Wisconsin Card Sorting Test Scores Research Articles

Computerized cognitive remediation therapy on cognitive impairment and social function in patients with chronic schizophrenia

BACKGROUND Patients with schizophrenia may have various disease manifestations, most of which gradually tend toward incurable chronic decline, leading to mental disability. The basic symptoms of the disease can impair social function, whereas long-term hospitalization produces hospitalization syndrome, causing serious damage to social function. AIM To investigate the effects of Computerized Cognitive Remediation Therapy (CCRT) on cognitive and social functioning in patients with chronic schizophrenia. METHODS A retrospective analysis of 120 patients with chronic schizophrenia in Shanghai Pudong New Area Mental Health Center was performed. They were divided into an intervention group (60 cases treated with CCRT combined with conventional medication) and a control group (60 cases treated with conventional medication). After treatment, effects on cognitive function and social roles were observed in both groups. The Positive and Negative Syndrome Scale (PANSS) was used to assess the patients' psychiatric symptoms. The Wisconsin Card Sorting Test (WCST) was used to assess the patients' cognitive functioning, and the Social Functioning Scale for Psychiatric Inpatients (SSPI) was used to assess the social functioning of the inpatient psychiatric patients. RESULTS No significant differences were observed in the PANSS, WCST, and SSPI intergroup scores before treatment (P > 0.05). After 2, 4, and 6 wk of therapy, general psychopathological factors, positive symptoms, negative symptoms, and total PANSS scores of PANSS in the intervention group were lower than in the control group (P < 0.05). After 2, 4, and 6 wk of treatment, the number of false responses, number of persistent bugs, and total responses in the WCST were significantly lower in the intervention group than in the control group (P < 0.05), and the amount of completed classification was significantly higher than in the control group (P < 0.05). After 2, 4, and 6 wk of therapy, the SSPI scores were significantly greater than those of the controls (P < 0.05). After 6 wk of treatment, the efficacy rates of the control and intervention groups were 81.67% and 91.67%, respectively. The curative effect in the intervention group was significantly higher than that in the control group (P < 0.05). CONCLUSION CCRT can significantly improve cognitive function and social abilities in patients with chronic schizophrenia.

Impaired cognitive flexibility and disrupted cognitive cerebellum in degenerative cerebellar ataxias.

There is a clinically unmet need for a neuropsychological tool that reflects the pathophysiology of cognitive dysfunction in cerebellar degeneration. We investigated cognitive flexibility in degenerative cerebellar ataxia patients and aim to identify the pathophysiological correlates of cognitive dysfunction in relation to cerebellar cognitive circuits. We prospectively enrolled degenerative cerebellar ataxia patients with age-matched healthy controls who underwent 3 T 3D and resting-state functional MRI. All 56 participants were evaluated with the Scale for Assessment and Rating of Ataxia and neuropsychological tests including the Wisconsin Card Sorting Test, Trail Making Test, Montreal Cognitive Assessment and Mini-Mental State Examination. From MRI scans, we analysed the correlation of whole-brain volume and cortico-cerebellar functional connectivity with the Wisconsin Card Sorting Test performances. A total of 52 participants (29 ataxia patients and 23 healthy controls) were enrolled in this study. The Wisconsin Card Sorting Test scores (total error percentage, perseverative error percentage, non-perseverative error percentage and categories completed), Trail Making Test A and Montreal Cognitive Assessment were significantly impaired in ataxia patients (P < 0.05) compared to age-matched healthy controls. The Wisconsin Card Sorting Test error scores showed a significant correlation with the ataxia score (P < 0.05) controlling for age and sex. In volumetric analysis, the cerebellar right crus I, II, VIIb and VIII atrophy correlated with non-perseverative error percentage in the ataxia group. In functional connectivity analysis, the connectivity between crus I, II and VIIb of the cerebellum and bilateral superior parietal and superior temporal gyrus was significantly altered in ataxia patients. The functional connectivity between left crus II and VIIb of the cerebellum and dorsolateral prefrontal and superior frontal/parietal cortices showed a positive correlation with perseverative error percentage. The connectivity between left crus VIIb and pontine nucleus/middle cerebellar peduncle showed a significant negative correlation with non-perseverative error percentage in the ataxia group. The impaired cognitive flexibility represented by the Wisconsin Card Sorting Test was significantly impaired in degenerative cerebellar ataxia patients and correlated with disease severity. The Wisconsin Card Sorting Test performance reflects hypoactivity of the cognitive cerebellum and disrupted cortico-cerebellar connectivity in non-demented patients with degenerative cerebellar ataxia.

