scholarly journals Changes in Processing Speed, Cognitive Flexibility, and Selective Attention over a Four-Week Treatment Period in Inpatients with Moderate to Severe Depression

2021 ◽  
Vol 32 (3) ◽  
pp. 129-140
Author(s):  
Brooke C. Schneider ◽  
Sabrina Diedrich ◽  
Marit Hauschildt ◽  
Sarah V. Biedermann ◽  
Sönke Arlt ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Selective Attention ◽  
Cognitive Performance ◽  
Treatment Period ◽  
Cognitive Flexibility ◽  
Processing Speed ◽  
Severe Depression ◽  
Cognitive Change ◽  
Practice Effects ◽  
Cognitive Improvement

Abstract. Cognitive dysfunction among individuals with depression is associated with reduced functional status, and cognitive improvement is often an important treatment goal. We compared changes in cognitive performance over four weeks among 45 inpatients with a unipolar depressive disorder completing inpatient treatment to that of 20 controls on measures of processing speed and set-shifting (Trail Making Test), as well as selective attention (Test d2). In the patients, depressive symptoms improved significantly and with a large effect over the treatment period ( d = 1.22–1.81). Among the three cognitive domains examined, the most pronounced reductions among patients compared to controls were observed in cognitive flexibility (Group effect: ηp2 = .04). The effect of Group; however, was not significant. Likewise, there were no significant improvements in cognitive flexibility over time, and changes in cognitive flexibility over the four-week period did not differ between the two groups (Group x Time interaction). Performances in selective attention and processing speed improved over the four-week period, though neither the effect of Group nor the interaction (Group x Time) was significant regarding these performances. Change in cognitive performance was not associated with changes in symptom severity (incl. remission status). Taken together, the significant improvements in selective attention and processing speed were largely attributable to practice effects. Our findings lend further support to the notion that cognitive flexibility, selective attention, and processing speed are independent of improvements in depressive symptoms. This study underscores the importance of including comparison groups to control for practice effects when examining cognitive change, and providing treatments specifically aimed at improving cognitive symptoms.

scholarly journals Basic and complex cognitive functions in Adult ADHD

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0256228
Author(s):  
Saleh M. H. Mohamed ◽  
Marah Butzbach ◽  
Anselm B. M Fuermaier ◽  
Matthias Weisbrod ◽  
Steffen Aschenbrenner ◽  
...  
Keyword(s):  
Working Memory ◽  
Selective Attention ◽  
Cognitive Flexibility ◽  
Processing Speed ◽  
Cognitive Functions ◽  
Neuropsychological Tests ◽  
Adult Adhd ◽  
Verbal Learning ◽  
Test Word ◽  
Basic Functions

Background Many clinical studies reported deficits in basic and complex cognitive functions in adults with Attention-Deficit/Hyperactivity Disorder (ADHD). However, the extent in which deficits in basic functions (i.e., processing speed and distractibility) contribute to complex cognitive impairments (i.e., working memory, planning, cognitive flexibility, memory functions) in adults with ADHD is not well-studied. So far, literature show only one study, revealing that basic functions explain 27–74% of executive dysfunctions. Yet, the authors reported that findings could be affected by the selection of neuropsychological tests. The goal of the present research is to replicate such a finding using a different sample and a different set of neuropsychological tests. Methods Forty-eight adult patients with ADHD were compared with 48 healthy controls in basic cognitive functions, namely processing speed and distractibility and more complex cognitive functions, namely selective attention, cognitive flexibility, planning, working memory, verbal fluency, and verbal memory. Basic and complex cognitive functions were assessed using the Vigilance and Sustained Attention, Selective Attention, N-Back, Tower of London, Trail Making Test, Word Fluency, and Verbal Learning and Memory. Results and conclusion Logistic regression analyses showed that impairments in complex cognitive functions explained 25% of the variance in ADHD diagnosis. The explained variance dropped from 25% to 9% after considering basic functions of processing speed and distractibility. This 64% reduction highlights the importance of basic functions for impairments in complex functions in patients with ADHD.

