scholarly journals Preliminary evidence of motor impairment among polysubstance 3,4-methylenedioxymethamphetamine users with intact neuropsychological functioning

2010 ◽  
Vol 16 (6) ◽  
pp. 1047-1055 ◽  
Author(s):  
CHAD A. BOUSMAN ◽  
MARIANA CHERNER ◽  
KRISTEN T. EMORY ◽  
DANIEL BARRON ◽  
PATRICIA GREBENSTEIN ◽  
...  
Keyword(s):  
Neuropsychological Functioning ◽  
Neuropsychological Testing ◽  
Motor Impairment ◽  
Preliminary Evidence ◽  
Group Differences ◽  
Motor Speed ◽  
Motor Impairments ◽  
Significant Group ◽  
Lifetime Number ◽  
Other Substances

AbstractNeuropsychological disturbances have been reported in association with use of the recreational drug “ecstasy,” or 3,4-methylenedioxymethamphetamine (MDMA), but findings have been inconsistent. We performed comprehensive neuropsychological testing examining seven ability domains in 21 MDMA users (MDMA+) and 21 matched control participants (MDMA−). Among MDMA+ participants, median [interquartile range] lifetime MDMA use was 186 [111, 516] doses, with 120 [35–365] days of abstinence. There were no significant group differences in neuropsychological performance, with the exception of the motor speed/dexterity domain in which 43% of MDMA+ were impaired compared with 5% of MDMA− participants (p= .004). Motor impairment differences were not explained by use of other substances and were unrelated to length of abstinence or lifetime number of MDMA doses. Findings provide limited evidence for neuropsychological differences between MDMA+ and MDMA− participants with the exception of motor impairments observed in the MDMA+ group. However, replication of this finding in a larger sample is warranted. (JINS, 2010,16, 1047–1055.)

scholarly journals C-02 An Unbiased Biomarker Approach to Neuropsychological, Behavioral, and Psychiatric Symptoms in a Mixed Clinical Sample

2019 ◽  
Vol 34 (6) ◽  
pp. 1029-1029
Author(s):  
N Hawley ◽  
L Bennett ◽  
A Ritter
Keyword(s):  
Psychiatric Symptoms ◽  
Clinical Sample ◽  
Neuropsychological Testing ◽  
Cleveland Clinic ◽  
Group Differences ◽  
Semantic Fluency ◽  
Clinical Dementia Rating ◽  
Significant Group ◽  
Clinical Criteria

Abstract Objective Suspected Non-Alzheimer’s Pathology (SNAPs) are individuals who present with a cognitive syndrome meeting clinical criteria for Alzheimer’s disease (AD) but are found to lack underlying AD pathology. Current clinical criteria for AD lack specificity in predicting underlying neurodegenerative pathology. With the advent of amyloid positron emission tomography (PET) the presence of amyloid pathology can now be identified in vivo. Using a biomarker-based approach, we aimed to characterize the neuropsychological, behavioral, and psychiatric profile of SNAPs in contrast to those with AD pathology (APs). Method 76 individuals (26 amyloid-negative [SNAPs], 50 amyloid- positive [APs]) completed neuropsychological testing and a PET amyloid scan as a part of a longitudinal observational study at the Cleveland Clinic LRCBH. Individuals meeting NIA-A criteria for MCI or mild AD with a Clinical Dementia Rating score of .05 -1 were included. Amyloid status was determined via clinical read of two clinicians trained in reading amyloid scans (neuroradiologist and neuropsychiatrist). Independent samples t tests assessed group differences between SNAPs and APs across cognitive, behavioral, and psychiatric measures. Results Mini-Mental State Examination scores were equivalent between SNAPs and APs. SNAPs performed significantly better on measures of verbal and nonverbal memory, set-shifting, and semantic fluency, as well as aspects of processing speed and working memory (all p’s < .05). Additionally, SNAPs endorsed more RBD symptoms (p < .05). No significant group differences were observed across neuropsychiatric or functional measures. Conclusion(s) Differences in an individual’s neuropsychological, behavioral, and psychiatric profile in consideration with a biomarker approach may provide key insights and afford greater diagnostic clarity.

scholarly journals Effects of Multiple Mild TBIs on Neuropsychological Functioning, Psychiatric Symptoms, and Neurobehavioral/Health-Related Symptoms in Combat-Exposed Veterans

2019 ◽  
Vol 34 (6) ◽  
pp. 851-851
Author(s):  
V Merritt ◽  
S Jurick ◽  
L Crocker ◽  
S Hoffman ◽  
A Keller ◽  
...  
Keyword(s):  
Brain Injuries ◽  
Sleep Problems ◽  
Psychiatric Symptoms ◽  
Pain Catastrophizing ◽  
Neuropsychological Functioning ◽  
Self Report ◽  
Group Differences ◽  
Significant Group ◽  
Health Related ◽  
Pain Symptoms

