Change in Balance and Neuropsychological Measures Post-Lumbar Drain Trial in Patients with Suspected Normal Pressure Hydrocephalus

2021 ◽  
pp. 1-6
Author(s):  
Hannah E. Wadsworth ◽  
Daniel K. Horton ◽  
Kaltra Dhima ◽  
C. Munro Cullum ◽  
Jonathan White ◽  
...  
Keyword(s):  
Normal Pressure Hydrocephalus ◽  
Digit Span ◽  
Verbal Learning ◽  
Normal Pressure ◽  
Berg Balance Scale ◽  
Trail Making Test ◽  
Clinical Change ◽  
Vp Shunt ◽  
Lumbar Drain ◽  
Trail Making

<b><i>Objective:</i></b> Ventriculoperitoneal (VP) shunting is commonly used to treat normal pressure hydrocephalus (NPH). Assessment of cognition and balance pre- and post-lumbar drain (LD) can be used to provide objective metrics which may help determine the potential benefit of VP shunting. The aim of this investigation was to determine which measures identify clinical change as a result of a LD trial and to develop recommendations for standard NPH clinical assessment procedures. <b><i>Methods:</i></b> The Berg Balance Scale (BBS) and a brief battery of commonly used neuropsychological tests pre- and post-LD (MMSE, trail making test, animal fluency, Hopkins Verbal Learning Test – Revised, and digit span) were administered to 86 patients with a diagnosis of NPH. Subjects were divided into groups based on whether or not clinical change was present, and thus, VP shunting was recommended post-LD, and predictors of group membership were examined. <b><i>Results:</i></b> Significant improvements (<i>p</i> &#x3c; 0.05) were seen on the BBS and Trail Making Part B in the VP shunt-recommended group, with no other significant changes over time in either group. Regression analyses found that VP shunt recommendation was accurately predicted for 80% of the sample using the BBS score alone, with accuracy increasing to 85% when Trails B was added. <b><i>Conclusions:</i></b> Scores from the BBS and Trails B were most likely to change in those chosen to undergo VP shunting post-LD. Given that the typical clinical presentation of NPH includes gait disturbance and cognitive impairment, it is recommended that a standard pre-/post-LD evaluation include the BBS and trail making test.

Younger age is a good predictor of better executive function after surgery for pituitary adenoma in adults

2009 ◽  
Vol 15 (5) ◽  
pp. 803-806 ◽  
Author(s):  
KARSTEN MÜSSIG ◽  
THOMAS LEYHE ◽  
BRITTA BESEMER ◽  
RALF SAUR ◽  
HANS-ULRICH HÄRING ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Verbal Memory ◽  
Digit Span ◽  
Verbal Learning ◽  
Pituitary Surgery ◽  
Favorable Effect ◽  
Trail Making Test ◽  
Test Part ◽  
Younger Age ◽  
Trail Making

AbstractPituitary adenomas, even after successful treatment, are associated with cognitive dysfunctions. We hypothesized that an association between the age of the patients at pituitary surgery and neuropsychological outcome may exist. Forty-two patients (mean age 51 ± 10 years) who had been successfully treated for pituitary adenoma (surgery with or without subsequent radiotherapy) underwent neuropsychological testing. Age at treatment (mean 37 ± 11 years) was significantly associated with Trail Making Test, Part B (TMT-B) results, a measure of executive control and attention (r = .60, p < .0001). This association remained significant after adjustment for age at testing and time since treatment (r = .42, p = .008). No associations were detected between age at treatment and Trail Making Test, Part A (TMT-A, attentional speed), the digit span test (acoustic working memory), and the German version of the Auditory Verbal Learning and Memory, and Memory Test (verbal memory, all p ≥ .3). Our data suggest a favorable effect of younger age at treatment in adults on neurocognitive outcome after surgery for pituitary adenoma. (JINS, 2009, 15, 803–806.)

scholarly journals Structural and functional changes related to memory deficit in non-demential elderly individuals