Predicting normative data in healthy individuals on the computerized wisconsin card sorting test using regression models.

Computerized neuropsychological tests provide advantages to clinicians with cost, administration, and time. However, studies have pointed out performance differences between manual and computerized versions of some neuropsychological tests. One of these is the Wisconsin Card Sorting Test (WCST). Due to the performance difference, the normative data of manual tests cannot be used for their computerized versions. Therefore, normative data searches are needed for computerized versions. This study aimed to determine the norm values of WCST-CV in a healthy sample. 422 healthy adults aged 18-78 participated in this study. WCST-CVsub-scores are modeled by Regression Analysis based on Age and Education level to generate normative data. Among the 13 WCST scores, the regression models for WCST 2, WCST 3, WCST 4, WCST 10, and WCST 11 are significant. WCST 2, WCST 4, and WCST 11 scores are estimated with Ordinary Least Squares (OLS). However, WCST 3 and WCST 10 scores are estimated with Weighted Least Squares (WLS) due to the violation of the homoscedasticity assumption. The regression results show that p-values calculated from error increase as age and education level increase. As a result of our research, norm values between 18-78 years of age were produced using RA. It was determined that gender was not significant for any sub-score. Therefore, only age and education level from socio-demographic variables were included in the model.

Protocol for a randomized controlled trial exploring the brain mechanism and therapeutic effect of electroacupuncture on cognitive function and sleep quality in chronic insomnia

BackgroundInsomnia is a prevalent sleep disorder that affects up to 15% of the population worldwide and is the second most common mental health issue. There is increasing interest in the effects of long-term insomnia on cognitive function. Electroacupuncture can effectively improve cognitive function and sleep quality, yet the underlying brain network mechanisms remain unclear. This study aims to explore the network regulatory mechanisms associated with enhanced cognitive function and sleep quality, providing theoretical support for the use of electroacupuncture in the clinical treatment of chronic insomnia.MethodsThis study is divided into two parts. Sixteen individuals with chronic insomnia and 16 healthy controls of similar age and gender will be recruited in Study 1 to examine the brain network topology of individuals with chronic insomnia. Study 2 will be a randomized controlled trial with 120 chronic insomnia patients divided into three groups: Group A (electroacupuncture plus placebo drug), Group B (drug plus placebo electroacupuncture), and Group C (placebo electroacupuncture plus placebo drug). Participants will be exposed to 24 treatments over an 8-week period (3 times per week) and monitored for 12 additional weeks. The primary outcome measure will be changes in brainwave data from before to after the treatment. In addition, the Wisconsin Card Sorting Test and the Pittsburgh Sleep Quality Index will be utilized as secondary outcomes to measure from before to after treatment and during the follow-up. A correlation analysis will be conducted to explore links among modifications in brainwave patterns, Wisconsin Card Sorting Test scores, and Pittsburgh Sleep Quality Index scores. Additionally, any adverse events will be strictly monitored.DiscussionElectroacupuncture may represent an alternative treatment for chronic insomnia, and this trial is expected to reveal the brain mechanism by which electroacupuncture improves cognitive function and sleep quality in chronic insomnia patients.Trial registrationChiCTR2200060150 (Chinese Clinical Trial Registry, http://www.chictr.org.cn, registered on 20 May 2022).

Correlation of Insulin-Like Growth Factor 1 With Cognitive Functions in Mild Traumatic Brain Injury Patients.

