Trial Making Test Research Articles

Effect of yoga program on executive functions of adolescents dwelling in an orphan home: A randomized controlled study

Executive function (EF) is important for physical and mental health of children. Studies have shown that children with poverty and early life stress have reduced EF. The aim of the study was to evaluate the effect of Yoga program on the EF of orphan adolescents. Seventy two apparently healthy orphan adolescents randomized and allocated into two groups as Yoga group (n = 40; 14 girls, age = 12.69 ± 1.35 yrs) and Wait List Control (WLC) group (n = 32, 13 girls, age = 12.58 ± 1.52 yrs). Yoga group underwent three months of Yoga program in a schedule of 90 min per day, four days per week whereas the WLC group followed the routine activities. They were assessed by Stroop Color-Word Task, Digit Symbol Substitution Test (DSST), Digits Span Test and Trial Making Test (TMT) at the beginning and end of the program.The repeated measures ANOVA showed significant difference in time and group interactions (p < 0.05) for all subtests of Stroop Color-Word Task and Digit Span Test and part-A of TMT whereas there were no significant difference found in DSST and TMT (part-B).The post-hoc test with Bonferroni adjustment also showed significant improvements (p < 0.001) within the Yoga group in all test scores while in wrong score of DSST did not exhibit significant reduction. Whereas the WLC group, showed significant improvement (p < 0.05) in Stroop Color, Color-Word score, net score of DSST, Digit Span forward and Digit Span Total.Three months Yoga program was found useful for the young orphan adolescents in improving their executive functions.

Comparison of motor performance of upper and lower extremities in dual-task tests in patients with mild Alzheimer’s dementia

Alzheimer's dementia (AD) is a progressive disease that threatens the self-care and quality of life of elderly people. Early diagnosis and early treatment are crucial. To examine the difference in executive function of patients with AD by analyzing their performance in gait analysis (Vicon MX system) and a trial making test (TMT) while counting forward or backward. Ten elderly persons who had been diagnosed by neurological specialists with mild AD were selected as study participants. Of these patients, 2 were men and 8 were women, and the average age was 74.0±8.6years. An additional group of 10 elderly persons without AD and matched according to age and sex constituted a control group. The average Mini-Mental State Examination score was 17.7±4.1, and the average clinical dementia rating scale score was 0.8±0.3. We found that backward counting of 3 digits during gait performance in mild AD patients elicited substantial changes in velocity, cadence, coefficient of variation of the stride length, and stride time compared with those of the control group. Regarding upper extremity performance, all TMT tasks were highly sensitive in revealing differences in reaction time between the mild AD group and the control group. Dual-task challenges for examining gait parameters and TMT performance can reveal obvious impairment of executive motor function in patients with very mild AD. Dual-task motor tests of the upper extremities can be used as screening tools for detecting AD at an early stage.

Assessment of Cognitive Functions in Methadone Maintenance Patients.

Methadone maintenance has received little scientific attention regarding neurocognitive effects. This study is aimed to assess the neuropsychological performance of methadone maintenance patients (MMP) compared to those healthy controls. Thirty-five MMP and 35 healthy controls, matched for age, gender, education and employment status, examined on a battery of tests aimed at assessing verbal fluency, executive functions, verbal memory, and working memory, using controlled oral word association test (COWAT), trial making test (TMT) Part A and B, Rey auditory verbal learning test (RAVLT), and backward digit span. MMP performed significantly poorly than controls in cognitive domains of verbal fluency, executive function, and verbal memory. MMP did not exhibit impairment in working memory, and TMT Part A compared to controls. These results suggest that methadone consumption induces significant cognitive impairment that could compromise drug-treatment outcomes in MMP.

Evaluating gaze control on a multi-target sequencing task: The distribution of fixations is evidence of exploration optimisation

Many high cognitive applications, such as vision processing and representation and understanding of images, often need to analyse in detail how an ongoing visual search was performed in a representative subset of the image, which may be arranged into sequences of loci, called regions of interest (ROIs). We used the Trial Making Test (TMT) in which subjects are asked to fixate a sequence of letters and numbers in a logical alphanumeric order. The main characteristic of TMT is to force the subject to perform a default and well-known path. The comparison of the expected scan-path with the observed scan-path provides a valuable method to investigate how a task force the subject to maintain a top-down internal representation of execution and how bottom-up influences the performance. We developed a mechanism that analyses the scan path using different algorithms, and we compared it with other methods: we found that fixations outside the ROI are direct influence of exploration strategy. The paper discusses the method in healthy subjects.

