Neuropsychological Performance 1 Year After Status Epilepticus in Adults

2020 ◽  
Author(s):  
Arne Gramstad ◽  
Kjersti N Power ◽  
Bernt A Engelsen
Keyword(s):  
Status Epilepticus ◽  
Cognitive Dysfunction ◽  
Cognitive Rehabilitation ◽  
Neuropsychological Test ◽  
Verbal Learning ◽  
Word List ◽  
Negative Influence ◽  
Brain Lesions ◽  
Adult Intelligence Scale

Abstract Objectives Status epilepticus (SE) may lead to or worsen cognitive dysfunction. Few studies have evaluated magnitude and profile of cognitive dysfunction in patients after SE. Characterization of cognitive deficits may be important for rehabilitation and follow-up. We assessed cognitive function in a consecutive, non-selected group of relatively healthy survivors with a comprehensive neuropsychological test battery. Methods A total of 33 patients (24 men, 9 women; mean age 54,9 years, mean education 11,8 years) were tested 1 year after SE with Wechsler Adult Intelligence Scale Fourth edition (WAIS-IV), Rey Auditory Verbal Learning Test, subtests from the Wechsler Memory Scale–Revised, Phonemic and Semantic word list generation, and the Halstead-Reitan Battery. Premorbid IQ was estimated with a Norwegian version of the National Adult Reading Test (NART). Results were compared to published norms. Regression analyses and independent groups t-tests were performed to assess the influence of background variables. Results Mean performance generally was about one standard deviation below average. Full scale IQ (WAIS-IV) was significantly reduced compared to estimated premorbid IQ (NART). Negative influence on cognition of brain lesions visible on computed tomography or magnetic resonance imaging and duration of SE >30 min was shown by group comparisons. Conclusions SE represents a marker for possible cognitive dysfunction, and follow-up with neuropsychological assessment and cognitive rehabilitation seems warranted in most patients. Complex problem-solving abilities with high general sensitivity to brain impairment showed the most prominent reduction. Otherwise, no specific profile of domain affection was found. Structural brain lesions and duration of SE over 30 min represent risk factors for cognitive deficit.

scholarly journals A-011 Stability of Impairment Rating Discrepancies in a Longitudinal Observational Alzheimer’s Study

2020 ◽  
Vol 35 (6) ◽  
pp. 801-801
Author(s):  
Kaylegian J ◽  
Ritter A ◽  
Caldwell J
Keyword(s):  
Rating Scale ◽  
Digit Span ◽  
Neuropsychological Test ◽  
Verbal Learning ◽  
Clinical Dementia Rating ◽  
Adult Intelligence Scale ◽  
Wechsler Adult Intelligence Scale ◽  
Wide Range Achievement Test ◽  
Wide Range ◽  
Wechsler Adult Intelligence

Abstract Objective The present study investigated frequency and 12-month persistence of discrepant Clinical Dementia Rating (CDR) and comprehensive neuropsychological assessment ratings of impairment. Methods We examined CDR and neuropsychological test scores from year 1 and 2 visits of 162 adults enrolled in a longitudinal observational study. Neuropsychological measures included Wide Range Achievement Test, American National Adult Reading Test, Rey Auditory Verbal Learning Test, Brief Visuospatial Memory Test-Revised, Dementia Rating Scale 2nd edition, Boston Naming, Verbal Fluency/Color Word Interference from the Delis-Kaplan Executive Function System, Judgment of Line Orientation, Trail Making Test, Symbol Digit Modalities Test, and Digit Span/Letter Number Sequencing from The Wechsler Adult Intelligence Scale 4th edition. Discrepancies were defined as: CDR = 0 and 2 test impairments, CDR = 0.5 and > 5 or 0 impairments, CDR = 1 and 0 impairments. Results Including all test domains, 40.1% of participants in year 1 and 44.3% in year 2 showed discrepancies. 69% maintained this discrepancy at year 2 and 68% of these showed no change in discrepancy type. Considering only memory tests, 37% of participants in year 1 and 28.4% in year 2 showed discrepancies, with 45% maintaining at year 2 (74% showing no change in discrepancy type). A majority of discrepancies observed in both years 1 and 2 revealed the CDR was under reporting impairment compared to the neuropsychological battery year. Conclusions The results provide evidence that within our study population, impairment as rated by the CDR frequently does not match the level of measured cognitive impairment and this observation is stable year to year.

scholarly journals A-202 A Normative Study of Neuropsychological Functioning in a Clinical Sample of Aviation Pilots