2016 ◽  
Vol 49 (6) ◽  
pp. 533
Author(s):  
Nísea De A. Corrêa ◽  
Maria P. Foss ◽  
Paula R. B. Diniz
Keyword(s):  
Systematic Review ◽  
Web Of Science ◽  
Digit Span ◽  
Meta Analysis ◽  
Memory Deficit ◽  
Trail Making Test ◽  
Elderly Individuals ◽  
Functional Changes ◽  
Wechsler Memory Scale ◽  
Trail Making

Objetivo: Verificar as alterações estruturais e funcionais, evidenciadas através da imagem por ressonância magnética, relacionadas aos déficits de memória identificados em idosos normais, quando comparados a adultos jovens. Metodologia: Procedeu-se à revisão sistemática, cujo protocolo obedeceu ao fluxograma do Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Foram investigadas as bases de dados PubMed, Scopus, EBSCO, utilizando o gerenciador de referências JabRef, na versão 2.10, e o Web of Science, pelo website. Foram incluídos artigos de estudos quase experimentais, transversais, em coorte ou tipo caso-controle, publicados entre 2005 e 2014, em periódicos indexados nacionais e internacionais, cuja amostra incluísse idosos a partir de 60 anos, não dementes, submetidos à investigação de alterações estruturais e funcionais do sistema nervoso central, por ressonância magnética e sua associação com déficits de memória avaliados por testes neuropsicológicos. Resultados: Quanto à técnica de imagem empregada, identificaram-se dois estudos com imagem por ressonância magnética estrutural, seis estudos com utilização de imagem por ressonância magnética funcional, e quatro estudos que empregaram ambas as técnicas. Nos 12 estudos foi identificado o emprego de 38 testes neuropsicológicos distintos, com uma média de cinco testes por estudo, com variação de um a 12 testes. Dentre os testes mais usados, estiveram o WAIS Digit Span Backwards (em sete estudos), o Trail Making Test A and B (em quatro estudos) e o Wechsler Memory Scale (em quatro estudos). Conclusão: Os estudos demonstraram que no envelhecimento normal, ocorre redução do volume de substância branca para-hipocampal, do volume do hipocampo e do córtex entorrinal com redução de memória verbal, possivelmente por desmielinização das fibras; redução das vias que ligam o lobo temporal e frontal, contribuindo para a redução da memória episódica, da memória de trabalho e da fluência verbal; redução da supressão de informações irrelevantes, o que contribui para menor registro de informação; alterações das áreas frontal e parietal que comprometem a memória de reconhecimento; modificações na atividade e na conectividade do default mode network; reorganização das funções cognitivas, bem como alentecimento de resposta por provável redução de ativação do córtex pré- frontal

A comparison of cognitive functioning in acute schizophrenia and depression

2013 ◽  
Vol 25 (6) ◽  
pp. 334-341 ◽  
Author(s):  
Tina Gooren ◽  
Peter Schlattmann ◽  
Peter Neu
Keyword(s):  
Major Depression ◽  
Cognitive Deficits ◽  
Verbal Fluency ◽  
Verbal Learning ◽  
Trail Making Test ◽  
Acute Schizophrenia ◽  
Wechsler Memory Scale ◽  
Schizophrenic Patients ◽  
Trail Making ◽  
Unipolar Major Depression

ObjectiveEven though cognitive deficits are well recognised in schizophrenia and depression, direct comparisons between the disorders are scarce in literature. This study aims to assess specificity and degree of cognitive deficits in inpatients with acute schizophrenia and unipolar major depression.MethodsA neuropsychological test battery was administered to 76 schizophrenic patients, 102 patients with unipolar major depression and 85 healthy controls (HCs), assessing verbal learning [Rey Auditory Verbal Learning Test (RAVLT)], processing speed (Trail Making Test), verbal fluency and visual memory (Wechsler Memory Scale-Revised test).ResultsBoth patient groups were significantly impaired compared with HCs with regard to all test outcomes. The schizophrenia group (SG) performed significantly worse in the Wechsler Memory Scale and verbal fluency than the depression group (DG). The DG reached significantly lower scores than the SG in the RAVLT delayed recall subtest. No significant group difference between SG and DG was found for the Trail Making Test and the RAVLT direct recall trails.ConclusionOur results indicate that cognitive impairment is present in both disorders. Schizophrenic patients performed worse than patients with unipolar depression in only two of the administered tests. Differences in cognitive performance between the groups are not as general as often assumed. Therefore, during the acute phase of illness, a diagnostic classification on the grounds of the patients’ neurocognitive performance has to be done with caution.