Assessment of cognitive dysfunction in kidney disease

Background: Cognitive dysfunction, include reducedmental alertness, intellectual impairment, decreasedattention and concentration, memory deficits anddiminished perceptual-motor coordination. Both CKDand chronic dialysis patients are thought to be associatedwith cognitive impairment. Cognitive impairment maydecrease an individual's quality of life, increase resourceutilization and result in suboptimal medical care.Neurophysiologic tests using imaging techniques areused to evaluate structural and functional abnormalities.Neuropsychological testing uses validated questions andscreening tests to evaluate cognition. Setting and participants: This study was carried out on120 patients with different stages of CKD fromnephrology outpatient clinic and hemodialysis unit inAin Shams University Hospitals. Group I: 50 CKDpatients, stage ? and stage IV. Group II: 50 ESRDpatients on regular hemodialysis with K t/v > 1.1. GroupIII: 20 acute kidney injury patients, followed up till theirrenal functions stabilized. Group ?V: 20 healthy subjectsmatched with patients. All patients underwent laboratoryinvestigations and psychometric tests which include trialmaking test part B, digit span test, digit symbol test,mini-mental state examination. Results: There were highly significant differences ofmean values of cognitive function tests between (groupsI,II and III as compared with group IV (control group),stage III CKD and stage IV CKD, CKD andhemodialysis patients, AKI patient at the insult and afterrecovery) and finally between hemoglobin and cognitivefunction tests score. Conclusions: There were significant differences of cognitive function tests results between CKD, III,IV,V, AKI patients as compared with healthy group, suggesting that kidney disease affects cognitive performance, there were significant differences of cognitive function tests results between stage III CKD and stage IV CKD, suggesting that the degree of cognitive impairment is associated with the severity of CKD, also significant differences of cognitive function tests results between CKD and ESRD on hemodialysis, suggesting that dialysis improves cognitive performance. Our results showed significant differences of cognitive function tests results between AKI patients at the insult and after recovery, suggesting that AKI also impair cognitive function. Finally cognitive performance is affected by hemoglobin level in CKD stage III, IV, V on hemodialysis and AKI patients, suggesting that treatment of anemia in AKI, CKD and ESRD patients improve cognitive performance.

Hormone replacement therapy to maintain cognitive function in women with dementia

As estrogens have been shown to have several potentially beneficial effects on the central nervous system, it is biologically plausible that maintaining high levels of estrogens in postmenopausal women by means of estrogen replacement therapy (ERT) could be protective against cognitive decline in women with Alzheimer's disease (AD) or other dementia syndromes. To investigate the effects of ERT (estrogens only) or HRT (estrogens combined with a progestagen) compared with placebo in randomized controlled trials (RCTs) on cognitive function of postmenopausal women with dementia. The Cochrane Dementia and Cognitive Improvement Group Specialized Register, which contains records from many medical databases, The Cochrane Library, EMBASE, MEDLINE, CINAHL, PsycINFO and LILACS were searched on 7 November 2007 using the terms ORT, PORT, ERT, HRT, estrogen*, oestrogen* and progesterone*. All double-blind randomized controlled trials (RCTs) into the effect of ERT or HRT for cognitive function with a treatment period of at least two weeks in postmenopausal women with AD or other types of dementia. Abstracts of the references retrieved by the searches were read by two reviewers (EH and KY) independently in order to discard those that were clearly not eligible for inclusion. The two reviewers studied the full text of the remaining references and independently selected studies for inclusion. Any disparity in the ensuing lists was resolved by discussion with all reviewers in order to arrive at the final list of included studies. The selection criteria ensured that the blinding and randomization of the included studies was adequate. The two reviewers also assessed the quality of other aspects of the included trials. One reviewer (EH) extracted the data from the studies, but was aided and checked by JB from Cochrane. A total of seven trials including 351 women with AD were analysed. Because different drugs were used at different studies it was not possible to combine more than two studies in any analysis.On a clinical global rating, clinicians scored patients taking CEE as significantly worse compared with the placebo group on the Clinical Dementia Rating scale after 12 months (overall WMD = 0.35, 95% CI = 0.01 to 0.69, z = 1.99, P < 0.05).Patients taking CEE had a worse performance on the delayed recall of the Paragraph Test (overall WMD = -0.45, 95% CI = -0.79 to -0.11, z = 2.60, P < 0.01) after one month than those taking placebo. They had a worse performance on Finger Tapping after 12 months (WMD = -3.90, 95% CI = -7.85 to 0.05, z = 1.93, P < 0.05).Limited positive effects were found for the lower dosage of CEE (0.625 mg/day) which showed a significant improvement in MMSE score only when assessed at two months, and disappeared after correction for multiple testing. No significant effects for MMSE were found at longer end points (3, 6 and 12 months of treatment). With a dosage of 1.25 mg/d CEE, short-term significant effects were found for Trial-Making test B at one month and Digit Span backward at four months. After two months of transdermal diestradiol (E2) treatment, a highly significant effect was observed for the word recall test (WMD = 6.50, 95% CI = 4.04 to 8.96, z = 5.19, P < 0.0001). No other significant effects were found for other outcomes measured. Currently, HRT or ERT for cognitive improvement or maintenance is not indicated for women with AD.

