Cognitive Impairment In Adult De Novo Acute Leukemia Patients

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4746-4746
Author(s):  
Stijn Verleden ◽  
Kurt Audenaert ◽  
Lucien Noens
Keyword(s):  
Cognitive Impairment ◽  
Executive Functions ◽  
Cognitive Deficits ◽  
Cognitive Functions ◽  
De Novo ◽  
Verbal Learning ◽  
Cognitive Domains ◽  
Motor Dexterity ◽  
De Novo Aml

Abstract Abstract 4746 Introduction: A significant percentage of cancer patients develop or have chemotherapy-induced cognitive impairment, during and even long after completion of aggressive treatment. Cognitive deficits are usually subtle and mild, and can occur in various cognitive domains. In AML/MDS patients, impaired cognitive functions, even prior to initiation of chemotherapy, have been described. Objective: To assess baseline cognitive functions and short-term cognitive evolution in de novo acute leukemia patients during induction treatment, and to compare our data with previous research. Methods: Current longitudinal-prospective study of adult de novo AML/ALL patients, treated with induction chemotherapy at the Hematology Department, UZ Ghent, Belgium. Eligible patients are enrolled and investigated with a comprehensive cognitive test battery, within on average five days after admission (pre-induction) and after completion of induction chemotherapy, on average after two months (pre-consolidation). Cognitive functions are assessed across various domains, including attention, executive functions, motor dexterity, and verbal/visual memory. Patients’ psychological functions and quality of life are assessed simultaneously. Results: Twenty adult patients were enrolled between 01/2009 and 06/2010. The median age was 43 years, 50% were male, 80% had AML (20% ALL), and median years of education was 12 years. Baseline hematological values were assessed, with WBC count (mean: 10,4 10E3/uL), RBC count (mean: 3,1 10E6/uL), and HgB (mean: 9,8 g/dL). Adult patients had normal cognitive functions (range: 1,0 SD below normative mean) in different cognitive domains, and mainly in attention and executive functions (COWA letter fluency & semantic fluency, and SCWT mental flexibility), except for mild cognitive deficits in verbal learning (AVLT A1-5), but especially in motor dexterity (PPT left and right hand). These functions were heterogeneous at baseline, ranging from severely impaired to good within a cognitive domain. At follow-up, attention, executive functions, motor dexterity, and verbal learning had all improved significantly (p<0.02). Conclusion: Adult de novo AML/ALL patients exhibit at baseline normal cognitive functions, except for verbal learning and motor dexterity. Cognitive deficits in attention, executive functions, and verbal learning were found similar to previous reported research in AML/MDS. However, our data showed less impaired motor dexterity. Moreover, cognitive functions improved at follow-up. Disclosures: No relevant conflicts of interest to declare.

Bipolar Disorder, Obesity and Cognitive Impairment

2017 ◽  
Vol 41 (S1) ◽  
pp. S207-S207 ◽  
Author(s):  
M. La Montagna ◽  
E. Stella ◽  
F. Ricci ◽  
L. Borraccino ◽  
A.I. Triggiani ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Cognitive Impairment ◽  
Problem Solving ◽  
Cognitive Deficits ◽  
Cognitive Functions ◽  
Visual Learning ◽  
Verbal Learning ◽  
Speed Of Processing ◽  
Anthropometric Measures ◽  
Cognitive Domains