Abstract Objective The purpose of this study was to examine the influence of multiple mild traumatic brain injuries (mTBI) on objective neuropsychological functioning and subjective symptom reporting in a sample of combat-exposed Veterans. Method Participants included 80 combat-exposed Iraq/Afghanistan Veterans (91.3% male; age: M = 34.33, SD = 6.44) divided into three groups based on mTBI history: 0 mTBIs (n = 33), 1-2 mTBIs (n = 26), and 3+ mTBIs (n = 21). Veterans with mTBI were assessed, on average, 7.5 years following their most recent mTBI. Participants underwent comprehensive neuropsychological testing and completed self-report measures assessing psychiatric and neurobehavioral/health-related symptoms. Results ANCOVAs adjusting for level of combat exposure showed no group differences on the memory and attention/executive functioning composite scores (p’s>.05). Additionally, groups did not differ with respect to symptoms of posttraumatic stress and depression (p’s>.05). In contrast, there were significant group differences on all neurobehavioral/health-related symptoms, including post-concussive symptom clusters (p’s < .001-.005), sleep problems (p = .024), pain symptoms (p < .001), and pain catastrophizing (p = .049). In general, Veterans with 3+ mTBIs self-reported the most severe symptoms, followed by Veterans with 1-2 mTBIs and 0 mTBIs. Conclusions History of multiple, remote mTBIs is associated with elevated subjective neurobehavioral/health-related symptoms in a dose-dependent fashion, but is not associated with objective neuropsychological functioning or ratings of psychiatric distress in combat-exposed Veterans. These results advance understanding of the long-term consequences of multiple mTBIs in this population and suggest that Veterans with 3 or more mTBIs may especially benefit from (1) early treatments aimed at ameliorating sleep and pain symptoms and (2) therapies that provide tools to temper catastrophic thinking about these symptoms.

Abstract 204: Efficacy of Mirror Therapy Combined with Afferent Stimulation on Motor Impairment, Motor Function, and Daily Function in Chronic Stroke: A Randomized Controlled Trial

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Ching-yi Wu ◽  
Pai-chuan Huang ◽  
Keh-chung Lin ◽  
Wen-ling Huang
Keyword(s):  
Motor Cortex ◽  
Primary Motor Cortex ◽  
Motor Impairment ◽  
Manual Dexterity ◽  
Cortical Reorganization ◽  
Mirror Therapy ◽  
Motor Impairments ◽  
Significant Group ◽  
Afferent Stimulation ◽  
Daily Function

Background: Studies have found that both mirror therapy (MT) and mesh-glove (MG) afferent stimulation reduce motor impairments after stroke. MT might recruit the premotor cortex or balance neural activation within the primary motor cortex toward the affected hemisphere. And MG stimulation might result in plastic changes in the primary motor cortex and induce an effect on motor cortical excitability. Adding MG to MT might further augment cortical reorganization. In addition, combining two treatment protocols has been advocated as a way to improve treatment efficacy in stroke rehabilitation. A combined protocol such as MT combined with MG (MT+MG) might broaden aspects of treatments effects. This study aimed to demonstrate the comparative efficacy of MT+MG, MT, and a conventional task-oriented training (CT). Methods: This study recruited forty-three participants with chronic stoke at the mild to moderate level of motor impairments. Participants were randomly assigned to one of the three groups: MT+MG, MT, or CT groups. All participants in these three groups received a 1.5-hour training session per day, 5 days/week for 4 weeks. Treatment outcomes included motor impairment measured by the Fugl-Meyer Assessment (FMA), motor functions measured by the Box and Block Test (BBT) indicating manual dexterity and 10-Meter Walk Test (10 MWT) indicating ambulation function, and daily function measured by the ABILHAND Questionnaire. Evaluations were administered before and after the 4-week treatments. Results: Significant effects on the FMA (p =.045), the BBT (p = .019), and the 10-MWT (velocity of self-pace: p =.011; stride of self-pace: p =.002; velocity of ASAP: p = .025) were found among the three groups. Post hoc analyses showed that MT+MG and MT groups elicited significantly better FMA total scores compared to the CT group (p = 0.0032 and 0.0031). MT+MG and CT groups performed significantly better on the BBT compared to the MT group (p = 0.007 and 0.036). MT+MG and CT groups performed significantly better on three of four 10 MWT subscales, the velocity of self-pace (p = 0.004 and 0.031), the stride of self-pace (p = 0.016 and 0.016), and the velocity of as-soon-as-possible (p = 0.014 and 0.023) than MT. There were no significant group effects on ABILHAND Questionnaire. Conclusions: The MT+MG group specifically demonstrated superior benefits on manual dexterity and ambulation function over the MT group. Both MT+MG and MT treatments showed significant benefits on the reduction of motor impairment. However, MT+MG and MT protocols did not yield extra benefits on daily function. Future studies might include functional task practice to enhance generalizability of the treatment effects to daily function in patients with various severities of motor impairments. The retention effect of MT + MG needs further investigation.

