Neuropsychological Alterations in Narcolepsy with Cataplexy and the Expression of Cognitive Deficits

2019 ◽  
Vol 26 (6) ◽  
pp. 587-595
Author(s):  
Pablo Medrano-Martinez ◽  
Rosa Peraita-Adrados
Keyword(s):  
Information Processing ◽  
Executive Function ◽  
Negative Correlation ◽  
Cognitive Deficits ◽  
Processing Speed ◽  
Disease Duration ◽  
Control Group ◽  
Depression Symptoms ◽  
Information Processing Speed ◽  
Significant Difference

AbstractObjectives:The objective of our study was to assess attention processes and executive function in patients with narcolepsy with cataplexy (NT1). To do so, we compared the results with those of a control group from the general population using an extensive neuropsychological test battery.Methods:We studied 28 patients with NT1 and 28 healthy control participants matched for age, gender, and educational level. They all completed questionnaires on sleepiness, anxiety, and depression symptoms. In addition, they underwent neuropsychological tests. The ability to maintain attention was assessed using three computer tasks with different levels of complexity.Results:Patients had significantly more daytime sleepiness than controls. A significant negative correlation between depression and disease duration was found in NT1 patients. The results of the anxiety questionnaire correlated with the presence of sleep paralysis. There were significant differences in information processing speed subtasks. Patients made significantly more omissions and generally reacted slower and more variably than controls in computerized tasks. As for executive function, patients performed worse in phonologic fluency tasks than controls. However, when the influence of processing speed on fluency tasks was statistically controlled, part of this significant difference disappeared.Conclusions:Our results indicate that the negative correlation between depression and disease duration probably reflects progressive adaptation to the functional burden of the disease. Information processing speed plays a fundamental role in the expression of cognitive deficits. We emphasized the need to control the influence of processing speed and sustained attention in the neuropsychological assessment of NT1 patients.

scholarly journals Cerebral small-vessel disease and decline in information processing speed, executive function and memory

Brain ◽  
2005 ◽  
Vol 128 (9) ◽  
pp. 2034-2041 ◽  
Author(s):  
Niels D. Prins ◽  
Ewoud J. van Dijk ◽  
Tom den Heijer ◽  
Sarah E. Vermeer ◽  
Jellemer Jolles ◽  
...  
Keyword(s):  
Information Processing ◽  
Executive Function ◽  
Processing Speed ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Small Vessel ◽  
Information Processing Speed ◽  
Vessel Disease

Abstract NS10: Patients with Mild and Moderate Stroke Have Frequent, Severe, and Persistent Impairment in Information Processing Speed

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Susan Alderman ◽  
Terri Armstrong ◽  
Geri Wood ◽  
Sean Savitz ◽  
Joshua Breier
Keyword(s):  
Information Processing ◽  
Processing Speed ◽  
Memory Impairment ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Stroke Recovery ◽  
Stroke Severity ◽  
Information Processing Speed ◽  
Significant Difference ◽  
Mild Stroke

Background: One year after stroke 50-70% of survivors have information processing speed (IPS) impairment. IPS is a complex, elemental cognitive function with close but separate relationships with memory, attention, executive function, reading, and writing. IPS impairment can be devastating, even without physical deficits. Hypothesis: The frequency and severity of IPS impairment in patients with acute stroke is unrelated to stroke severity. Methods: In a longitudinal study, 30 adults with acute mild (NIHSS <5) versus moderate stroke (NIHSS 5-12) were assessed for IPS and memory impairments at three time points (< 72 hours, Week 3, and Week 12). The Symbol Digit Modalities Test (SDMT) was the primary IPS instrument, scores below the norm (51-62 points) indicate impairment. Results: Using linear mixed model regression, no significant difference was noted between patients with mild and moderate stroke in frequency and severity of IPS impairment (p=0.2). All patients had baseline abnormal SDMT scores, improving 21% by Week 12 (p=.005) with one patient scoring as unimpaired (51 points). Patients with mild stroke (n=18) had baseline scores on average 53% lower than SDMT norm (mean score 24 (12), [95% CI] 6 [18, 30], Standard Error (SEM) 3) and 32% lower at Week 12 (mean 34 (11), [95% CI] 5 [29, 40], SEM 3). Patients with moderate stroke (n=12) had baseline SDMT scores 60% lower than norm (mean 21 (11), [95% CI] 6 [15, 27], SEM 3) and 39% lower by Week 12 (mean 31 (12), [95% CI] 7 [25, 38], SEM 3). Memory impairment at enrollment (<72 hours post stroke) was noted in 100% of patients with moderate stroke and 78% of patients with mild stroke; at Week 12 the frequency of memory impairment was equal in both groups (67%). Conclusion: IPS were critically impaired, in both mild and moderate stroke, with minimal spontaneous recovery at Week 12. IPS impairment is clinically significant during stroke recovery. IPS impairment should be considered in the planning of healthcare of stroke victims even with mild stroke.