IntroductionAccording to scientific literature, cognitive impairment is a disabling feature of the bipolar disorder (BD), present in all the phases of the disease. Obesity and metabolic disorders represent another risk factor for cognitive dysfunctions in BD, since the excess of weight could adversely influence several cognitive domains.ObjectiveTo highlight the presence of impairment of cognitive functions in a sample of subjects suffering from BD and obesity.AimsEvaluation of the cognitive performance in a sample of BD patients, considering their anthropometric measures (height and weight) and body mass index (BMI).MethodsThe neuropsychological battery MATRICS Consensus Cognitive Battery (MCCB) was administered by trained physicians for the evaluation of seven different cognitive domains in 46 patients (mean age: 43.17 years old; 39.13% male), affected by BD enrolled in the psychiatric unit of Azienda Sanitaria Locale and University of Foggia. In particular, cognitive functions assessed were speed of processing, attention/vigilance, working memory, verbal learning, visual learning, reasoning and problem solving, and social cognition. BMI was calculated, and patients were divided into a group of normal weight and another one of overweight or obese, on the base of BMI value (BMI cut-off = 25).ResultsThe obese patients amounted at 56.52%. We have found the presence of cognitive deficits in two of the seven domains assessed, that are speed of processing (P < 0.01) and reasoning and problem solving (P < 0.05) in the sample of overweight patients.ConclusionsCognitive deficits are clearly revealed in BD patients during the euthymic phase of the disorder. The obesity in BD could contribute to increase dysfunctions in cognitive domains.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Correlating cognitive functions to symptom domains and insight in Egyptian patients with schizophrenia

2020 ◽  
Vol 66 (3) ◽  
pp. 240-248 ◽  
Author(s):  
Afaf Hamed Khalil ◽  
Marwa Abd el-Meguid ◽  
Mostafa Bastawy ◽  
Samah Rabei ◽  
Ramy Ali ◽  
...  
Keyword(s):  
Working Memory ◽  
Cognitive Impairment ◽  
Problem Solving ◽  
Cognitive Functions ◽  
Visual Learning ◽  
Verbal Learning ◽  
General Psychopathology ◽  
Cognitive Domains ◽  
Reasoning Problem ◽  
Egyptian Patients

Introduction: Cognitive impairment is one of the fundamental features among patients with schizophrenia. The relationship between schizophrenia symptoms, insight and cognitive domains remains controversial. We aimed to study these relations in a sample of Egyptian patients with schizophrenia. Methods: A total of 109 patients with schizophrenia were assessed using Structured Clinical Interview for DSM-IV ( Diagnostic and Statistical Manual of Mental Disorders (4th ed.)) Axis I diagnosis (SCID-I), Positive and Negative Syndrome Scale (PANSS) and Scale to Assess Unawareness of Medical Disorder (SUMD). Cognitive functions were assessed using the Wechsler Adult Intelligence Scale (WAIS), the Wisconsin Card Sorting Test (WCST) and the Wechsler Memory Scale (WMS). The cognitive functions would be distributed to cover six cognitive domains: attention/vigilance speed of processing, verbal learning, visual learning, working memory and reasoning/problem solving. Results: There was a significant correlation between all cognitive domains (except attention) and PANSS subscales. PANSS negative and general psychopathology subscales were significantly correlated with five cognitive domains: speed of processing, verbal learning, visual learning, working memory and reasoning/problem solving. PANSS negative subscale was significantly correlated with verbal learning (verbal paired association 1) and visual learning (visual paired association 1). There was a significant correlation between all cognitive domains and SUMD, except verbal and visual learning domains assessed by verbal and visual paired association 1 subtests, as well as attention assessed by failure to maintain set subtest. Only visual learning (trials administered), working memory (percentage error), and processing speed (perseverative responses, and trials to complete first category) were significantly negatively correlated to SUMD. Conclusion: Cognitive impairment in patients with schizophrenia is most likely to underlie negative symptoms, general psychopathology symptoms and poor insight, suggesting that treatment strategies minimizing these symptoms would improve cognitive impairment.

The cognitive profile of behavioural variant FTD and its similarities with ALS: a systematic review and meta-analysis

2018 ◽  
Vol 89 (9) ◽  
pp. 995-1002 ◽  
Author(s):  
Emma Beeldman ◽  
Joost Raaphorst ◽  
Michelle Klein Twennaar ◽  
Rosanne Govaarts ◽  
Yolande A L Pijnenburg ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Social Cognition ◽  
Executive Functions ◽  
Verbal Memory ◽  
Cognitive Profile ◽  
Effect Sizes ◽  
Healthy Controls ◽  
Cognitive Profiles ◽  
Cognitive Domains ◽  
Visual Comparison