2020 ◽  
Vol 35 (6) ◽  
pp. 997-997
Author(s):  
Crane A ◽  
Dacosta A ◽  
Roccaforte A ◽  
Davies M ◽  
Prewett D ◽  
...  
Keyword(s):  
Clinical Sample ◽  
Neuropsychological Functioning ◽  
Neuropsychological Test ◽  
Verbal Learning ◽  
Federal Aviation Administration ◽  
Normative Study ◽  
Short Delay ◽  
Adult Intelligence Scale ◽  
Neuropsychological Evaluations ◽  
Aviation Pilots

Abstract Objective Neuropsychological evaluations are mandated by the Federal Aviation Administration (FAA) to ensure that pilots with certain known or suspected medical/neurological or psychiatric conditions do not have neurocognitive sequelae that would impair their ability to safely carry out their responsibilities (Federal Aviation Administration, 2020). However, intact pilots’ performance on cognitive measures appears unique compared to the general population (Causse, Dehias, Arexis, & Pastor, 2011). In an effort to make appropriate comparisons, the current study thus presents normative data on the FAA core neuropsychological test battery. Method Sixty-three aviation pilots (age 25–62, M = 44.9, SD = 0.235) underwent neuropsychological testing using the FAA core battery following referral for alcohol utilization. All participants were considered to be cognitively intact at the time of their evaluations. Results Participants’ average IQ on the Wechsler Adult Intelligence Scale 4th edition (WAIS-IV) fell in the Superior range using traditional norms (M = 125.29, SD = 10.04). Pilots performed better than “average” across a number of neuropsychological measures. For example, pilots completed Trails-A in 19.38 seconds (SD = 4.10) and Trails-B in 40.73 seconds (SD = 10.56), which is approximately 10 seconds faster than average among individuals aged 35–44 years. Meanwhile, pilots recalled an average of 15.08 out of 16 words on the California Verbal Learning Test Version 2 (CVLT-II) short delay and 15.34 words on the CVLT-II long delay. Conclusion(s) This study provides comparison data for future neuropsychological evaluations of pilots with alcohol concerns. The data suggests that pilots generally outperform the civilian population across neuropsychological tests.

the Role of Cognition in Vocational Functioning of Schizophrenic Patients

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1 ◽  
Author(s):  
C.A. Popescu ◽  
I.V. Miclutia
Keyword(s):  
Cognitive Functioning ◽  
Cognitive Dysfunction ◽  
Work Experience ◽  
Cognitive Rehabilitation ◽  
Negative Symptoms ◽  
Mental Health Problems ◽  
Clinical Symptoms ◽  
Neuropsychological Test ◽  
Rehabilitation Programs ◽  
Schizophrenic Patients

Background:Unemployment is a factor that negatively affects the health of the entire population and is an important cause of exclusion, affecting persons with severe mental health problems. the rise of unemployment rates for these persons contrasts with the dropping of unemployment rate for the general population. Schizophrenia is associated with long-term unemployment. Cognitive dysfunction, rather than clinical symptoms, may be the most important factor in the ability to work for patients with this disorder.Aims:This study aims to evaluate the relationship between clinical symptoms, cognitive functioning and employment status in patients with schizophrenia.Methods:40 patients with schizophrenia were evaluated with PANSS, CANTAB (Cambridge Neuropsychological Test Automated Battery) and with an interview regarding work experience.Results:The results suggest that poor premorbid function, negative symptoms and cognitive dysfunction are significantly associated with unemployment in schizophrenia.Conclusions:The results of this study confirm the importance of cognitive functioning as a predictor of work function in patients with schizophrenia and the need of cognitive rehabilitation programs.

Prodromal frontal/executive dysfunction predicts incident dementia in Parkinson's disease

2003 ◽  
Vol 9 (1) ◽  
pp. 17-24 ◽  
Author(s):  
STEVEN PAUL WOODS ◽  
ALEXANDER I. TRÖSTER
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Verbal Learning ◽  
Word List ◽  
Executive Dysfunction ◽  
Wisconsin Card Sorting Test ◽  
Card Sorting ◽  
Incident Dementia ◽  
One Year