A-80 Global Neuropsychological Assessment (GNA): Preliminary Evidence of Clinical Utility

2019 ◽  
Vol 34 (6) ◽  
pp. 940-940
Author(s):  
J Raines ◽  
A Carroll ◽  
L Morra ◽  
D Schretlen
Keyword(s):  
Neuropsychological Assessment ◽  
Spatial Working Memory ◽  
Cognitive Disorders ◽  
Preliminary Evidence ◽  
Effect Sizes ◽  
Cognitive Test ◽  
Medical Psychology ◽  
Group Differences ◽  
Healthy Controls ◽  
Significant Group

Abstract Objective The Global Neuropsychological Assessment (GNA) is an 18-minute cognitive test battery with seven subtests that is being translated into multiple languages and standardized worldwide. This study seeks to evaluate the GNA’s ability to discriminate patients from healthy controls. Data Selection We are recruiting adults who are referred to the Johns Hopkins Medical Psychology Clinic for neuropsychological assessment, along with caregivers or family members who accompany them for this ongoing study. We have administered the GNA to 10 patients with mild cognitive impairment or another disorder and 22 healthy controls to date. Data Synthesis Patients and healthy controls did not differ on age, sex, or years of education.Independent samples t-tests showed that patients performed worse than healthy controls (p < 0.05) on 14 measures derived from five of seven GNA subtests. These included measures of episodic memory, processing speed, semantic verbal fluency, set-switching, and spatial working memory. Cohen’s d effect sizes of 1.0 to 2.2 were observed. The groups did not differ on tests of digit repetition or an anxiety/depression screener (Patient Health Questionnaire-4) although these revealed small to medium group differences (Cohen’s ds = 0.27 to 0.71) as well. Conclusions Five of seven GNA subtests effectively discriminated controls from patients with mixed cognitive disorders. If effect sizes found for the other two GNA subtests persist, they also will show significant group differences as the sample sizes increase. In related studies, we are examining inter-form equivalence and other psychometric properties of the GNA.

Abstract 9956: Effects of Robot-Assisted Therapy Combined With Electrical Stimulation on Motor Control, Motor Impairment, and Daily Function in Stroke Patients

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Ching-yi Wu ◽  
Keh-chung Lin ◽  
Hsiao-wen Chen ◽  
Man-chiao Hsiao
Keyword(s):  
Electrical Stimulation ◽  
Motor Control ◽  
Upper Limb ◽  
Peak Velocity ◽  
Motor Impairment ◽  
Group Differences ◽  
Stroke Patients ◽  
Robot Assisted ◽  
Significant Group ◽  
Daily Function

Introduction: Upper-limb robot-assisted therapy (RT) has been shown to improve motor recovery in chronic stroke patients. Some review studies demonstrated that compared with severely affected patients, moderately affected patients with stroke were more responsive to RT. Neuromuscular electrical stimulation (ES) can effectively induce muscle contraction for stroke patients with severe motor deficit. Thus, ES might serve as an adjuvant intervention for RT to optimize treatment effects. This study aimed to examine the effects of combined robot-assisted therapy with electrical stimulation (RT+ES) on motor control, motor impairment, and daily function. Methods: Twenty-nine patients (mean age: 65 years, mean onset time: 26 months) were randomized into one of the three groups: RT+ES, robot-assisted therapy with sham electrical stimulation (RT+sham ES), and control therapy (CT) groups. Each patient received 90-100 minutes of therapy, 5 days per week for a total of 4 weeks. Outcome measures, representing motor control, motor impairment, and daily function, were kinematic variables, the Fugl-Meyer Assessment (FMA), and the Motor Activity Log (MAL), respectively. Kinematic variables included total displacement (TD), peak velocity (PV), percentage of time where peak velocity occurs (PPV), and movement units (MU). All assessments were performed before and after treatment. Analysis of covariance was used to evaluate training effects. Results: Results showed significant group differences in two kinematic variables (PPV, F = 1.82, p < 0.01; normalized MU, F = 3.41, p = 0.05), proximal subscore of FMA (F = 3.58, p = 0.05) and MAL (amount of use, F = 4.38, p = 0.03; quality of movement, F = 3.71, p = 0.05) in favor of RT+ES. There were no significant group differences for TD, PV, the total FMA score, and the FMA distal subscore. Conclusions: These findings suggest that RT+ES may improve motor control by increasing movement smoothness, reduce motor impairment of proximal part of upper limb, and enhance the performance on daily activities. Further studies could may involve the outcome measures at the participation level such as performance on extended activities of daily living or community reintegration, and evaluate the follow-up effects for RT+ES training.