Tacrine in Alzheimer's Disease

1992 ◽  
Vol 160 (1) ◽  
pp. 36-40 ◽  
Author(s):  
Sarah Eagger ◽  
Nicola Morant ◽  
Raymond Levy ◽  
Barbara Sahakian
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Treatment Period ◽  
Practice Effects ◽  
Cognitive Tests ◽  
Rebound Effects ◽  
Short Intervals ◽  
Positive Effects ◽  
Cognitive Improvement ◽  
Practical Management

This paper concerns certain questions which arose during the analysis of a trial showing positive effects of tacrine in Alzheimer's disease. Cognitive improvement occurred during the first two weeks, reached a maximum at one month and was maintained during the rest of the three-month treatment period. Rebound effects were not detected in any of the key outcome variables, but were suggested by one of the supporting cognitive tests and other measures. Practice effects occurred on tests which were repeated at short intervals or too frequently. The paper discusses the significance of these findings for the interpretation of other trials and for practical management.

scholarly journals Depression, social support, executive functioning, functionality, and quality of life in institutionalized elderly people

2020 ◽  
Vol 8 (1) ◽  
pp. 288-302
Author(s):  
Anabela Ribeiro ◽  
Beatriz Rosa ◽  
Jorge Oliveira ◽  
Paulo Lopes
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Depressive Symptoms ◽  
Executive Functioning ◽  
Cognitive Performance ◽  
Social Isolation ◽  
Cognitive Flexibility ◽  
Neuropsychological Tests ◽  
Daily Living

Aim Our aim was to study the executive functioning, functionality, and quality of life of institutionalized old aged persons and to determine the potential roles of self-reported depression and satisfaction with social support on these domains. Method The sample comprised 36 volunteers (13 males and 23 females) aged between 71 and 94 years. The measures used consisted of well-established battery of neuropsychological tests. A comparative study was performed. Results Participants with depressive symptoms shown impaired executive functioning. Cognitive flexibility, functionality in instrumental activities of daily living, and quality of life are more affected in participants with higher levels of depression that also report higher levels of satisfaction with social support. Conclusion This result is intriguing and may highlight the relevance of considering not only depression, but also factors related to social isolation and loneliness in the explanation of cognitive performance, functionality, and quality of life.

537 Insomnia Symptoms and Subsequent Cognitive Performance in Older Adults: Are Depressive Symptoms and Vascular Disease Mediators?

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A212-A212
Author(s):  
Afsara Zaheed ◽  
Adam Spira ◽  
Ronald Chervin ◽  
Laura Zahodne
Keyword(s):  
Executive Function ◽  
Depressive Symptoms ◽  
Episodic Memory ◽  
Cognitive Performance ◽  
Processing Speed ◽  
Vascular Diseases ◽  
Cognitive Domains ◽  
Falling Asleep ◽  
Function Language ◽  
Insomnia Symptoms