Impairment of Response Inhibition Precedes Motor Alteration in the Early Stage of Liver Cirrhosis: A Behavioral and Electrophysiological Study

Abnormality in movement initiation may partially explain psychomotor delay of cirrhotic patients, even in the absence of overt hepatic encephalopathy (HE). Therefore, the aim of this study was to determine the mechanisms of psychomotor delay observed in patients with cirrhosis in the absence of overt HE. Fourteen patients with nonalcoholic cirrhosis and 12 healthy matched control subjects underwent the lateralized readiness potential (LRP) measurement elicited by a visuospatial compatibility task (Simon task). Stimulus-triggered LRPonset reflects the time in which response is selected, while response-triggered LRP onset reflects motor execution. Cirrhotic patients showed delayed reaction times (RTs) compared to controls, particularly those with trial-making test A (TMT-A) or electroencephalogram (EEG) alterations. Stimulus-triggered LRP onset was found to be delayed in cirrhotic patients compared to controls, with a significant Group-versus-Condition interaction, showing a reduced cognitive ability to cope with interfering codes, even in patients without minimal HE (MHE). Response-triggered LRP was found to be delayed only in the patients with TMT-A or EEG alterations. In conclusion, cirrhotic patients without overt HE display a psychomotor slowing, depending first lyon response inhibition and only later accompanied by impaired motor execution.

Brain aging in a sample of normal Egyptians cognition, education, addiction and smoking

The impact of duration of education, cannabis addiction and smoking on cognition and brain aging is studied in 211 normal Egyptian volunteers with mean age 46.4±3.6 years (range: 20–76 years). Subjects were classified into two groups: Gr I (non-addicts) with 174 subjects, mean age 49.9±3.8 years (range 20–76 years), smokers and non-smokers, educated and non-educated and Gr II (cannabis addicts) with 37 subjects, mean age 43.6±2.6 years (range 20–72 years) all smokers, educated and non-educated. Outcome measures included the Paced Auditory Serial Addition test (PASAT) for testing attention and the Trailmaking test A, and B (TMa and TMb) for testing psychomotor performance. Age correlated positively with score of Trailmaking test (TMb) in the non-addict group and in the addict group (TMa and TMb). Years of education correlated negatively with scores of Trialmaking test (TMb) in the non-addict group (Gr I) but not the addict group (Gr II). However, in both groups mean scores of the Trailmaking test (TMa) were significantly lower in subjects with a primary level of education than those with higher levels of education. No significant difference was detected between male smokers and nonsmokers of Gr I (non-addicts) regarding any of the neuropsychological tests. Yet, smokers and the non-educated group had poorer attention compared to non-smokers of the same group. Cannabis addicts (Gr II) had significantly poorer attention than non-addict normal volunteers (Gr I). It is concluded that impairment of psychomotor performance is age related whether in normal non-addicts or in cannabis addicts. A decline in attention was detected in cannabis addicts and has been considered a feature of pathological aging. Education in early life as well as the duration of education are neuroprotectors for brain aging more so in the non-addict than addict group. Though cigarette smoking per se has no effect on cognitive abilities in normal aging, it becomes evident that its association with lack of education impairs attention.

Central-nervous-system dysfunction after warm or hypothermic cardiopulmonary bypass

The increasing popularity of warm heart surgery led us to assess the effect of temperature during cardiopulmonary bypass (CPB) on neuropsychological function after coronary surgery. 34 patients enrolled in a randomised trial of normothermic versus hypothermic CPB were subjected to a battery of psychomotor and memory tests before and after their operations. The mean nasopharyngeal temperature for warm CPB was 34·7 (SD 0·5)°C and that for hypothermic CPB was 27·8 (2·0)°C. In all seven neuropsychological tests the postoperative scores were better in the warm CPB than in the hypothermic group, although only one difference achieved significance (trial-making test A; p<0·023). Thus, neurological function after normothermic CPB seems to be no worse than that after hypothermic procedures.