Spiral Maze Performance in Dementia

1998 ◽  
Vol 87 (1) ◽  
pp. 328-330 ◽  
Author(s):  
Robert Taylor
Keyword(s):  
Neuropsychological Tests ◽  
Task Complexity ◽  
Neuropsychological Functioning ◽  
Group Differences ◽  
Maze Performance ◽  
Significant Group ◽  
Alzheimer Dementia

58 patients with probable Alzheimer dementia and 58 with probable multi-infarct dementia were given spiral mazes of differing complexity and 20 other neuropsychological tests. When age and over-all neuropsychological functioning were taken into account, spiral maze performance was poorer for patients with multi-infarct dementia but there were no significant group differences related to task complexity or indices of performance strategy

scholarly journals Associations Between Multiple Remote Mild TBIs and Objective Neuropsychological Functioning and Subjective Symptoms in Combat-Exposed Veterans

2020 ◽  
Vol 35 (5) ◽  
pp. 491-505 ◽  
Author(s):  
Victoria C Merritt ◽  
Sarah M Jurick ◽  
Laura D Crocker ◽  
Molly J Sullan ◽  
McKenna S Sakamoto ◽  
...  
Keyword(s):  
Brain Injuries ◽  
Neuropsychological Functioning ◽  
Combat Exposure ◽  
Self Report ◽  
Group Differences ◽  
Subjective Symptoms ◽  
Cross Sectional ◽  
Significant Group ◽  
Psychiatric Distress ◽  
Pain Symptoms

Abstract Objective The purpose of this study was to evaluate relationships between multiple mild traumatic brain injuries (mTBIs) and objective and subjective clinical outcomes in a sample of combat-exposed Veterans, adjusting for psychiatric distress and combat exposure. Method In this cross-sectional study, 73 combat-exposed Iraq/Afghanistan Veterans were divided into three groups based on mTBI history: 0 mTBIs (n = 31), 1–2 mTBIs (n = 21), and 3+ mTBIs (n = 21). Veterans with mTBI were assessed, on average, 7.78 years following their most recent mTBI. Participants underwent neuropsychological testing and completed self-report measures assessing neurobehavioral, sleep, and pain symptoms. Results MANCOVAs adjusting for psychiatric distress and combat exposure showed no group differences on objective measures of attention/working memory, executive functioning, memory, and processing speed (all p’s &gt; .05; ηp2 = .00–.06). In contrast, there were significant group differences on neurobehavioral symptoms (p’s = &lt; .001–.036; ηp2 = .09–.43), sleep difficulties (p = .037; ηp2 = .09), and pain symptoms (p &lt; .001; ηp2 = .21). Pairwise comparisons generally showed that the 3+ mTBI group self-reported the most severe symptoms, followed by comparable symptom reporting between the 0 and 1–2 mTBI groups. Conclusions History of multiple, remote mTBIs is associated with elevated subjective symptoms but not objective neuropsychological functioning in combat-exposed Veterans. These results advance understanding of the long-term consequences of repetitive mTBI in this population and suggest that Veterans with 3+ mTBIs may especially benefit from tailored treatments aimed at ameliorating specific neurobehavioral, sleep, and pain symptoms.

scholarly journals A-04 The Relationship of ApoE Status and Cognition in Non-demented Older Adults

2020 ◽  
Vol 35 (6) ◽  
pp. 794-794
Author(s):  
Hawley N ◽  
Caldwell J ◽  
Miller J ◽  
Shan G ◽  
Salazar A ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Performance ◽  
Verbal Memory ◽  
Medial Temporal Lobe ◽  
Neuropsychological Testing ◽  
Total Sample ◽  
Group Differences ◽  
Boston Naming Test ◽  
Significant Group ◽  
Nonverbal Memory

