scholarly journals Cognitive outcomes in meningioma patients undergoing surgery: individual changes over time and predictors of late cognitive functioning

2019 ◽  
Vol 21 (7) ◽  
pp. 911-922 ◽  
Author(s):  
Sophie J M Rijnen ◽  
Ikram Meskal ◽  
Marjan Bakker ◽  
Wouter De Baene ◽  
Geert-Jan M Rutten ◽  
...  
Keyword(s):  
Cognitive Functioning ◽  
Cognitive Performance ◽  
Cognitive Deficits ◽  
Cognitive Rehabilitation ◽  
Cognitive Outcomes ◽  
Cognitive Outcome ◽  
Normative Sample ◽  
Before And After ◽  
Preoperative Predictors ◽  
Over Time

Abstract Background Meningioma patients are known to face cognitive deficits before and after surgery. We examined individual changes in cognitive performance over time and identified preoperative predictors of cognitive functioning 12 months after surgery in a large sample of meningioma patients. Methods Patients underwent neuropsychological assessment (NPA) using CNS Vital Signs 1 day before (T0) and 3 (T3) and 12 (T12) months after surgery. Patients’ sociodemographically corrected scores on 7 cognitive domains were compared with performance of a normative sample using one-sample z tests and chi-square tests of independence. Reliable change indices with correction for practice effects were calculated for individual patients. Linear mixed effects models were used to identify preoperative predictors of performance at T12. Results At T0, 261 patients were assessed, and 229 and 82 patients were retested at T3 and T12, respectively. Patients showed impaired cognitive performance before and after surgery, and although performance improved on the group level, cognitive scores remained significantly lower than in the normative sample up to T12. On the individual level, performance remained stable in the majority of patients. Better preoperative performance, younger age, male sex, and higher educational level predicted better late cognitive performance. Conclusions Meningioma patients face serious and persistent pre- and postsurgical cognitive deficits. A preoperative NPA together with sociodemographic characteristics may provide valuable information on the late cognitive outcome of individual meningioma patients. These results can help to inform patients and clinicians on late cognitive outcomes at an early stage, and emphasizes the importance of presurgical NPA and timely cognitive rehabilitation.

scholarly journals Cognitive Functioning and Late-Life Depression

2014 ◽  
Vol 20 (5) ◽  
pp. 461-467 ◽  
Author(s):  
Aaron M. Koenig ◽  
Rishi K. Bhalla ◽  
Meryl A. Butters
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Cognitive Functioning ◽  
Neuropsychological Assessment ◽  
Cognitive Deficits ◽  
Late Life ◽  
Cognitive Outcomes ◽  
Review Of The Literature ◽  
Late Life Depression ◽  
The Relationship

AbstractThis brief report provides an introduction to the topic of cognitive functioning in late-life depression (LLD). In addition to providing a review of the literature, we present a framework for understanding the heterogeneity of cognitive outcomes in this highly prevalent disorder. In addition, we discuss the relationship between LLD and dementia, and highlight the importance of regularly assessing cognitive functioning in older adults who present with depressive symptoms. If cognitive deficits are discovered during a neuropsychological assessment, we recommend referral to a geriatric psychiatrist or cognitive neurologist, for evaluation and treatment of the patient’s symptoms. (JINS, 2014, 20, 1–7)

Research … How Fun Is That? Interesting Questions Relative to the Effects of Exercise on Cognitive Performance

2014 ◽  
Vol 3 (3) ◽  
pp. 151-160 ◽  
Author(s):  
Jennifer L. Etnier
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Cognitive Functioning ◽  
Cognitive Performance ◽  
Cognitive Outcomes ◽  
Future Research ◽  
North American Society ◽  
National Meeting ◽  
The North ◽  
American Society

In developing a senior lecture for the 2014 national meeting of the North American Society for the Psychology of Sport and Physical Activity, I had the opportunity to reflect upon a career of research and to focus on three interesting questions that my colleagues and I have attempted to address. These questions have led to several studies that all revolve around identifying ways to increase the effects of exercise on cognitive performance. In particular, the questions examine the possibility of increasing effects by focusing on particular populations (e.g., older adults, children) and by increasing our understanding of dose-response relationships between exercise parameters (e.g., intensity, duration) and cognitive outcomes. I present empirical evidence relative to each of these questions and provide directions for future research on physical activity and cognitive functioning.

scholarly journals Effect of revascularization on cognitive outcomes in intracranial steno-occlusive disease: a systematic review