Approximately 30% of patients with amyotrophic lateral sclerosis (ALS) have cognitive impairment and 8%–14% fulfil the criteria for behavioural variant frontotemporal dementia (bv-FTD). The cognitive profiles of ALS and bv-FTD have been reported to be comparable, but this has never been systematically investigated. We aimed to determine the cognitive profile of bv-FTD and examine its similarities with that of ALS, to provide evidence for the existence of a cognitive disease continuum encompassing bv-FTD and ALS. We therefore systematically reviewed neuropsychological studies on bv-FTD patients and healthy volunteers. Neuropsychological tests were divided in 10 cognitive domains and effect sizes were calculated for all domains and compared with the cognitive profile of ALS by means of a visual comparison and a Pearson’s r correlation coefficient. We included 120 studies, totalling 2425 bv-FTD patients and 2798 healthy controls. All cognitive domains showed substantial effect sizes, indicating cognitive impairment in bv-FTD patients compared to healthy controls. The cognitive domains with the largest effect sizes were social cognition, verbal memory and fluency (1.77–1.53). The cognitive profiles of bv-FTD and ALS (10 cognitive domains, 1287 patients) showed similarities on visual comparison and a moderate correlation 0.58 (p=0.13). When social cognition, verbal memory, fluency, executive functions, language and visuoperception were considered, i.e. the cognitive profile of ALS, Pearson’s r was 0.73 (p=0.09), which raised to 0.92 (p=0.03), when language was excluded in this systematic analysis of patients with a non-language subtype of FTD. The cognitive profile of bv-FTD consists of deficits in social cognition, verbal memory, fluency and executive functions and shows similarities with the cognitive profile of ALS. These findings support a cognitive continuum encompassing ALS and bv-FTD.

Cognitive Functions in the Geriatric Population

2021 ◽  
pp. 123-146
Author(s):  
Shivani Sharma ◽  
Ashima Nehra
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Clinical Diagnosis ◽  
Predictive Validity ◽  
Cognitive Deficits ◽  
Cognitive Functions ◽  
Diagnostic Challenge ◽  
Geriatric Population ◽  
Clinical Criteria ◽  
Cognitive States

This chapter describes how one of the challenging issues of clinical diagnosis is distinguishing between the cognitive deficits manifested in normal aging, depression, mild cognitive impairment (MCI) and dementia. The diagnostic challenge is that there is a great deal of overlap in the symptom constellations of these conditions. It is thus important to establish conceptual and clinical criteria with sufficient predictive validity to accurately identify differences and similarities in cognitive states to justify initiation of appropriate treatments.

scholarly journals P2-457: VERBAL LEARNING DEFICITS TO IDENTIFY PEOPLE AT RISK OF COGNITIVE IMPAIRMENT: THREE-YEAR FOLLOW-UP

2019 ◽  
Vol 15 ◽  
pp. P790-P791
Author(s):  
Loreli Alvarez ◽  
Gilberto Isaac Acosta-Castillo ◽  
Ana Luisa Sosa-Ortiz
Keyword(s):  
At Risk ◽  
Cognitive Impairment ◽  
Verbal Learning ◽  
Learning Deficits

White Matter Changes and Cognitive Decline in a Ten-Year Follow-Up Period: A Pilot Study on a Single-Center Cohort from the Leukoaraiosis and Disability Study

2016 ◽  
Vol 41 (5-6) ◽  
pp. 303-313
Author(s):  
Sofia Madureira ◽  
Ana Verdelho ◽  
Carla Moleiro ◽  
Catarina Santos ◽  
Philip Scheltens ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
White Matter ◽  
Verbal Learning ◽  
White Matter Lesions ◽  
Disease Assessment ◽  
California Verbal Learning Test ◽  
Clinical Diagnoses ◽  
Neuropsychological Predictors ◽  
Learning Test