Abstract Introduction Alzheimer’s disease and related dementias (ADRD) are growing public health concerns, and poor sleep may represent a modifiable risk factor. However, there is limited research on insomnia as a predictor of subsequent performance in different cognitive domains and mechanisms that might underlie domain-specific associations. The current study examined: (1) which insomnia symptoms predicted performance across five cognitive domains 14 years later, and (2) whether depressive symptoms and/or vascular diseases mediated these associations. Methods Participants included 2,496 adults aged 51+ in the Health and Retirement Study. Insomnia symptoms in 2002 (i.e., “baseline”) were quantified by four self-reported items on frequency of trouble falling asleep, nighttime awakenings, early awakenings, and feeling rested upon awakening. Cognition was assessed in 2016 as part of the Harmonized Cognitive Assessment Protocol and operationalized with five factor scores corresponding to episodic memory, executive function, language, visuoconstruction, and processing speed. Multiple regressions examined associations between baseline insomnia symptoms and subsequent cognitive performance, controlling for sociodemographics and baseline global cognitive performance. Mediation models tested whether associations were explained by self-reported depressive symptoms and/or vascular diseases (i.e., hypertension, heart disease, diabetes, and/or stroke) in 2014, controlling for baseline values. Results Only trouble falling asleep in 2002 was associated with cognition in 2016. Specifically, more frequent trouble falling asleep predicted poorer episodic memory, executive function, language and processing speed performance, but not visuoconstruction. These associations were mediated by depressive symptoms and vascular diseases in 2014 for all domains except episodic memory; only depressive symptoms mediated the association involving memory. After accounting for these mediators, direct effects of trouble falling asleep remained for episodic memory, executive function and language, but not processing speed. Conclusion Difficulty with sleep initiation may be more consequential for later-life cognition than other insomnia symptoms. Depressive symptoms and vascular diseases may partially drive these associations. We speculate that sleep-onset insomnia could mean less total sleep, immune dysfunction, or endocrine effects that worsen mood, vascular health, and cognition. Remaining associations indicate that additional research is needed to characterize other mechanisms through which sleep initiation problems could contribute to later impairments in frontal and temporal cognitive systems, which are implicated early in ADRD. Support (if any):

Exercise for Cognitive Improvement and Rehabilitation (EXCIR) Improves Attention and Executive Functions in Children with ADHD

2020 ◽  
Author(s):  
Vahid Nejati
Keyword(s):  
Selective Attention ◽  
Executive Functions ◽  
Inhibitory Control ◽  
Cognitive Flexibility ◽  
Sustained Attention ◽  
Cognitive Rehabilitation ◽  
Control Group ◽  
Children With Adhd ◽  
Cognitive Improvement ◽  
Experimental Group

Abstract Background: Physical activities improves cognitive functioning. The purpose of the present study is to effect of physical activity with progressive cognitive demands on attention and executive functions in children with ADHD. Methods: Thirty children with ADHD were randomly assigned into two equal experimental and control groups. The experimental group received 12 sessions of exercise for cognitive improvement and rehabilitation (EXCIR). Working memory, selective attention, sustained attention, inhibitory control and cognitive flexibility were administered pre- and post-intervention through 1-back test, Stroop test, attention registration test, go no go test and trial making test in order. The repeated measure ANOVAs were used for analysis.Results: The results showed that experimental group has a greater performance in selective attention, sustained attention, inhibitory control and cognitive flexibility compared to control group. Conclusions: These findings implicate that the cognitive rehabilitation program is advantageous for improvement of attention and executive functions in children with ADHD.

Sleep characteristics, cognitive performance, and gray matter volume: findings from the BiDirect Study

SLEEP ◽  
2020 ◽  
Author(s):  
Marco Hermesdorf ◽  
András Szentkirályi ◽  
Henning Teismann ◽  
Inga Teismann ◽  
Peter Young ◽  
...  
Keyword(s):  
Selective Attention ◽  
Cognitive Performance ◽  
Cognitive Flexibility ◽  
Gray Matter ◽  
Principal Components ◽  
Gray Matter Volume ◽  
Cortical Arousal ◽  
Frontal Pole ◽  
Matter Volume ◽  
Physiological Sleep

Abstract Study Objectives Sleep is essential for restorative metabolic changes and its physiological correlates can be examined using overnight polysomnography. However, the association between physiological sleep characteristics and brain structure is not well understood. We aimed to investigate gray matter volume and cognitive performance related to physiological sleep characteristics. Methods Polysomnographic recordings from 190 community-dwelling participants were analyzed with a principal component analysis in order to identify and aggregate shared variance into principal components. The relationship between aggregated sleep components and gray matter volume was then analyzed using voxel-based morphometry. In addition, we explored how cognitive flexibility, selective attention, and semantic fluency were related to aggregated sleep components and gray matter volume. Results Three principal components were identified from the polysomnographic recordings. The first component, primarily described by apnea events and cortical arousal, was significantly associated with lower gray matter volume in the left frontal pole. This apnea-related component was furthermore associated with lower cognitive flexibility and lower selective attention. Conclusions Sleep disrupted by cortical arousal and breathing disturbances is paralleled by lower gray matter volume in the frontal pole, a proposed hub for the integration of cognitive processes. The observed effects provide new insights on the interplay between disrupted sleep, particularly breathing disturbances and arousal, and the brain.