Abstract Objective Apolipoprotein (ApoE)-e4 is well established as a genetic risk factor for Alzheimer’s disease (AD) as well as a predictor for the rate of cognitive decline in AD. Among older adults without dementia, some research has found that e4 carriers have worse episodic memory compared to e4 non-carriers, whereas others have not found this association. The present study examined differences in cognitive performance between ApoE-e4 carriers and non-carriers. Method 91 non-demented individuals (age range: 55–87) were genotyped for ApoE (41 e4 carriers, 49 e4 non-carriers) and completed neuropsychological testing as a part of a longitudinal study at the Center for Neurodegeneration and Translational Neuroscience. Cognitively normal (CN) and mild cognitive impairment (MCI) participants were included (41 CN, 49 MCI). Group differences between e4 carriers and non-carriers were compared across cognitive measures after controlling for age, gender, and education. Results In the total sample, e4 carriers performed significantly worse across measures of verbal and nonverbal memory, as well as on the Boston Naming Test and Symbol Digit Modalities Test (all p’s &lt; .05). No significant group differences were observed across visuospatial or executive function tasks. When diagnostic subgroups were examined, e4 carriers had worse verbal memory than non-carriers in the MCI group, but there was no effect of e4 status on cognition among CN participants. Conclusion(s) These findings support that ApoE-e4 positivity is associated with worse cognitive performance, especially on tasks related to medial temporal lobe function, among non-demented older adults. In MCI, worse verbal memory in e4 carriers likely reflects increased progression of underlying AD pathology.

Comparison of Auditory, Language, Memory, and Attention Abilities in Children With and Without Listening Difficulties

2020 ◽  
Vol 29 (4) ◽  
pp. 710-727
Author(s):  
Beula M. Magimairaj ◽  
Naveen K. Nagaraj ◽  
Alexander V. Sergeev ◽  
Natalie J. Benafield
Keyword(s):  
Auditory Processing ◽  
Short Term Memory ◽  
Group Differences ◽  
Long Term Memory ◽  
Short Term ◽  
Significant Group ◽  
Term Memory ◽  
Memory And Attention ◽  
Speed And Accuracy

Objectives School-age children with and without parent-reported listening difficulties (LiD) were compared on auditory processing, language, memory, and attention abilities. The objective was to extend what is known so far in the literature about children with LiD by using multiple measures and selective novel measures across the above areas. Design Twenty-six children who were reported by their parents as having LiD and 26 age-matched typically developing children completed clinical tests of auditory processing and multiple measures of language, attention, and memory. All children had normal-range pure-tone hearing thresholds bilaterally. Group differences were examined. Results In addition to significantly poorer speech-perception-in-noise scores, children with LiD had reduced speed and accuracy of word retrieval from long-term memory, poorer short-term memory, sentence recall, and inferencing ability. Statistically significant group differences were of moderate effect size; however, standard test scores of children with LiD were not clinically poor. No statistically significant group differences were observed in attention, working memory capacity, vocabulary, and nonverbal IQ. Conclusions Mild signal-to-noise ratio loss, as reflected by the group mean of children with LiD, supported the children's functional listening problems. In addition, children's relative weakness in select areas of language performance, short-term memory, and long-term memory lexical retrieval speed and accuracy added to previous research on evidence-based areas that need to be evaluated in children with LiD who almost always have heterogenous profiles. Importantly, the functional difficulties faced by children with LiD in relation to their test results indicated, to some extent, that commonly used assessments may not be adequately capturing the children's listening challenges. Supplemental Material https://doi.org/10.23641/asha.12808607

Behavioral and emotional differences between children of divorce and children from intact families: Clinical significance and mediating processes *This study is part of a dissertation () supported from the German research community.

2002 ◽  
Vol 61 (1) ◽  
pp. 5-14 ◽  
Author(s):  
Andreas Schick
Keyword(s):  
Self Esteem ◽  
Research Community ◽  
Children Of Divorce ◽  
Group Differences ◽  
Significant Group ◽  
Intact Families ◽  
Divorce Adjustment ◽  
Theoretical Assumptions ◽  
German Research ◽  
Clinically Significant

The following study is based on a sample of 241 9-13-year-old children (66 children from divorced parents, 175 children from non divorced parents). They were examined for differences regarding anxiety, self-esteem, different areas of competence, and degree of behavior problems. With a focus on the children’s experiences, the clinically significant differences were examined. Clinically significant differences, revealing more negative outcomes for the children of divorce, were only found for social anxiety and unstable performance. The frequency of clinical significant differences was independent of the length of time the parents had been separated. The perceived destructiveness of conflict between the parents one of four facets of interparental conflict in this study functioned as a central mediator of the statistically significant group differences. The children’s perception of the father’s social support was a less reliable indicator of variance. Further studies should try to make underlying theoretical assumptions about the effects of divorce more explicit, to distinguish clearly between mediating variables, and to investigate them with respect to specific divorce adjustment indicators.

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