this type of disorder and its evolution. AIMS. The evaluation and diagnosis of sub clinical disorders of sustained attention in patients with cerebral infarction by using ERP as a method of diagnosis and follow up.We studied 13 patients with cerebral infarction located in the left parietal lobe, 13 with infarction in the right parietal lobe and 26 healthy control subjects, who were paired by gender, age and educational level. All subjects were submitted to a computerized continuous performance test, associated with the recording of electrical brain activity.Patients with right parietal lesions made more mistakes due to omission, answered fewer questions correctly and had a lower attention index than the rest of the patients and healthy controls. Although there were no significant differences in the P3 amplitude values, patients with right lesion presented significantly increased latencies in the F7, Fz and Cz derivations. After five months there was a significant improvement in performance in the attentional test. The value of the latency in the Cz derivation, nine days after the occurrence of the cerebral infarction, was related with the number of mistakes made by the subjects five months later in the attention test.Patients with an ischemic lesion in the right parietal lobe presented disorders in sustained attention, which were only diagnosed adequately by use of computerized tests associated with ERP recordings. This shows that evoked potentials are valuable in cognitive diagnosis, and also demonstrates the relation that exists between the capacity to hold the attention on a stimulus over a period of time and the structures of the right parietal lobe. Five months later, these disorders of a sub clinical nature can disappear. The value of the latency in Cz, nine days after the occurrence of the event, acts as a predictor of this recovery. Cognitive rehabilitation plans could benefit from the use of these diagnostic tools.

Sustained attention in patients with obsessive–compulsive disorder: a controlled study

Studies on attentional processes in obsessive–compulsive disorder (OCD) have been inconsistent. The present study focused on the question of sustained attention in OCD, using the ‘Degraded Stimulus Continuous Performance Test’ (DS-CPT) sensitivity index over time. This study included 20 OCD patients and 25 control subjects, comparable in sex, age and educational level. All subjects had a neuropsychiatric structured diagnostic interview, as well as a psychometric battery. The DS-CPT evaluated sustained attention. The sensitivity decrement during DS-CPT was significant in both controls and OCD subjects. Contrary to our expectations, OCD patients did not show a greater decrease in sensitivity over time, compared to controls: thus, OCD patients presented a no more important attention decrease than controls. Controls and OCD subjects became more conservative in their response criteria throughout the DS-CPT test. Comparing OCD with and without pharmacological treatment did not reveal any difference in CPT outcome. Moreover, we observed, in OCD, a positive significant correlation between the Y-BOCS compulsion score and the CPT sensitivity index. A significant negative correlation of the Y-BOCS compulsive score with the CPT false alarm score was also found. In conclusion, OCD patients did not present any disturbance in sustained attention during a task requiring an increased processing load.

Processing speed and visual sustained attention in patients with predominantly positive and negative symptom schizophrenia

Processing speed and visual sustained attention in patients with predominantly positive and negative symptom schizophrenia

A Test for the Determination of Sustained Attention in Patients with Obstructive Sleep Apnea Syndrome

Background and Objectives: To investigate the parameter daytime sleepiness in patients with the sleep apnea syndrome (SAS), a test for measurement of sustained attention was developed. The present studies were performed on volunteers undergoing preemployment medical examinations and SAS patients to determine the extent to which test results are in agreement with the symptoms of SAS and traffic accident reports, and also with daytime sleepiness, and whether learning or therapeutic effects can be seen with repeated tests prior to and following treatment with nasal continuous positive airway pressure (nCPAP). Methods: Participants: 125 healthy volunteers, and two groups of 28 SAS patients each. Design: Study A: The volunteers underwent a single attention test and completed a questionnaire concerned with traffic accidents and symptoms of sleep-related breathing disorders. Study B: SAS patients underwent two attention tests before treatment. Study C: SAS patients underwent one attention test before and one after nCPAP therapy. Results: Study A: The error rate in volunteers without symptoms of sleep-related breathing disorders (51 persons) was 4.7 ± 4.3% (number of errors 14.1 ± 12.9), 95% CI: 1.2 (number of errors 3.6). No dependence of the error rate on age, BMI or sex was found. In persons with a history of apneic events (n = 10), the error rate was 10.6 ± 10.0% (number of errors 31.8 ± 30), in those with more than two accidents during the last 5 years (n = 4), it was increased to 15.3 ± 9.7% (number of errors 45.9 ± 29.1). Study B: Among SAS patients, no significant learning effect was seen, and prolongation of the test duration beyond 30 min had no effect on the test results. Study C: The error rate improved significantly with nCPAP [10.6 ± 13.5 vs. 6.4 ± 8.9% (number of errors 31.8 ± 40.5 vs. 19.2 ± 26.7), p < 0.001]. Conclusions: The attention test can be helpful for the measurement of daytime sleepiness, and CPAP therapy can improve test performance.