Mild traumatic brain injury (mTBI) is a prevalent health concern with variable recovery trajectories, necessitating reliable prognostic markers. Insulin-like growth factor 1 (IGF-1) emerges as a potential candidate because of its role in cellular growth, repair, and neuroprotection. However, limited studies investigate IGF-1 as a prognostic marker in mTBI patients. This study aimed to explore the correlation of IGF-1 with cognitive functions assessed using the Wisconsin Card Sorting Test (WCST) in mTBI patients. We analyzed data from 295 mTBI and 200 healthy control participants, assessing demographic characteristics, injury causes, and IGF-1 levels. Cognitive functions were evaluated using the WCST. Correlation analyses and regression models were used to investigate the associations between IGF-1 levels, demographic factors, and WCST scores. Significant differences were observed between mTBI and control groups in the proportion of females and average education years. Falls and traffic accidents were identified as the primary causes of mTBI. The mTBI group demonstrated worse cognitive outcomes on the WCST, except for the "Learning to Learn" index. Correlation analyses revealed significant relationships between IGF-1 levels, demographic factors, and specific WCST scores. Regression models demonstrated that IGF-1, age, and education years significantly influenced various WCST scores, suggesting their roles as potential prognostic markers for cognitive outcomes in mTBI patients. We provide valuable insights into the potential correlation of IGF-1 with cognitive functions in mTBI patients, particularly in tasks requiring cognitive flexibility and problem solving.

Clinical characteristics and cognitive function in bipolar disorder patients with different onset symptom.

In recent years, studies on the clinical features and cognitive impairment of patients with different first-episode types of bipolar disorder have received increasing attention. The patients with bipolar disorder may present with different symptoms at first onset. The aim of this study is to assess the cognitive functions of a patient's index episode of bipolar disorder, depression or mania, on risk factors of effecting on cognitive functions. One hundred sixty eight patients with bipolar disorder diagnosed for the first time were enrolled in the study. All patients were divided into two groups according to their index episode of bipolar disorder, either depression or mania. Seventy three patients of the cohort had an index episode mania and 95 patients had initial symptoms of depression. Demographic and clinical disease characteristic data of all enrolled patients were collected. Meanwhile, 75 healthy controls were included. Demographic data of controls were collected. The cognitive functions of all patients and controls were detected by continuous performance test (CPT), digital span test (DST) and Wisconsin card sorting test (WCST). The main cognitive functions data were compared among the mania group, depression group and control group. The relevant risk factors affecting cognitive function were analyzed. (1) Most patients with bipolar disorder had an index episode depression (56.55% vs. 43.45%). Compared with the depression group, the mania group had later age of onset [(24.01 ± 4.254) vs. (22.25 ± 6.472), t = 2. 122, p = 0.035]. The education level of patient groups was lower than control group (p < 0.001). (2) The healthy control group's DST, WCST and CPT scores were better than the patient groups (All p < 0.05). The mania group's DST (forward, reverse, sum), WCST (total responses, completed classifications, correct responses, incorrect responses, percentage of correct responses, completed the number of responses required for classification, the percentage of conceptualization level, the number of persistent responses, non-persistent errors), CPT (2 digit score, 3 digit score, 4 digit score) was better than the depression group (p < 0.05). (3) In mania group, correlation analysis showed that all CPT parameter, inverse digit span, and the sum of DST was negatively correlated with the education level (All p < 0.05). The CPT-4 digit score was negatively correlated with onset age (p < 0.05). In the WCST, the number of correct responses, the percentage of correct responses and the percentage of conceptualization level were positively correlated with the BRMS score (All p < 0.05). The number of false responses and persistent responses were negatively correlated with the BRMS score (All p < 0.05). The number of persistent errors and percentage of persistent errors was positively correlated with education years (All p < 0.05). In depression group, there was a positive correlation between inverse digit span and the education level (p < 0.05). In our study, there were cognitive impairments in attention, memory, and executive function of patients with different onset syndromes of bipolar disorder. Compared with the mania group, the degree of cognitive impairments in bipolar patients with the depressive episode was more severe. The risk factors affecting cognitive impairments included the age of onset, education level, number of hospitalizations and severity of illness.