2019 ◽  
Vol 46 (2) ◽  
pp. E14 ◽  
Author(s):  
Bradley Kolb ◽  
Hassan Fadel ◽  
Gary Rajah ◽  
Hamidreza Saber ◽  
Ali Luqman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Decline ◽  
Cognitive Performance ◽  
Observational Studies ◽  
English Language ◽  
Randomized Trials ◽  
Occlusive Disease ◽  
Cognitive Outcomes ◽  
Thomson Reuters ◽  
Before And After

OBJECTIVESteno-occlusive diseases of the cerebral vasculature have been associated with cognitive decline. The authors performed a systematic review of the existing literature on intracranial steno-occlusive disease, including intracranial atherosclerosis and moyamoya disease (MMD), to determine the extent and quality of evidence for the effect of revascularization on cognitive performance.METHODSA systematic search of PubMed/MEDLINE, the Thomson Reuters Web of Science Core Collection, and the KCI Korean Journal Database was performed to identify randomized controlled trials (RCTs) in the English-language literature and observational studies that compared cognitive outcomes before and after revascularization in patients with steno-occlusive disease of the intracranial vasculature, from which data were extracted and analyzed.RESULTSNine papers were included, consisting of 2 RCTs and 7 observational cohort studies. Results from 2 randomized trials including 142 patients with symptomatic intracranial atherosclerotic steno-occlusion found no additional benefit to revascularization when added to maximal medical therapy. The certainty in the results of these trials was limited by concerns for bias and indirectness. Results from 7 observational trials including 282 patients found some cognitive benefit for revascularization for symptomatic atherosclerotic steno-occlusion and for steno-occlusion related to MMD in children. The certainty of these conclusions was low to very low, due to both inherent limitations in observational studies for inferring causality and concerns for added risk of bias and indirectness in some studies.CONCLUSIONSThe effects of revascularization on cognitive performance in intracranial steno-occlusive disease remain uncertain due to limitations in existing studies. More well-designed randomized trials and observational studies are needed to determine if revascularization can arrest or reverse cognitive decline in these patients.

scholarly journals A-70 Beyond Validity: The Utility of the Test of Memory Malingering in Assessing Cognitive Functioning in Veterans

2019 ◽  
Vol 34 (6) ◽  
pp. 930-930
Author(s):  
J Clark ◽  
B Zaccari ◽  
S Tadrous-Furnanz ◽  
D Storzbach
Keyword(s):  
Cognitive Functioning ◽  
Cognitive Performance ◽  
Verbal Learning ◽  
Cognitive Outcomes ◽  
Test Of Memory Malingering ◽  
Memory And Attention ◽  
Substance Dependent ◽  
Neuropsychological Assessment Battery ◽  
Iraqi Freedom

Abstract Objective The objective of the present analyses was to replicate analyses from an interim sample which found that scores on the Test of Memory Malingering (TOMM) predicted objective cognitive outcomes in the domains of attention and verbal learning even when invalid TOMM scores were excluded. Methods Participants consisted of 92 United States Veterans from Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) enrolled at the VA Portland Health Care System and recruited for a larger study on the role of blast exposure. Veterans were included if they had a valid performance on the TOMM (Trial 2 score > 47) were not currently substance dependent. Data was analyzed through linear regressions examining raw TOMM Trial 1 scores to predict objective cognitive performance on measures of memory and attention from the Neuropsychological Assessment Battery (NAB). Results In performance on the tasks of Driving Scenes (Beta = .328, p < .01), Initial Story Learning (Beta = .209, p < .05), and Attention Index Percentile (Beta = .208, p < .05) of the NAB, TOMM Trial 1 was a significant predictor. TOMM scores were also predictive of years of education (Beta = .303, p < .01). Conclusion These findings replicate results derived from interim data. TOMM Trial 1 significantly predicted objective cognitive performance in OEF/OIF Veterans even when invalid performance was excluded. This suggests that TOMM has a utility in assessing cognitive functioning and not just valid performance. Similarly, results also suggest that the TOMM may be sensitive to education as well.

scholarly journals Cognitive functioning and predictors thereof in patients with 1–10 brain metastases selected for stereotactic radiosurgery

2019 ◽  
Vol 145 (2) ◽  
pp. 265-276 ◽  
Author(s):  
Wietske C. M. Schimmel ◽  
Karin Gehring ◽  
Patrick E. J. Hanssens ◽  
Margriet M. Sitskoorn
Keyword(s):  
Information Processing ◽  
Brain Metastases ◽  
Cognitive Functioning ◽  
Cognitive Performance ◽  
Cognitive Flexibility ◽  
Verbal Memory ◽  
Test Performance ◽  
Neuropsychological Test ◽  
Cognitive Outcome ◽  
Individual Level