scholarly journals The Effects of Aerobic Exercise and Gaming on Cognitive Performance

2018 ◽  
Vol 61 (1) ◽  
pp. 73-83 ◽  
Author(s):  
Peter C. Douris ◽  
John P. Handrakis ◽  
Demitra Apergis ◽  
Robert B. Mangus ◽  
Rima Patel ◽  
...  
Keyword(s):  
Executive Function ◽  
Selective Attention ◽  
Aerobic Exercise ◽  
Cognitive Performance ◽  
Processing Speed ◽  
Video Gaming ◽  
Mixed Design ◽  
Attentional Capacity ◽  
Capacity Limits ◽  
B Test

AbstractThe purpose of our study was to investigate the effects of video gaming, aerobic exercise (biking), and the combination of these two activities on the domains of cognitive performance: selective attention, processing speed, and executive functioning. The study was a randomized clinical trial with 40 subjects (mean age 23.7 ± 1.8 years) randomized to one of four thirty-minute conditions: video gaming, biking, simultaneous gaming and biking, and a control condition. Cognitive performance was measured pre and post condition using the Stroop test and Trails B test. A mixed design was utilized. While video gaming, biking, simultaneous gaming and biking conditions improved selective attention and processing speed (p < 0.05), only the bike condition improved the highest order of cognitive performance, executive function (p < 0.01). There were no changes in cognitive performance for the control condition. Previous studies have shown that if tasks approach the limits of attentional capacity there is an increase in the overall chance for errors, known as the dual-task deficit. Simultaneous biking and gaming may have surpassed attentional capacity limits, ultimately increasing errors during the executive function tests of our cognitive performance battery. The results suggest that the fatiguing effects of a combined physically and mentally challenging task that extends after the exercise cessation may overcome the eventual beneficial cognitive effects derived from the physical exercise.

scholarly journals M60. EARLY VERSUS DELAYED PRESCRIPTION OF CLOZAPINE AND THE COGNITIVE PERFORMANCE ON SCHIZOPHRENIA

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S157-S158
Author(s):  
Silvia Amoretti ◽  
Marina Garriga ◽  
Gisela Mezquida ◽  
Andrea Mallorqui ◽  
Rafael Penadés ◽  
...  
Keyword(s):  
Working Memory ◽  
Executive Functions ◽  
Cognitive Performance ◽  
Processing Speed ◽  
Treatment Initiation ◽  
Cognitive Domains ◽  
Clozapine Treatment ◽  
Cognitive Improvement ◽  
Significant Difference ◽  
Late Treatment