Cognitive flexibility in inpatient children and adolescents with a history of suicide attempts

An increase in suicide rates during adolescence has made it the second leading cause of death for this age group. While potential deficits in cognitive flexibility have been thought to contribute to suicidality, this factor has been evaluated in only a few studies among this age group. The current study sought to evaluate cognitive flexibility in 100 psychiatric inpatient children and adolescents (age X=14.39, SD=2.53), with (n=26) and without (n=74) a history of suicide attempts, using the Wisconsin Card Sorting Test (WCST). Results showed no differences between the groups in WCST scores. However, in a small sub-sample with mood disorders only, those with a history of a suicide attempt performed better than those without such history. These findings are contrary to our hypothesis that those who attempted suicide have worse cognitive flexibility, though consistent with earlier data in adults. Further research is needed to shed light on these findings.

Consequences of diabetes and pre-diabetes and the role of biochemical parameters of carbohydrate metabolism for the functioning of the prefrontal cortex in obese patients.

The role of executive functions (EF) is to maintain particular behaviours in order to achieve intended goals. EF are crucial in management of pre-diabetes, diabetes and obesity which are grievous diseases and can lead to severe complications. The aims of our study were to: assess EF in group of obese subject with carbohydrate disorders, evaluate whether biochemical factors and comorbidities related to metabolic disorders have adverse effect on EF in this group of patients. The study included 185 obese patients (146 women; 39 men) who were divided on three groups: pre-diabetic, diabetic and control subgroup. Patient underwent Wisconsin Card Sorting Test (WCST) to evaluate EF. Assessed biochemical factors included C-peptide, fasting plasma glucose (FPG) and glycosylated hemoglobin A1c (HbA1c). Diabetic patients showed the worst WCST scores among the rest of groups. Pre-diabetic individuals did not differ in EF performance from control subgroup. We observed significant correlations between FPG and HbA1c and worse WCST scores in pre-diabetic subgroup. In diabetic patients C-peptide correlated with poorer EF. Depressive symptoms and hypertension significantly correlated with non-perseverative errors in WCST. The subgroup of diabetic patients were the most obese and had the worst glycemia parameters. They also showed the worst EF in WCST. According to obtained results, hyperglycemia positively correlated with poor EF in pre-diabetes. However, in diabetic subjects cognitive deterioration may results from insulin resistance rather than hyperglycemia. In obese individuals with carbohydrate disorders both hypertension and depressive symptoms significantly contributed to EF dysfunction.

Functional and structural MRI correlates of executive functions in multiple sclerosis

Background: Executive dysfunctions, including difficulties in attention, working memory, planning, and inhibition affect 15%–28% of multiple sclerosis (MS) patients. Objectives: To investigate structural and functional magnetic resonance imaging (MRI) abnormalities underlying executive function (EF) in MS patients. Methods: A total 116 MS patients and 65 controls underwent resting-state (RS) and diffusion-weighted sequences and neuropsychological examination, including Wisconsin Card Sorting Test (WCST) to test EF. Brain RS cognitive networks and fractional anisotropy (FA) from a priori selected white matter tracts were derived. Associations of WCST scores with RS functional connectivity (FC) and FA abnormalities were investigated. Results: In MS patients, predictors of working memory/updating were: lower corpus callosum (CC) FA, lower left working-memory network (WMN), right WMN RS FC for worse performance; lower executive control network (ECN), higher default-mode network (DMN), and salience network (SN) RS FC for better performance (R2 = 0.35). Predictors of attention were lower CC genu FA, lower left WMN, and DMN RS FC for worse performance; higher left WMN and ECN RS FC for better performance (R2 = 0.24). Predictors of worse shifting/inhibition were lower CC genu and superior cerebellar peduncle (SCP) FA, lower left WMN RS FC for worse performance; and higher ECN RS FC for better performance (R2 = 0.24). Conclusions: CC and SCP microstructural damage and RS FC abnormalities in cognitive networks underlie EF frailty in MS.

Assessment of Executive Function in Patients with Traumatic Brain Injury with the Wisconsin Card-Sorting Test.