Aims: To describe the contribution of white matter lesions to the long-term neuropsychological profiles of different groups of clinical diagnoses, and to identify neuropsychological predictors of cognitive impairment in a 10-year follow-up. Methods: The Lisbon subcohort of the Leukoaraiosis and Disability (LADIS) study was re-evaluated performing a clinical, functional and cognitive evaluation [including Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale - Cognition (ADAS-Cog) and ADAS-Cog with the extension for vascular impairment (VADAS-Cog), the 9-word version of the California Verbal Learning Test (CVLT-9), the Trail-Making test and the Stroop test] as well as an MRI scan. Using clinical diagnostic criteria, participants were identified as having no cognitive impairment (NI), cognitive impairment but no dementia (CIND) or dementia (DEM), and the effect of time on clinical diagnosis and neuropsychological profiles was analyzed. Results: From the initial group of 66 participants, 37 out of 41 survivors (90%) were re-evaluated (mean age 81.40 years, 57% women). Fifteen patients (41%) had DEM, 12 (32%) CIND and 10 (27%) NI. Over time, the three groups presented distinct profiles in the MMSE [F2, 62 = 15.85, p = 0.000], ADAS [F2, 62 = 15.85, p = 0.000] and VADAS [F2, 48 = 5.87, p = 0.008]. Logistic regression analysis identified higher scores on MMSE (β = 1.14, p = 0.03, OR = 3.13, 95% CI 1.09-8.97) as predictors of NI after 10 years of follow-up. Conclusion: Higher scores on baseline MMSE were the only neuropsychological predictors of NI after 10 years.

Cognitive Impairment in Children with Arachnoid Cyst of Sylvian Fissure: Does it Justify the Neurosurgical Treatment?

2020 ◽  
Vol 81 (04) ◽  
pp. 362-367 ◽  
Author(s):  
Karolina Kwiatkowska ◽  
Magdalena Dębicka ◽  
Agnieszka Maryniak ◽  
Stanisław Kwiatkowski
Keyword(s):  
Cognitive Impairment ◽  
Clinical Practice ◽  
Intracranial Hypertension ◽  
Cognitive Deficits ◽  
Cognitive Functions ◽  
Clinical Symptoms ◽  
Cognitive Impairments ◽  
Neurological Deficits ◽  
Neurosurgical Treatment ◽  
The Relationship

AbstractThis report discusses the relationship between arachnoid cysts (ACs) and cognitive deficits, and we ask if cognitive impairments could justify neurosurgical treatment. In clinical practice, only AC patients with symptoms of intracranial hypertension or focal neurological deficits are referred to surgery. Occasionally, one might assume that nonspecific problems such as impairment of learning, speech, or cognitive functions are caused by an AC and can be improved by surgery. We describe three patients, in which surgery was indicated on the basis of clinical symptoms such as headaches and the size of the cysts. A neuropsychological examination before AC surgery revealed reduced cognitive potential, and the same examination repeated after surgery showed improvement. We have not found any other reason for this change, except for the decompression of the AC.

The onset of dementia in patients with an acute ischemic stroke

2011 ◽  
Vol 26 (S2) ◽  
pp. 484-484
Author(s):  
C. Bacila
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Cognitive Deficits ◽  
De Novo ◽  
Cognitive Disorder ◽  
Number Of Patients ◽  
Great Prevalence ◽  
Dsm Iv ◽  
Anxiety Depression

IntroductionStroke is a disorder that has great prevalence, defined vascular territories and psychiatric signs generally emerge in association with specific cognitive deficits.ObjectiveDementia occurs frecquently after acute ischemic stroke. The incidence of dementia six months after stroke is about 42%. Fortunately, in recent years, more attention has been paid to organic disorders provoked by strokes, especially to dementia.AimTo follow up the occuring dementia after stroke and also to follow the various psychiatric disorders with the onset during or after an acute ischemic stroke.MethodsAltogether 110 patients were recruited to this observational and non-interventional study, patients who were suffering from a psychiatric disorder after an ischemic stroke (according to DSM IV TR). The screening was followed by four visits during six months, when CGI, 17-HAMD, CROCQ and MMSE scales were used.ResultsOf 110 patients, 39,09% has been diagnosed with dementia. A number of these patients (n = 26) developed an onset like paroxistic disorder (60,46%), or an acute syndrom (20,93%) and 8 patients were considered “de novo” (with the onset of cognitive impairement after 60 days). There were various acute disorders occuring in the onset of dementia, that includes: amnestic syndrom, organic delirium, organic anxiety syndrom and a small number of patients (n=2) who developed mild cognitive disorder.ConclusionsThe literature considers vascular dementia occuring after an ischemic stroke and increasing step by step mnestic deficits; our study releaved a metamorphosis of various types of onset (anxiety, depression, delirium) or cognitive impairement could occurs after 30 days.