To identify the cognitive characteristics predictive of incident dementia in Parkinson's disease (PD), we examined the baseline neuropsychological profiles of 18 initially non-demented patients with PD who met diagnostic criteria for dementia (PDD) at one-year follow-up. PDD participants' baseline neuropsychological test scores were compared to the baseline performance of 18 patients with PD who did not meet criteria for dementia at one-year follow-up (PDND) and 18 normal controls (NC). The three groups were matched on baseline demographic and disease variables. Relative to the PDND group, the incident PDD participants demonstrated significantly poorer performance on digits backward (Wechsler Memory Scale–Revised), word list learning and recognition (California Verbal Learning Test), and perseverative errors on the Wisconsin Card Sorting Test. Each of these baseline neuropsychological variables exhibited adequate diagnostic classification accuracy in predicting PDD and PDND group membership at follow-up. These results suggest that subtle frontal/executive dysfunction is evident during the immediate PDD prodrome and may be of prognostic value in identifying PD patients at risk for dementia. Accordingly, neuropsychological evaluation may facilitate early identification of PDD and thereby inform appropriate dispositional planning. (JINS, 2003, 9, 17–24.)

Dynamic Assessment of Cognitive Rehabilitation Potential in Schizophrenic Persons and in Elderly Persons With and Without Dementia

2001 ◽  
Vol 17 (2) ◽  
pp. 112-119 ◽  
Author(s):  
Karl H. Wiedl ◽  
Henning Schöttke ◽  
M. Dolores Calero Garcia
Keyword(s):  
Cognitive Rehabilitation ◽  
Clinical Training ◽  
Dynamic Assessment ◽  
Verbal Learning ◽  
Verbal Working Memory ◽  
Wisconsin Card Sorting Test ◽  
Elderly Persons ◽  
Card Sorting ◽  
Static Test ◽  
Rehabilitation Potential

Summary: Dynamic assessment is a diagnostic approach in which specific interventions are integrated into assessment procedures to estimate cognitive modifiability. The study investigates the utility of this approach in persons with compelling rehabilitational needs. Samples of schizophrenic patients and of elderly with and without dementia were assessed with dynamic versions of the Wisconsin Card Sorting Test and the Auditory Verbal Learning Test. Both tests were administered by applying specific procedures of verbal mediation designed to increase performance. Results demonstrated superior predictive validity with regard to proficiency in a clinical training in schizophrenic subjects and better discrimination of nondemented and demented elderly with the help of dynamic measures compared to static test scores. Subsequent correlational analyses indicated that, for both tests, performance change following intervention is related to the processing of verbal context information. Results are discussed with respect to the concept of verbal working memory as one component of the patients' rehabilitation potential.

scholarly journals Physiotherapy versus Consecutive Physiotherapy and Cognitive Treatment in People with Parkinson’s Disease: A Pilot Randomized Cross-Over Study

2021 ◽  
Vol 11 (8) ◽  
pp. 687
Author(s):  
Valentina Varalta ◽  
Paola Poiese ◽  
Serena Recchia ◽  
Barbara Montagnana ◽  
Cristina Fonte ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Treatment Group ◽  
Cognitive Rehabilitation ◽  
Rating Scale ◽  
Verbal Learning ◽  
Functional Mobility ◽  
Cognitive Treatment ◽  
Rehabilitation Programs ◽  
Significant Difference

Background: Parkinson’s disease (PD) is characterized by motor and cognitive dysfunctions that can usually be treated by physiotherapy or cognitive training, respectively. The effects of consecutive physiotherapy and cognitive rehabilitation programs on PD deficits are less investigated. Objective: We investigated the effects of 3 months of physiotherapy (physiotherapy treatment group) or consecutive physiotherapy and cognitive (physiotherapy and cognitive treatment group) rehabilitation programs on cognitive, motor, and psychological aspects in 20 PD patients. Methods: The two groups switched programs and continued rehabilitation for another 3 months. The outcomes were score improvement on cognitive (Montreal Cognitive Assessment, Frontal Assessment Battery, Trail Making Test, Verbal Phonemic Fluency, Digit Span, and Rey Auditory Verbal Learning), motor (Unified Parkinson’s Disease Rating Scale-III, Berg Balance Scale, Two-Minute Walking Test, and Time Up and Go), and psychological (Beck Depression Inventory and State-Trait Anxiety Inventory) scales. Results: Between-group comparison revealed a significant difference in functional mobility between the two rehabilitation programs. Improvements in walking abilities were noted after both interventions, but only the patients treated with consecutive training showed better performance on functional mobility and memory tasks. Conclusion: Our findings support the hypothesis that consecutive physiotherapy plus cognitive rehabilitation may have a greater benefit than physiotherapy alone in patients with PD.