Abstract Purpose Information on predictive factors of cognitive functioning in patients with (multiple) brain metastases (BM) selected for radiosurgery may allow for more individual care and may play a role in predicting cognitive outcome after radiosurgery. The aim of this study was to evaluate cognitive performance, and predictors thereof, in patients with 1–10 BM before radiosurgery. Methods Cognition was measured before radiosurgery using a standardized neuropsychological test battery in patients with 1–10 BM (expected survival > 3 months; KPS ≥ 70; no prior BM treatment). Regression formulae were constructed to calculate sociodemographically corrected z scores. Group and individual cognitive functioning was analyzed. Multivariable regression was used to explore potential predictors. Results Patients (N = 92) performed significantly worse than controls (N = 104) on all 11 test variables (medium-large effect sizes for 8 variables). Percentages of impairment were highest for information processing (55.3%), dexterity (43.2%) and cognitive flexibility (28.7%). 62% and 46% of patients had impairments in at least two, or three test variables, respectively. Models including combinations of clinical and psychological variables were predictive of verbal memory, psychomotor speed, information processing and dexterity. Neither number nor volume of metastases predicted patients’ test performance. Conclusions Already before radiosurgery, almost half of the patients suffered from severe cognitive deficits in at least three test variables. At group and individual level, information processing, cognitive flexibility, and dexterity were most affected. These cognitive impairments may impair daily functioning and patients’ ability to make (shared) treatment decisions. Both clinical (symptomatic BM; timing of BM diagnosis) and psychological (mental fatigue) characteristics influenced cognitive performance. Clinical trial information Cognition and Radiation Study A (CAR-Study A; ClinicalTrials.gov Identifier: NCT02953756; Medical Ethics Committee file number: NL53472.028.15/P1515).

scholarly journals P05.61 Cognitive outcomes in meningioma patients undergoing surgery: individual changes over time and predictors of late cognitive functioning

2018 ◽  
Vol 20 (suppl_3) ◽  
pp. iii317-iii317
Author(s):  
S Rijnen ◽  
I Meskal ◽  
M Bakker ◽  
G Rutten ◽  
K Gehring ◽  
...  
Keyword(s):  
Cognitive Functioning ◽  
Cognitive Outcomes ◽  
Changes Over Time ◽  
Over Time

The UCLA study of Predictors of Cognitive Functioning Following Moderate/Severe Pediatric Traumatic Brain Injury

2016 ◽  
Vol 22 (5) ◽  
pp. 512-519 ◽  
Author(s):  
Lisa M. Moran ◽  
Talin Babikian ◽  
Larissa Del Piero ◽  
Monica U. Ellis ◽  
Claudia L. Kernan ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Cognitive Functioning ◽  
Cognitive Performance ◽  
Behavioral Problems ◽  
Parental Education ◽  
Injury Severity ◽  
Cognitive Outcomes ◽  
Acute Injury

AbstractObjectives:Following pediatric moderate-to-severe traumatic brain injury (msTBI), few predictors have been identified that can reliably identify which individuals are at risk for long-term cognitive difficulties. This study sought to determine the relative contribution of detailed descriptors of injury severity as well as demographic and psychosocial factors to long-term cognitive outcomes after pediatric msTBI.Methods:Participants included 8- to 19-year-olds, 46 with msTBI and 53 uninjured healthy controls (HC). Assessments were conducted in the post-acute and chronic stages of recovery. Medical record review provided details regarding acute injury severity. Parents also completed a measure of premorbid functioning and behavioral problems. The outcome of interest was four neurocognitive measures sensitive to msTBI combined to create an index of cognitive performance.Results:Results indicated that none of the detailed descriptors of acute injury severity predicted cognitive performance. Only the occurrence of injury, parental education, and premorbid academic competence predicted post-acute cognitive functioning. Long-term cognitive outcomes were best predicted by post-acute cognitive functioning.Discussion:The findings suggest that premorbid factors influence cognitive outcomes nearly as much as the occurrence of a msTBI. Furthermore, of youth with msTBI who initially recover to a level of moderate disability or better, a brief cognitive battery administered within several months after injury can best predict which individuals will experience poor long-term cognitive outcomes and require additional services. (JINS, 2016,22, 1–8)

Factors Associated with Cognitive Outcomes After First-Ever Ischemic Stroke: The Impact of Small Vessel Disease Burden and Neurodegeneration

2021 ◽  
pp. 1-11
Author(s):  
Pi-Shan Sung ◽  
Kang-Po Lee ◽  
Po-Yu Lin ◽  
Hui-Chen Su ◽  
Rwei-Ling Yu ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cognitive Performance ◽  
Small Vessel Disease ◽  
Cognitive Outcomes ◽  
Small Vessel ◽  
Factors Associated ◽  
Post Stroke ◽  
Vessel Disease ◽  
Potential Factors ◽  
Over Time