scholarly journals Alteração na atenção e o tratamento da dor do câncer

2008 ◽  
Vol 42 (1) ◽  
pp. 143-151 ◽  
Author(s):  
Geana Paula Kurita ◽  
Cibele Andrucioli de Mattos Pimenta ◽  
José Oswaldo de Oliveira Júnior ◽  
Ricardo Caponeiro
Keyword(s):  
Digit Span ◽  
Trail Making Test ◽  
Digit Span Test ◽  
Span Test ◽  
Trail Making

Os danos à vida diária que a alteração cognitiva pode provocar motivaram a elaboração deste estudo, cujo objetivo foi analisar o impacto do tratamento da dor com opióides sobre a atenção. Os doentes foram divididos em grupos que recebiam (n=14) e não recebiam opióides (n=12). Foram feitas três entrevistas, utilizando-se o Trail Making Test e o Digit Span Test, que avaliam a atenção. Os grupos foram homogêneos nas variáveis sociodemográficas, dor e depressão; não foram homogêneos no índice de Karnofsky e no recebimento de analgésicos adjuvantes. Os doentes sem opióides tiveram melhor desempenho no Digit Span Test - ordem inversa, na segunda avaliação (p=0,29) e não foram observadas diferenças no Trail Making Test. As alterações observadas foram limitadas, mas, enquanto novos estudos não confirmem os achados, doentes, profissionais e cuidadores devem ser alertados dos possíveis efeitos deletérios dos opióides sobre a função cognitiva.

scholarly journals Serial Tap Test of Patients With Idiopathic Normal Pressure Hydrocephalus - Impact on Cognitive Function and Its Meaning

2021 ◽  
Author(s):  
Samanta Fabricio Blattes da Rocha ◽  
Pedro Andre Kowacs ◽  
Ricardo Krause Martinez de Souza ◽  
Matheus Kahakura Franco Pedro ◽  
Ricardo Ramina ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Normal Pressure Hydrocephalus ◽  
Digit Span ◽  
Normal Pressure ◽  
Stroop Test ◽  
Control Group ◽  
Test Protocol ◽  
Tap Test ◽  
Cognitive Improvement ◽  
Cerebrospinal Fluid Shunting

Abstract BackgroundIdiopathic normal pressure hydrocephalus (INPH) is characterized by gait disturbance, urinary incontinence and cognitive decline. Symptoms are potentially reversible and treatment is based on cerebrospinal fluid shunting. The tap test (TT) is used to identify patients that will benefit from surgery. This procedure consists on the withdrawal of 20 to 50 mL of cerebrospinal fluid (CSF) through a lumbar puncture (LP) after which the symptoms of the triad are tested. Improvement in the quality and speed of gait are already recognized but cognitive improvement depends on several factors such as tests used, time elapsed after LP for re-testing, and number of punctures. Serial punctures may trigger similar conditions as external lumbar drainage (ELD) to the organism. ObjectiveThis study aimed to identify how serial punctures affect cognition in order to increase the sensitivity of the test and consequently the accuracy of surgical indication. MethodsSixty-one patients with INPH underwent baseline memory and executive tests repeatedly following the 2-Step Tap Test protocol (2-STT – two procedures of 30 mL lumbar CSF drainage separated by a 24-hour interval). The baseline scores of INPH patients were compared with those of 55 healthy controls, and with intragroup post-puncture scores of the 2-STT. ResultsThe group with INPH had lower performance than the control group in all cognitive tests (RAVLT, Stroop, CFT, FAR-COWA, FAB, MMSE, orientation, mental control), except for the forward digit span test (p = 0.707). After conducting LP procedures, the Stroop test (words, colors and errors), RAVLT (stage A1, A6 and B1), and CFT (immediate and delayed R) scores were equal to those of the control group (p > 0.05). The INPH group presented significant improvement after the first puncture in MMSE (p = 0.031) and in the Stroop Test (points) (p < 0.001). After the second puncture, subjects improved in orientation, MMSE, RAVLT (B1), Stroop (points, words, errors) and CFT (IR). ConclusionProgressive cognitive improvement occurred over the 2-STT and changes were more significant after the second LP in all cognitive domains except for RAVLT (A7). Encephalic alert system ‘arousal’ seems to participate in early improvements observed during 2-STT. The second LP increased the sensitivity of the drainage test to detect changes in cognitive variables, and consequently improved the quality of the method.