scholarly journals T157. THE COURSE OF SCHIZOPHRENIA-RELATED NEURAL FINGERPRINTS OVER NINE YEARS - A LONGITUDINAL POPULATION-BASED MACHINE LEARNING STUDY

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S290-S291
Author(s):  
Johannes Lieslehto ◽  
Erika Jääskeläinen ◽  
Jouko Miettunen ◽  
Matti Isohanni ◽  
Dominic Dwyer ◽  
...  
Keyword(s):  
Machine Learning ◽  
Sensitivity And Specificity ◽  
Verbal Learning ◽  
Clinical Variable ◽  
Support Vector ◽  
Cohen’S D ◽  
Low Degree ◽  
Cohen's D ◽  
Over Time

Abstract Background Previous machine learning studies using structural MRI (sMRI) have been able to separate schizophrenia from controls with relatively high (about 80%) sensitivity and specificity (Kambeitz et al. Neuropsychopharmacology 2015). Interestingly, prediction accuracy in first-episode psychosis is lower compared to older and probably more chronic patients. One possibility is that the appearance of the neurodiagnostic fingerprints (NF) originated from the schizophrenia vs. controls classifier become more visible over time in schizophrenia due to the progressive nature of the disorder. Methods Using the Cobre sample (70 schizophrenia and 74 controls), we trained support vector machine (SVM) to differentiate schizophrenia from controls using sMRI. Next, we utilized the Northern Finland Birth Cohort 1966 (NFBC 1966) sample of 29 schizophrenia and 61 non-psychotic controls who participated in the nine-year follow-up. We applied the Cobre-trained SVM models at the baseline (participants 34 years old) and the follow-up (participants 43 years old) using out of sample cross-validation without any in-between retraining. Two independent schizophrenia datasets (the Neuromorphometry by Computer Algorithm Chicago [NMorphCH] and the Consortium for Neuropsychiatric Phenomics [CNP]) were utilized for replication analyses of the SVM generalizability. To address the possibility that the NF mainly capture some general psychopathology, we tested whether the NF generalize to depression using two independent MDD samples from Munich and Münster, Germany. Results Using the Cobre-trained SVM models for schizophrenia vs. controls differentiation in the NFBC 1966, we found balanced accuracy (i.e. mean of sensitivity and specificity, [BAC]) of 72.8% (sensitivity=58.6%, specificity=86.9%) at the baseline and BAC of 79.7% (sensitivity=75.9%, specificity=83.6%) at the follow-up. In the NFBC 1966 schizophrenia patients, we found that SVM decision scores varied as a function of timepoint into the direction of more schizophrenia-likeness at the follow-up (paired T-test, Cohen’s d=0.58, P=0.004). The same was not true in controls (Cohen’s d=0.09, P=0.49). The SVM decision score difference*timepoint interaction related to the decrease of hippocampus and medial prefrontal cortex. The SVM models’ performance was also validated at the two replication samples (BAC of 77.5% in the CNP and BAC of 69.1% in the NMorphCH). In the NFBC 1966 the strongest clinical variable correlating with the trajectory of SVM decision scores over the follow-up was poor performance in the California Verbal Learning Test. This finding was also replicated in the CNP dataset. Further, in the NFBC 1966, those schizophrenia patients with a low degree of SVM decision scores had a higher probability of being in remission, being able to work, and being without antipsychotic medication at the follow-up. The generalization of the SVM models to MDD was worse compared to schizophrenia classification (DeLong’s tests for the two ROC curves: P<0.001). Discussion The degree of schizophrenia-related neurodiagnostic fingerprints appear to magnify over time in schizophrenia. By contrast, the discernibility of these fingerprints in controls does not change over time. This indicates that the NF captures some schizophrenia-related progressive neural changes, and not, e.g., normal aging-related brain volume loss. The fingerprints were also generalizable to other schizophrenia samples. Further, the fingerprints seem to have some disorder specificity as the SVM models do not generalize to depression. Lastly, it appears that a low degree of schizophrenia-related NF in schizophrenia might possess some value in predicting patients’ future remission and recovery-related factors.

scholarly journals De novo status epilepticus during influenza B infection: when follow-up matters

2020 ◽  
pp. 100413
Author(s):  
G. Giovannini ◽  
G. Turchi ◽  
M. Mazzoli ◽  
A.E. Vaudano ◽  
S. Meletti
Keyword(s):  
Status Epilepticus ◽  
De Novo ◽  
Influenza B
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