scholarly journals Associations of the Lifestyle for Brain Health Index With Structural Brain Changes and Cognition: Results From the Maastricht Study

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012572
Author(s):  
Irene S Heger ◽  
Kay Deckers ◽  
Miranda T Schram ◽  
Coen DA Stehouwer ◽  
Pieter C Dagnelie ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Information Processing ◽  
Executive Function ◽  
White Matter ◽  
Processing Speed ◽  
Grey Matter ◽  
White Matter Hyperintensities ◽  
Information Processing Speed ◽  
Brain Health ◽  
Dementia Risk

Background and Objectives:Observational research has shown that a substantial proportion of all dementia cases worldwide is attributable to modifiable risk factors. Dementia risk scores might be useful to identify high-risk individuals and monitor treatment adherence. The objective of this study was to investigate whether a dementia risk score, the LIfestyle for BRAin health (LIBRA) index, is associated with MRI markers and cognitive functioning/impairment in the general population.Methods:Cross-sectional data was used from the observational population-based cohort of The Maastricht Study.. The weighted compound score of LIBRA (including twelve dementia risk and protective factors, e.g. hypertension, physical inactivity) was calculated, with higher scores indicating higher dementia risk. Standardized volumes of white matter, grey matter, CSF (as proxy for general brain atrophy), white matter hyperintensities, and presence of cerebral small vessel disease were derived from 3T MRI. Cognitive functioning was tested in three domains: memory, information processing speed, and executive function and attention. Values ≤1.5 SD below the average were defined as cognitive impairment. Multiple regression analyses and structural equation modelling were used, adjusted for age, sex, education, intracranial volume and type-2 diabetes.Results:Participants (n=4,164; mean age 59y; 49.7% men) with higher LIBRA scores (mean=1.19, range=-2.7 to +9.2), denoting higher dementia risk, had higher volumes of white matter hyperintensities (β=0.051, p=.002), and lower scores on information processing speed (β=-0.067, p=.001) and executive function and attention (β=-0.065, p=.004). Only in men, associations between LIBRA and volumes of grey matter (β=-0.093, p<.001), CSF (β=0.104, p<.001) and memory (β=-0.054, p=.026) were found. White matter hyperintensities and CSF volume partly mediated the association between LIBRA and cognition.Discussion:Higher health- and lifestyle-based dementia risk is associated with markers of general brain atrophy, cerebrovascular pathology and worse cognition, suggesting that LIBRA meaningfully summarizes individual lifestyle-related brain health. Improving LIBRA factors on an individual level might improve population brain health. Sex differences in lifestyle-related pathology and cognition need to be further explored.Classification of Evidence:This study provides Class II evidence that higher LIBRA scores are significantly associated with lower scores on some cognitive domains and a higher risk of cognitive impairment.

scholarly journals Stroop performance in multiple sclerosis: Information processing, selective attention, or executive functioning?

2008 ◽  
Vol 14 (5) ◽  
pp. 805-814 ◽  
Author(s):  
J.A.B. MACNIVEN ◽  
C. DAVIS ◽  
M.-Y. HO ◽  
C.M. BRADSHAW ◽  
E. SZABADI ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Information Processing ◽  
Executive Functioning ◽  
Patient Group ◽  
Processing Speed ◽  
Neuropsychological Test ◽  
Stroop Test ◽  
Control Group ◽  
Information Processing Speed ◽  
Impaired Performance

Cognitive impairments in information processing speed, attention and executive functioning are widely reported in patients with multiple sclerosis (MS). Several studies have identified impaired performance on the Stroop test in people with MS, yet uncertainty remains over the cause of this phenomenon. In this study, 25 patients with MS were assessed with a neuropsychological test battery including a computerized Stroop test and a computerized test of information processing speed, the Graded Conditional Discrimination Tasks (GCDT). The patient group was compared with an individually age, sex and estimated premorbid IQ-matched healthy control group. The patients' reaction times (RTs) were significantly longer than those of the controls on all Stroop test trials and there was a significantly enhanced absolute (RTincongruent-RTneutral) and relative (100·[RTincongruent-RTneutral]/RTneutral) Stroop interference effect for the MS group. The linear function relating RT to stimulus complexity in the GCDT was significantly steeper in the patient group, indicating slowed information processing. The results are discussed with reference to the difference engine model, a theory of diversity in speeded cognition. It is concluded that, in the assessment of people with MS, great caution must be used in the interpretation of performance on neuropsychological tests which rely on RT as the primary measure. (JINS, 2008, 14, 805–814.)