scholarly journals Applicability of the Test of Variables of Attention – T.O.V.A in Brazilian adults

2018 ◽  
Vol 12 (4) ◽  
pp. 394-401 ◽  
Author(s):  
Cláudia M. Memória ◽  
Henrique C.S. Muela ◽  
Natália C. Moraes ◽  
Valéria A. Costa-Hong ◽  
Michel F. Machado ◽  
...  
Keyword(s):  
Performance Test ◽  
Digit Span ◽  
Screening Tests ◽  
Trail Making Test ◽  
Digit Symbol ◽  
Cognitive Screening ◽  
Or Education ◽  
Attentional Processes ◽  
Trail Making ◽  
State Examination

ABSTRACT The functioning of attention is complex, a primordial function in several cognitive processes and of great interest to neuropsychology. The Test of Variables of Attention (T.O.V.A) is a continuous computerized performance test that evaluates some attention components such as response time to a stimulus and errors due to inattention and impulsivity. Objective: 1) To evaluate the applicability of T.O.V.A in Brazilian adults; 2) To analyze the differences in performance between genders, age ranges, and levels of education; 3) To examine the association between T.O.V.A variables and other attention and cognitive screening tests. Methods: The T.O.V.A was applied to 63 healthy adults (24 to 78 years of age) who also underwent the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Digit Span and Digit Symbol (Wechsler Intelligence Scale for Adults – WAIS-III) and the Trail Making Test. Results: the T.O.V.A was little influenced by age or education, but was influenced by gender. The correlations between some T.O.V.A variables and the Digit Symbol and Trail Making test were weak (r-values between 0.2 and 0.4), but significant (p<0.05). There was no correlation with the Digit Span test. Conclusion: The T.O.V.A showed good applicability and proved adequate for evaluating attentional processes in adults.

scholarly journals A-166 The Role of Apathy on Executive Functioning After Stroke

2020 ◽  
Vol 35 (6) ◽  
pp. 960-960
Author(s):  
Lopez A ◽  
Lopez Palacios D ◽  
Quintana A ◽  
Gibson D ◽  
Arguelles-Borge S
Keyword(s):  
Executive Functioning ◽  
Cognitive Performance ◽  
Verbal Learning ◽  
Depression Scale ◽  
Trail Making Test ◽  
Stroke Patients ◽  
Data Set ◽  
Test Part ◽  
Trail Making

Abstract Objective This study examined the role of apathy on performance of an executive functioning task. Method The data for this study was derived from the National Alzheimer’s Coordinating Center’s Uniform Data Set containing neuropsychological information for stroke patients (n = 317) who completed the Neuropsychiatric Inventory-Questionnaire (NPI-Q) and the Trail Making Test (Part B). The sample was divided into two groups. One which endorsed feelings of apathy in the last month (n = 102; mean age = 84,SD = 8.33) and a second group which denied feelings of apathy within the last month (n = 215; mean age = 86, SD = 8.02). Results After controlling for depression [as measured by the Geriatric Depression Scale (GDS)], age, gender, and motor impairment, the results of an ANCOVA showed that those who reported apathy performed significantly slower on the Trail Making Test—Part B than those who did not report it [F(1,312 = 6.01, p = .02]. Conclusions It has previously been found that cognitive performance can be impacted by depression on stroke patients. However, recently, it has been identified that apathy specifically, can have an effect on cognitive domains such as verbal learning, short-term, and long-term memory. The present study further supports that apathy may play a role in overall cognitive performance. Therefore, even if patients do not meet criteria for depression, the presence of apathy should still be taken into account. Future research should examine other possible contributing factors such as processing speed should be taken into account as they could be affecting the scores. Finally, researchers should utilize additional measures of executive functioning as only one was available for this study.