Background: Differences exist regarding post-stroke cognitive outcomes. Objective: The aim of this study investigates the potential factors associated with post-stroke cognitive performance and trajectories. Methods: We performed a prospective cohort study using serial monitoring of cognitive function over a 1-year period after a first-ever ischemic stroke. Small vessel disease (SVD) burden and hippocampal atrophy (HA) were evaluated using the modified cerebral small vessel disease scores (mCSVD) and medial temporal atrophy score (MTA) scores. A generalized estimating equation (GEE) model and a group-based trajectory model (GBTM) was used to analyze the potential factors associated with post-stroke cognitive outcomes. Results: A total of 112 patients were enrolled. The GEE model showed that all patients, regardless of initial cognitive performance, had a tendency to show an increase in the Montreal Cognitive Assessment over time. The cognitive performance was better in male patients with higher education levels (p = 0.046 and p <  0.001, respectively), but tended to be worse in patients with higher SVD burden and HA. The GBTM model grouped patients into low, intermediate, and high performance (LP, IP, and HP) after stroke. A higher SVD burden, rather than HA and initial stroke severity and location, independently predicted a higher odds of poor post-stroke cognitive trajectory (being in the LP group) after stroke (adjusted odds ratio 2.74, 95%CI 1.09–6.86). Conclusion: In patients with first-ever mild stroke, cognitive improvement over time was evident. The detrimental impact of the SVD burden may outweigh the effect of HA or acute stroke insult on the post-stroke cognitive trajectory during the 1-year follow-up.

scholarly journals Cognitive performance in distinct groups of children undergoing epilepsy surgery—a single-centre experience

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e7790
Author(s):  
Barbora Benova ◽  
Anezka Belohlavkova ◽  
Petr Jezdik ◽  
Alena Jahodová ◽  
Martin Kudr ◽  
...  
Keyword(s):  
Cognitive Performance ◽  
Epilepsy Surgery ◽  
Cognitive Outcomes ◽  
Tertiary Centre ◽  
Large Patient ◽  
Significant Difference ◽  
Before And After ◽  
Individual Variables ◽  
One Year ◽  
Paediatric Epilepsy

Background We aimed first to describe trends in cognitive performance over time in a large patient cohort (n = 203) from a single tertiary centre for paediatric epilepsy surgery over the period of 16 years divided in two (developing—pre-2011 vs. established—post-2011). Secondly, we tried to identify subgroups of epilepsy surgery candidates with distinctive epilepsy-related characteristics that associate with their pre- and post-surgical cognitive performance. Thirdly, we analysed variables affecting pre-surgical and post-surgical IQ/DQ and their change (post- vs. pre-surgical). Methods We analysed IQ/DQ data obtained using standardized neuropsychological tests before epilepsy surgery and one year post-surgically, along with details of patient’s epilepsy, epilepsy surgery and outcomes in terms of freedom from seizures. Using regression analysis, we described the trend in post-operative IQ/DQ. Cognitive outcomes and the associated epilepsy- and epilepsy surgery-related variables were compared between periods before and after 2011. Using multivariate analysis we analysed the effect of individual variables on pre- and post-operative IQ/DQ and its change. Results Epilepsy surgery tends to improve post-surgical IQ/DQ, most significantly in patients with lower pre-surgical IQ/DQ, and post-surgical IQ/DQ strongly correlates with pre-surgical IQ/DQ (Rho = 0.888, p < 0.001). We found no significant difference in pre-, post-surgical IQ/DQ and IQ/DQ change between the periods of pre-2011 and post-2011 (p = 0.7, p = 0.469, p = 0.796, respectively). Patients with temporal or extratemporal epilepsy differed in their pre-surgical IQ/DQ (p = 0.001) and in IQ/DQ change (p = 0.002) from those with hemispheric epilepsy, with no significant difference in post-surgical IQ/DQ (p = 0.888). Groups of patients with different underlying histopathology showed significantly different pre- and post-surgical IQ/DQ (p < 0.001 and p < 0.001 respectively) but not IQ/DQ change (p = 0.345).Variables associated with severe epilepsy showed effect on cognitive performance in multivariate model. Discussion Post-surgical IQ/DQ strongly correlates with pre-surgical IQ/DQ and greatest IQ/DQ gain occurs in patients with lower pre-surgical IQ/DQ scores. Cognitive performance was not affected by changes in paediatric epilepsy surgery practice. Pre- and post-operative cognitive performances, as well as patients’ potential for cognitive recovery, are highly dependent on the underlying aetiology and epileptic syndrome.

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