scholarly journals A comparison of cognitive performances between neuromyelitis optica spectrum disorder and multiple sclerosis patients in Indian context

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Swati Kumar ◽  
Goutam Gangopadhyay ◽  
Atanu Biswas ◽  
Souvik Dubey ◽  
Alak Pandit ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Information Processing ◽  
Executive Function ◽  
Neuromyelitis Optica ◽  
Processing Speed ◽  
Verbal Fluency ◽  
Spectrum Disorder ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Information Processing Speed

Abstract Background To compare the frequency and pattern of cognitive impairment in neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS) patients. Results Twenty NMOSD and forty MS patients were included. Clinical and detailed neuropsychological assessment was done using frontal assessment battery and Kolkata cognitive battery supplemented with additional standard tests for different domains of cognitive functions. Domain wise tests were performed and compared. 15/20 (75%) NMOSD and 32/40 (80%) MS patients had cognitive impairment (p = 0.65). Executive function, verbal fluency, information processing speed, visuo-constructional ability, attention, complex calculation, and memory were more commonly involved in NMOSD in decreasing order. Compared to MS, the pattern was similar except that verbal fluency was more impaired in NMOSD. Expanded Disability Status scale (EDSS) correlated with cognitive involvement in NMOSD (p = 0.02) as against MS. Conclusions Executive function, verbal fluencies, and information processing speed were more affected compared to visual and verbal memory in NMOSD patients. The pattern of cognitive performance was similar in the MS group, even though clinical and radiological characteristics and pathophysiology is different, suggesting similar brain involvement.

Targeted Cognitive Game Training Enhances Cognitive Performance in Multiple Sclerosis Patients Treated With Interferon Beta 1-a

2021 ◽  
Author(s):  
Shay Menascu ◽  
Roy Aloni ◽  
Mark Dolev ◽  
David Magalashvili ◽  
Keren Gutman ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Information Processing ◽  
Executive Function ◽  
Mild Cognitive Impairment ◽  
Cognitive Performance ◽  
Processing Speed ◽  
Interferon Beta ◽  
Training Group ◽  
Information Processing Speed

Abstract BackgroundPrevention of cognitive decline in Multiple Sclerosis (MS) is of major importance. We explored the effect of short-term computerized game training on cognitive performance in MS patients with mild cognitive impairment.MethodsWe enrolled in this prospective study 100 eligible MS patients treated with Interferon-beta-1a (Rebif). All had mild cognitive impairment in either executive function or information processing speed. Patients were randomized 1:1 to either use the cognitive games platform byHappyNeuron (HN) or receive no intervention. Executive function and information processing speed scores were measured at 3 and 6 months from baseline to evaluate the effect of game training on cognitive scores.ResultsIn both executive function and information processing speed, the game Training group showed significant improvement after 3 and 6 months. The Non-Training group showed mild deterioration in both domains at 3 months, and further deterioration that became significant at 6 months in executive function. Furthermore, at 6 months, the percent of patients in the Training group that improved or remained stable in both cognitive domains was significantly higher compared to the Non-Training group.ConclusionsOur findings suggest that cognitive game training has a beneficial effect on cognitive performance in MS patients suffering from mild cognitive impairment. While further evaluation is required to assess the longevity of that effect, we nonetheless recommend to MS patients to be engaged in cognitive gaming practice as part of a holistic approach to treating their condition.

scholarly journals P.004 Neurogenic orthostatic hypotension results in impaired information processing speed

2018 ◽  
Vol 45 (s2) ◽  
pp. S17-S17
Author(s):  
L Robinson ◽  
K Kimpinski
Keyword(s):  
Blood Pressure ◽  
Information Processing ◽  
Orthostatic Hypotension ◽  
Processing Speed ◽  
Stroop Test ◽  
Control Group ◽  
Neurogenic Orthostatic Hypotension ◽  
Information Processing Speed ◽  
Control Subjects ◽  
Increased Risk

Background: Neurogenic orthostatic hypotension (NOH) is characterized by a reduction in systolic blood pressure of ≥20 mmHg or diastolic blood pressure of ≥10 mmHg within three minutes of upright posture. NOH is prevalent in the elderly population who is at increased risk for cognitive decline, therefore it is imperative to investigate if there is a relationship between NOH and impaired cognition. Methods: Currently, 9 control subjects and 4 NOH patients have been recruited. Cognitive function is assessed using the symbol digit modalities test (SDMT) which assesses information processing speed and the Stroop test which measures response inhibition. SDMT and Stroop test are administered when the table is supine and during tilt. Results: NOH patients scored significantly worse on SDMT when lying (p=0.018) and standing (p=0.004) compared to the control group. Control subjects performed significantly better when standing for both SDMT (p=0.008) and Stroop (p=0.026), whereas NOH patients had similar scores when lying and standing for SDMT and Stroop. Conclusions: Preliminary results show that information processing speed is slower in NOH patients than controls in both the supine and standing positions. NOH patients have a more difficult time inhibiting unwanted responses compared to controls when standing, which is represented by a greater interference score in NOH patients.