Performance of Older Japanese American Adults on Selected Cognitive Instruments

2013 ◽  
Vol 19 (7) ◽  
pp. 773-781 ◽  
Author(s):  
Nobuko Kemmotsu ◽  
Yurika Enobi ◽  
Claire Murphy
Keyword(s):  
Test Performance ◽  
Verbal Learning ◽  
The United States ◽  
Demographic Variables ◽  
Cognitive Test ◽  
Japanese American ◽  
Trail Making Test ◽  
Third Generation ◽  
Trail Making ◽  
Fluency Test

AbstractThis study examined cognitive test performance of second- and third-generation Japanese American (JA) adults, a relatively homogeneous Asian American subgroup. Sixty-five JA and 65 non-Hispanic White (NHW) adults, ages between 45 and 91, were administered the Boston Naming Test-2 (BNT), Letter Fluency Test, Semantic Fluency Test, California Verbal Learning Test (CVLT), Brief Visuospatial Memory Test-Revised (BVMT-R), and Trail Making Test. Levels of acculturation, quality of educational attainment, and generation status in the United States, were also collected. There were no significant differences in the scores between the two groups on the tests administered. JA and NHW groups, however, differed in the patterns of the associations between some of the test performance and demographic variables. JA adults showed a stronger age-score relationship on BNT, CVLT, and the BVMT-R. Furthermore, second-generation JA adults performed lower than the third-generation adults even after controlling for basic demographic variables on CVLT and Trail Making Test. Acculturation on the other hand did not explain score differences once demographic variables were considered. Our results suggest the importance of considering unique history and characteristics of ethnic groups, and interactions of the aging process and culture on tasks with different cognitive demands. (JINS, 2013, 19, 1–9)

scholarly journals Questioning the Effort Hypothesis That Depressed Patients Perform Disproportionately Worse on Effortful Cognitive Tasks

2020 ◽  
Vol 127 (2) ◽  
pp. 401-414
Author(s):  
Dustin B. Hammers ◽  
Sara Weisenbach
Keyword(s):  
Digit Span ◽  
Severe Depression ◽  
Clinical Settings ◽  
Trail Making Test ◽  
Moderate Depression ◽  
Self Reports ◽  
Trail Making ◽  
Neuropsychological Evaluations ◽  
Accuracy Indices ◽  
Effort Hypothesis

The debate over Hasher and Zacks’ effort hypothesis—that performance on effortful tasks by patients with depression will be disproportionately worse than their performance on automatic tasks—shows a need for additional research to settle whether or not this notion is “clinical lore.” In this study, we categorized 285 outpatient recipients of neuropsychological evaluations into three groups—No Depression, Mild-to-Moderate Depression, and Severe Depression—based on their Beck Depression Inventory-2 self-reports. We then compared these groups’ performances on both “automatic” and “effortful” versions of the Ruff 2 & 7 Selective Attention Test Total Speed and Total Accuracy Indices, the Digit Span subtest from the Wechsler Adult Intellectual Scale—Fourth Edition, and Trail Making Test Parts A and B, using a two-way (3 × 2) mixed multivariate analysis of variance. Patients with Mild-to-Moderate Depression or Severe Depression performed disproportionately worse than patients with No Depression in our sample on more effortful versions of only one of the four attention or executive functioning measures (Trail Making Test). Thus, these data failed to fully support a hypothesis of disproportionately worse performance on more effortful tasks. While this study failed to negate the effort hypothesis in some specific instances, particularly for use in the Trail Making Test, there is cause for caution in routinely applying the effort hypothesis when interpreting test findings in most clinical settings and for most measures.

Sign in / Sign up

Export Citation Format

Share Document