This review aimed at providing a brief and comprehensive summary of recent research regarding the use of the Wisconsin Card-Sorting Test (WCST) to assess executive function in patients with traumatic brain injury (TBI). A bibliographical search, performed in PubMed, Web of Science, Scopus, Cochrane Library, and PsycInfo, targeted publications from 2010 to 2020, in English or Spanish. Information regarding the studies’ designs, sample features and use of the WCST scores was recorded. An initial search eliciting 387 citations was reduced to 47 relevant papers. The highest proportion of publications came from the United States of America (34.0%) and included adult patients (95.7%). Observational designs were the most frequent (85.1%), the highest proportion being cross-sectional or case series studies. The average time after the occurrence of the TBI ranged from 4 to 62 years in single case studies, and from 6 weeks up to 23.5 years in the studies with more than one patient. Four studies compared groups of patients with TBI according to the severity (mild, moderate and/or severe), and in two cases, the studies compared TBI patients with healthy controls. Randomized control trials were seven in total. The noncomputerized WCST version including 128 cards was the most frequently used (78.7%). Characterization of the clinical profile of participants was the most frequent purpose (34.0%). The WCST is a common measure of executive function in patients with TBI. Although shorter and/or computerized versions are available, the original WCST with 128 cards is still used most often. The WCST is a useful tool for research and clinical purposes, yet a common practice is to report only one or a few of the possible scores, which prevents further valid comparisons across studies. Results might be useful to professionals in the clinical and research fields to guide them in assessment planning and proper interpretation of the WCST scores.

Dysfunctional personality beliefs and executive performance in patients with juvenile myoclonic epilepsy

BackgroundThis article intends to verify the association of dysfunctional beliefs of personality disorders with the executive performance in people with juvenile myoclonic epilepsy (JME). MethodsFifty-two patients (35 women, 67.3%) with JME aged 18–50 yrs. (32.3 ± 9.7) were evaluated between May 2017 and April 2018 and compared with controls. All subjects were submitted to the Personality Beliefs Questionnaire (PBQ) (Beck & Beck, 1991; Savoia et al., 2006), Dysexecutive Questionnaire (DQ; Wilson et al., 1996; Macuglia et al., 2016), estimated intelligence quotient (IQ) using Vocabulary and Block Design tests, attention and executive functions evaluation (Controlled Oral Word Association (COWA), Digit Span, Trail Making Tests (TMT) A and B, Stroop and Wisconsin Card Sorting Test (WCST)). The inclusion criteria were as follows: diagnosis of JME (ILAE, 1989); age ≥18 yrs., schooling ≥ 11 yrs. and IQ ≥70. The inclusion criteria for the control group were the same except diagnosis of epilepsy. ResultsCompared with controls, patients presented higher scores in PBQ for personality disorders, namely Narcissistic (z = −0.79; p < 0.001), Borderline (z = −0.58; p = 0.002), Paranoid (z = −0.43; p = 0.017), and Histrionic (z = −0.39; p = 0.041). Executive functions were impaired when compared with controls in TMT A (z = −0.97; p = 0.038), TMT B (z = −0.65; p = 0.023), and COWA (z = −0.51; p = 0.001). Patients showed higher WCST scores for Errors (z = −1.62; p ≤ 0.001), Perseverative Errors (z = −0.77; p = 0.001), Non-Perseverative Errors (z = −1.01; p = 0.001), Conceptual Level Response (z = −1.56; p ≤ 0.001), Completed Categories (z = −2.12; p = 0.002), and Failure to Maintain Context (z = −0.49; p = 0.015). Personality Beliefs Questionnaire results showed correlation with lower values in TMT A, Antisocial (r = −0.298; p = 0.032), Narcissistic (r = −0.303; p = 0.029), Schizoid (r = − 0.410; p = 0.003), Histrionic (r = −0.341; p = 0.013), Passive-aggressive (r = −0.341; p = 0.015), and Obsessive–compulsive (r = −0.319; p = 0.021); TMT B results showed a trend for Obsessive–compulsive traits (r = −0.261; p = 0.052); COWA was correlated to Dependent (r = 0.319; p = 0.021); and Digit Span to Passive-aggressive (r = 0.287; p = 0.039). On WCST, Failure to Maintain Context was correlated to Avoidant (r = 0.335; p = 0.017). The DQ was not correlated with PBQ. ConclusionPeople with JME presented dysfunctional beliefs of personality disorder that were correlated with executive dysfunction. These findings reinforce the need for psychological rehabilitation in these patients.

A Meta-Analysis of Relationships between Measures of Wisconsin Card Sorting and Intelligence.