scholarly journals Cognition and Cerebrovascular Reactivity in Midlife Women With History of Preeclampsia and Placental Evidence of Maternal Vascular Malperfusion

2021 ◽  
Vol 13 ◽  
Author(s):  
C. Elizabeth Shaaban ◽  
Caterina Rosano ◽  
Ann D. Cohen ◽  
Theodore Huppert ◽  
Meryl A. Butters ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Information Processing ◽  
Executive Function ◽  
Processing Speed ◽  
Cerebrovascular Reactivity ◽  
Midlife Women ◽  
Breath Hold ◽  
Information Processing Speed ◽  
Air Breathing

Background: Preeclampsia is emerging as a sex-specific risk factor for cerebral small vessel disease (SVD) and dementia, but the reason is unknown. We assessed the relationship of maternal vascular malperfusion (MVM), a marker of placental SVD, with cognition and cerebral SVD in women with and without preeclampsia. We hypothesized women with both preeclampsia and MVM would perform worst on information processing speed and executive function.Methods: Women (n = 45; mean 10.5 years post-delivery; mean age: 41 years; 42.2% Black) were classified as preeclampsia-/MVM-, preeclampsia+/MVM-, or preeclampsia+/MVM+. Information processing speed, executive function, and memory were assessed. In a pilot sub-study of cerebrovascular reactivity (CVR; n = 22), cerebral blood flow during room-air breathing and breath-hold induced hypercapnia were obtained via arterial spin labeling MRI. Non-parametric tests and regression models were used to test associations.Results: Between-group cognitive differences were significant for information processing speed (p = 0.02); preeclampsia+/MVM+ had the lowest scores. Cerebral blood flow increased from room-air to breath-hold, globally and in all regions in the three groups, except the preeclampsia+/MVM+ parietal region (p = 0.12). Lower parietal CVR (less change from room-air breathing to breath-holding) was correlated with poorer information processing speed (partial ρ = 0.63, p = 0.005) and executive function (ρ = 0.50, p = 0.03) independent of preeclampsia/MVM status.Conclusion: Compared to women without preeclampsia and MVM, midlife women with both preeclampsia and MVM have worse information processing speed and may have blunted parietal CVR, an area important for information processing speed and executive function. MVM in women with preeclampsia is a promising sex-specific indicator of cerebrovascular integrity in midlife.

scholarly journals Targeted cognitive game training enhances cognitive performance in multiple sclerosis patients treated with interferon beta 1-a

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Shay Menascu ◽  
Roy Aloni ◽  
Mark Dolev ◽  
David Magalashvili ◽  
Keren Gutman ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Information Processing ◽  
Executive Function ◽  
Mild Cognitive Impairment ◽  
Cognitive Performance ◽  
Processing Speed ◽  
Interferon Beta ◽  
Training Group ◽  
Information Processing Speed

Abstract Background Prevention of cognitive decline in Multiple Sclerosis (MS) is of major importance. We explored the effect of a 6 months computerized game training program on cognitive performance in MS patients with mild cognitive impairment. Methods This was a single-center, randomized prospective study. We enrolled in this study 100 eligible MS patients treated with Interferon-beta-1a (Rebif). All had mild cognitive impairment in either executive function or information processing speed. Patients were randomized 1:1 to either use the cognitive games platform by HappyNeuron (HN) or receive no intervention. Executive function and information processing speed scores were measured at 3 and 6 months from baseline to evaluate the effect of game training on cognitive scores. Results In both executive function and information processing speed, the game Training group showed significant improvement after 3 and 6 months. The Non-Training group showed mild deterioration in both domains at 3 months, and further deterioration that became significant at 6 months in executive function. Furthermore, at 6 months, the percent of patients in the Training group that improved or remained stable in both cognitive domains was significantly higher compared to the Non-Training group. Conclusions Our findings suggest that cognitive game training has a beneficial effect on cognitive performance in MS patients suffering from mild cognitive impairment. While further evaluation is required to assess the longevity of that effect, we nonetheless recommend to MS patients to be engaged in cognitive gaming practice as part of a holistic approach to treating their condition.

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