Abstract Background Patients with schizophrenia display a wide and characteristic array of cognitive deficits. A range of factors has been shown to influence cognition, including cognitive reserve (CR). Amongst antipsychotics only clozapine has shown positive results on cognition to date. Although it is known that delayed initiation of clozapine may be related to poor clinical psychotic response, no previous results have been tested on relation to cognitive improvements. This study aimed to analyze the improvement in cognitive performance after starting clozapine treatment according to the early versus late treatment initiation after diagnosis. Methods 41 patients with schizophrenia were enrolled. All subjects were assessed clinically, neuropsychologically and functionally at baseline and at the 18th week of clozapine treatment. Premorbid IQ was calculated with the vocabulary subtest of the WAIS-III and it was considered a measure of CR. For study purposes, sample was divided into early or late treatment initiation of clozapine (± 3 years after diagnosis). Lineal mixed model analyses were used while confounding from different factors. Results There were no differences between groups in terms of gender, functional, clinical and neuropsychological outcomes at baseline and follow-up. Neither clozapine dose, nor plasma concentration of nor-clozapine, have been found to be different at 18 weeks. Significant difference in age was found (p&lt;0.001). In early initiation clozapine treatment group (n=22), improvements in working memory, attention, executive functions, and processing speed were found. Thus, CR was the only significant factor explaining these improvements in all cognitive domains, except in processing speed that was explained by time. Late onset group (n=19) improved their cognitive performance on working memory and executive functions, both explained by CR (not time or age). Discussion There were no differences between groups at baseline, except for age. Patients who started an early treatment of clozapine improved more cognitive domains at 18-week that those who started it later. In both cases, CR is a key factor in predicting cognitive improvement. Reducing clozapine treatment delay might represent immediate prospective improvements on cognitive domains in comparison with delayed start. Time-wise cognitive monitoring and CR enhancement at early stages of the psychotic illness/treatment may be helpful in order to prevent cognitive impairment.

scholarly journals Coming off cannabis: a cognitive and magnetic resonance imaging study in patients with multiple sclerosis

Brain ◽  
2019 ◽  
Vol 142 (9) ◽  
pp. 2800-2812 ◽  
Author(s):  
Anthony Feinstein ◽  
Cecilia Meza ◽  
Cristiana Stefan ◽  
Richard W. Staines
Keyword(s):  
Multiple Sclerosis ◽  
Executive Function ◽  
Functional Mri ◽  
Processing Speed ◽  
Visual Memory ◽  
Cognitive Change ◽  
Group Differences ◽  
Lesion Volume ◽  
Memory Processing ◽  
Cognitive Improvement

AbstractCognitive dysfunction affects 40–80% of patients with multiple sclerosis. Smoking cannabis may add to these deficits. It is unclear whether coming off cannabis results in cognitive improvement. To address this question, 40 patients with multiple sclerosis who started using cannabis after the onset of multiple sclerosis and who used it for at least 4 days a week over many years were divided by odd-even number selection into two groups: cannabis continuation and cannabis withdrawal. Assessments took place at baseline and after 28 days and included serial versions of the Brief Repeatable Neuropsychological Battery for multiple sclerosis containing tests of verbal and visual memory, processing speed and executive function; structural and functional MRI, the latter entailing a compatible version of the Symbol Digit Modalities Test; urine for cannabinoid metabolites to detect compliance with abstinence. Only those participants deemed globally impaired at baseline (failure on at least two cognitive domains) were enrolled. The results revealed that the two groups were well matched demographically and neurologically. One subject was removed from the withdrawal group because of failed abstinence. Urine analysis revealed the cannabinoid consumed was predominantly tetrahydrocannabinol (THC). There were no baseline between group cognitive differences, but by Day 28 the withdrawal group performed significantly better on every cognitive index (P < 0.0001 for all). Significant within group differences were present for every test over time, but only in the abstinent group (P < 0.0001 for all tests). There were no between group baseline or Day 28 differences in structural MRI indices (global atrophy, total T1 and T2 lesion volume). At index assessment the two groups had a similar performance on the functional MRI-compatible Symbol Digit Modalities Test and there were no group differences in brain activation. However, by Day 28, the withdrawal group completed more trials correctly (P < 0.012) and had a faster reaction time (P < 0.002), associated with significantly increased activation in brain regions known to be associated with performance of the test (bilateral inferior frontal gyri, caudate and declive/cerebellum, P < 0.001 for all regions). These results reveal that patients with multiple sclerosis who are frequent, long-term cannabis users can show significant improvements in memory, processing speed and executive function after 28 days of drug abstinence. The absence of similar improvements in a matched multiple sclerosis group that remained on cannabis shows that beneficial cognitive change after stopping cannabis is not solely attributable to the effects of practice.

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