The Wisconsin Card Sorting Test (WCST) represents a widely utilized neuropsychological assessment technique for executive function. This meta-analysis examined the discriminant validity of the WCST for the assessment of mental shifting, considered as an essential subcomponent of executive functioning, against traditional psychometric intelligence tests. A systematic search was conducted, resulting in 72 neuropsychological samples for the meta-analysis of relationships between WCST scores and a variety of intelligence quotient (IQ) domains. The study revealed low to medium-sized correlations with IQ domains across all WCST scores that could be investigated. Verbal/crystallized IQ and performance/fluid IQ were indistinguishably associated with WCST scores. To conclude, the WCST assesses cognitive functions that might be partially separable from common conceptualizations of intelligence. More vigorous initiatives to validate putative indicators of executive function against intelligence are required.

Age, education and gender effects on Wisconsin card sorting test: standardization, reliability and validity in healthy Argentinian adults

ABSTRACT The Wisconsin Card Sorting Test (WCST) is a widely used neuropsychological assessment of executive functioning. The aim of this study was to provide norm values and analyze the psychometric properties of WCST in healthy Argentinian adults aged from 18 to 89 years old (N = 235). Descriptive statistics are reported as means, standard deviations and percentiles, with the effects of age, education and gender being investigated by ANOVA, and with the effect sizes being calculated. The psychometrics were studied using the WCST structure, reliability, convergent validity, and discriminant validity, and WCST norms adjusted for age and educational level are proposed. This instrument is a reliable and valid tool for the assessment of executive functions. However, as the age- and educational-related effects were demonstrated, these characteristics need to be considered before interpreting WCST scores. Regarding gender, no differences were found. Our results expand the geographical and sociocultural applicability of WCST.

Cognitive flexibility and problem-solving in patients with bipolar disorder

Introduction: This study focuses on the cognitive impairment in patients with bipolar disorder and also the distribution of cognitive flexibility and problem-solving by degree of education, chronicity, and episode of patient is in at the time of evaluation.Methods: This was a cross sectional descriptive study with purposive sampling method. The population was the Harmony in Diversity Group in Surabaya, Indonesia. Twenty-two patients agreed to be subjects and each of them finished the Wisconsin Card Sorting Test (WCST) to measure cognitive flexibility and the Tower of London (TOL) to measure problem-solving. Results: The WCST score are below normal for 90.9% of the patients. Higher cognitive flexibility is found in patients with bachelor’s degree and euthymic patients, while lower cognitive flexibility is found in patients in depression episode, manic episode, and mixed episode. No patients could finish the TOL within the minimum required steps. Better problem-solving is found in patients in manic episode and euthymic patients while lower problem-solving is found in mixed episode and depressive episode.Conclusion: The cognitive flexibility and problem-solving in patients with bipolar disorder are lower than the normal cut off. The type of episode and chronicity are contributing factors. Euthymic patients tend to have better cognitive flexibility and manic patients tend to have better problem-solving ability.

Mild cognitive impairment in mild brain injury (MBI) patients: An event related potential (ERP) and neuropsychology study.

Objectives: To evaluate auditory cognitive function in mild brain injury (MBI) patients, which is important to determine for rehabilitation and improve quality of their life.&#x0D; Methods: Participants (n=19/group) were divided into group 1 (G1-control), group 2 (G2/1st test-MBI/within 7 days of road traffic accident-RTA) and group 3 (G3/2nd test-MBI/2-6 months after RTA). Event related potentials (ERPs) were conducted using a 128-sensor net; participants counted silently rare target tone stimuli and ignored standard tones. Several neuropsychology tests like Verbal fluency test (PAS), Wisconsin Card Sorting Test (WCST), Rey Auditory Verbal and Learning Test (RAVLTIM, RAVLTDR and RAVLTTS) and Beck Depression Inventory (BDI) were subsequently administered.&#x0D; Results: Sensory (P50, N100) and cognitive (P300) ERP components were analysed from ERP waveforms. There were no significant group differences in amplitudes or latencies for all components across sites except P300 component amplitudes at T6 location. P50, N100 and P300 ERP components exhibited non-significantly increased amplitudes in G2 and G3 compared with G1 at all sites; non-significantly shorter latencies were identified at various sites. At several locations, G3 evoked non-significantly increased amplitudes and longer latencies with shorter latencies to other sites compared with G2 in all components. The MBI (G3) group exhibited significantly increased WCST, RAVLTIM and RAVLTDR scores compared with G1.&#x0D; Conclusion: These findings indicate MBI patients may have mild auditory, cognitive and executive dysfunctions with good auditory memory. MBI was associated with mild depression.&#x0D; Bangladesh Journal of Medical Science Vol.18(3) 2019 p.557-566

NMDA receptors of blood lymphocytes anticipate cognitive performance variations in healthy volunteers

Working memory (WM) system, temporarily stores information and uses this information for complex cognitive tasks. WM connects memory, emotional feelings and perception. Evidence compelling that N-methyl d-aspartate receptor (NMDAR) expression relatively affect WM performance in animal models. It has been suggested some peripheral blood lymphocyte's (PBL) receptors are similar with neuronal receptors in the brain, so we measured PBL's receptors changes as a marker of the neuronal receptor. In this study, we examined one hundred adult men with Wisconsin Card Sorting Test (WCST) as a tool for primary screening for executive function (EF) which include WM. Then, we selected fifty individuals with high and low WCST scores. With digit span and symmetry span tasks, we screened 20 samples for high WM group and 19 samples for low WM group. After separating PBL, we measured mRNA expression level changes in NMDAR subunits with Reverse transcription-polymerase chain reaction method. We demonstrated that GluN2D increased and GluN3A decreased in individuals with high WM compared with the low WM (P < .01 and P < .001, respectively). The expression levels of GluN2A, GluN2B, and GluN3B were not altered between two groups (P > .05). Modifying the PBL receptors could be future approaches to defend memory loss and concentrate the senses over WM-related processes in physiological and pathological statuses. We hypothesized that increasing in GluN2 subunits and decreasing in GluN3 subunits led to improving current via NMDAR and subsequently affect WM.

Effect of olanzapine combined with repetitive transcranial magnetic stimulation in the treatment of schizophrenia with auditory hallucination

Objective To study the effect of olanzapine combined with repetitive transcranial magnetic stimulation(rTMS) in the treatment of phonism dominated schizophrenia. Methods From August 2015 to November 2016, 112 patients with phonism based schizophrenia in Ningbo Kangning Hospital were selected in the research.According to the different treatment, the patients were divided into observation group and control group, with 56 cases in each group.The observation group was treated with olanzapine combined with rTMS chemotherapy, the control group was treated with olanzapine.Before and after treatment, the positive and negative symptom scale(PANSS) score, Wisconsin Card Sorting Test(WCST) score of the two groups were observed.The clinical efficacy was compared between the two groups. Results Before treatment, there were no statistically significant differences in PANSS score and WCST score between the two groups(all P>0.05). After treatment for 1 week, 2 weeks, 4 weeks, the PANSS scores of the two groups were significantly lower than those before treatment(F=170.710, 106.028, 28.530, 30.328, 25.806, 10.832, 203.342, 372.253, all P 0.05). Conclusion Olanzapine combined with rTMS is effective in the treatment of schizophrenia, and olanzapine combined with rTMS is more effective in improving the cognitive ability of patients than olanzapine alone. Key words: Schizophrenia; Auditory hallucination; Olanzapine; Repetitive transcranial magnetic stimulation

Cognitive Ability and the L evel of Serum Homocysteine Correlations in First-Episode Schizophrenia Subjects

Objective: To explore relationships between cognitive ability and first-episode schizophrenia patient serum homocysteine (Hcy) levels. Methods: One hundred and twelve (112) first-episode schizophrenia patients (FESP) were selected for the schizophrenia group (SG) and 100 healthy volunteers were selected as the healthy control group (CG or HCG). High homocysteine septicemia (HHcy) and serum Hcy levels were compared between the two. SG Patient psychiatric symptoms were assessed using the Positive and Negative Symptoms Scale (PANSS). Hcy and Non-Hcy subjects cognitive abilities were assessed using the Wisconsin Card Sorting Test (WCST) and MATRICS Consensus Cognitive in Schizophrenia (MCCB). Results: SG serum Hcy levels were significantly higher than HG Hcy levels with a statistical significance (p 0.05) way. The difference in the MCCB total score (89.22 ± 3.06) of HHcy SG subjects and non-HHcy SG subjects (96.11 ± 2.74) was a statistically significant (p < 0.05). WCST scores, categories completed (Cc) and correct responses (Rc) of HHcy subjects compared to non-HHcy patients were significantly lower and was statistically significant (p < 0.05). HHcy subjects error responses (Re), perseverative responses (Rp), and non-perseverative responses (nRp) were significantly higher than non-HHcy subjects and was statistically significant (p < 0.05). Conclusion: Serum Hcy elevation may be used as a laboratory assistant diagnostic index for cognitive dysfunction severity in first-episode schizophrenics.

Efficacy of group cognitive rehabilitation therapy in multiple sclerosis.

Cognitive impairment occurs in 40%-65% of patients with multiple sclerosis (MS). Several techniques for cognitive rehabilitation (CR) in these patients have been evaluated; however, the results have been controversial. In this study, we investigated the efficacy of group compensatory CR in patients with MS-related cognitive impairment. Thirty-four female patients with diagnosed relapsing-remitting MS and evidence of impaired cognitive function were included and randomized to intervention (n=17) and control (n=17) groups. CR intervention consisted of eight 2-hour sessions of comprehensive group CR over a 4-week period that focused on improvement of memory, attention, and executive function. As placebo, the control group received the same number of non-therapeutic group sessions. Assessment of cognitive function was performed before intervention (pretest), at the end of intervention (post-test), and 3months later (follow-up). The study population included 34 patients with a mean age of 35.5years. Statistical comparison of memory assessments at 3-month follow-up showed significantly higher scores in the CR group than in the control group (93.33 vs 86.40 for Addenbrooke's Cognitive Examination test and 16.58 vs 12.00 for visual memory, 19.32 vs 14.05 for verbal memory, and 51.28 vs 44.41 for general scores on the Memory Functioning Questionnaire test, respectively). Wisconsin card sorting test score comparison showed significantly lower total time consumption in the CR group than in the control group (308.1 vs 340.8seconds, respectively). Behavior rating inventory of executive function-adultscores in all four subtests were significantly higher in the CR group than in the control group (40.25 vs 55.4 for behavioral regulation index, 51.16 vs 68.6 for metacognition index, and 97.41 vs 124.00 for global executive composite, respectively). Attention was the only domain in which we did not observe any significant variation between groups in terms of post-test and follow-up scores. This study supports the efficacy of group CR in the improvement of cognitive function in patients with MS.

Neuropsychological Profile of Specific Executive Dysfunctions in Patients with Deficit and Non-deficit Schizophrenia.

Objectives: Although it has been shown that there are more profound deficits present in deficit schizophrenia (DS) patients than in non-deficit schizophrenia (NDS) patients, there still remain some matters requiring further investigation. In this context, we formulated three research aims: (1) to compare executive functions between the investigated groups, (2) to determine the relationship between particular aspects of executive functions within the groups, and (3) to draw up a neuropsychological profile for executive functions.Methods: The study involved 148 schizophrenia patients divided into two groups on the basis of the Schedule for the Deficit Syndrome: DS (n = 70) and NDS (n = 78). Patients were matched for sex, age, years of education, and overall cognitive functioning. For assessing executive functions we used the Wisconsin Card Sorting Test (WCST), the Trail Making Test (TMT), the Phonemic Verbal Fluency Test (VFT P), the Stroop Color and Word Test (SCWT), and the Go/No Go task (GNG).Results: Deficit schizophrenia patients scored lower on the WCST and TMT (relative flexibility) than did the NDS patients. There were no inter-group differences in the VFT P, SCWT (relative inhibition), or GNG. There were significant correlations between WCST and TMT scores in both groups. The general neuropsychological profiles were similar in both groups.Conclusion: Deficit schizophrenia patients exhibited slightly greater interference with concept formation and non-verbal cognitive flexibility. Therefore, such problems may be specific to this particular type of schizophrenia. These results may be useful for the development of neuropsychological diagnostic methods for patients with schizophrenia.