Retrospective Comparison of Using or Not Using Donor Lymphocyte Transfusion in the Treatment of Hematological Relapse after Allogeneic Stem Cell Transplantation in 489 Adults with Acute Myeloid Leukemia.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 298-298
Author(s):  
Christoph Schmid ◽  
Myriam Labopin ◽  
Juergen Finke ◽  
Gerhard Ehninger ◽  
Olle Ringden ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
De Novo ◽  
Patient Age ◽  
Entire Cohort ◽  
Post Transplant ◽  
Patient Âgé ◽  
Retrospective Comparison ◽  
De Novo Aml

Abstract Relapsed AML after allogeneic SCT has a poor prognosis. So far, no standard therapy could be defined. Donor lymphocyte transfusion (DLT) has been effective in a minority, however, no data is available to identify patients who will benefit from the procedure. Neither, the outcome of patients treated with or without DLT have been compared. We retrospectively evaluated overall survival (OS) of 489 adults with de novo AML in hematological relapse after SCT, receiving DLT (n=190) or not (n=299). DLT and noDLTgroups were well balanced in terms of patient age (median:37y in both groups), donor age, cytogenetics (good:5vs7%, intermediate:83vs79%, poor:12%vs14%), WBC at diagnosis, donor type (geno-id:71vs72%, MUD:18% both, mismatched:11vs10%), status at transplantation (CR1:38vs41%, CR2:13vs15%, advanced:49vs44%), conditioning, source of stem cells, and time from transplant to relapse (5vs4.5 months). However, DLT patients had a median of 39% BM blasts, as compared to 54% for the noDLT group (p=0.03). Follow-up was 32 and 30 months. Within the DLT group, chemotherapy was additionally given in 130 cases. Nevertheless, only 33% of patients received DLT in CR or aplasia, 67% had measurable disease. AGvHD developed in 41% of patients following DLT. CR and PR were achieved in 31.1% and 4.8% of DLT patients. In a multivariate analysis, younger patient age (&lt;36 years) (HR=1.53,p=0.02) and a longer interval (&gt; 5 months) from transplant to relapse (HR=7.74,p=0.002) were associated with better OS after DLT. When comparing the outcome of patients receiving or not DLT, OS at 2 years was 10±1% for the entire cohort, 18±3% for DLT and 6±1% for noDLT (p&lt;.0001). In a multivariate analysis, use of DLT (HR=2.11,p&lt;0.0001); recipient’s age&lt;36 y (HR=1.69, p&lt;0.001); longer interval (&gt;5 months) from transplant to relapse (HR=2.40, p&lt;0.0001) and number of BM blasts (&lt;48%) at relapse (HR=1.56,p=0.002) were favorable for OS. In this retrospective analysis the results suggest that DLT may be of advantage in the treatment of AML relapse post transplant, at least in younger patients with a longer post transplant remission and relapsing with smaller amounts of blasts in BM. However, patients receiving DLT might represent a positive selection among all relapsed cases, since a considerable number from the noDLT cohort had died too early to proceed to DLT. An intetion-to-treat analysis and further prospective studies should investigate the role of DLT and other approaches, such as second reduced intensity SCT.

Outcomes in CCG-2961, a Children’s Cancer Group Phase III Trial for Untreated Acute Myeloid Leukemia (AML).

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 169-169 ◽  
Author(s):  
Beverly J. Lange ◽  
Franklin O. Smith ◽  
Patricia A. Dinndorf ◽  
Carola A.S. Arndt ◽  
Dorothy R. Barnard ◽  
...  
Keyword(s):  
De Novo ◽  
Interleukin 2 ◽  
Disease Free Survival ◽  
Phase Iii ◽  
Remission Induction ◽  
High Dose ◽  
Free Survival ◽  
Cancer Group ◽  
De Novo Aml

Abstract CCG-2961 tested an intensively timed induction therapy consisting of cytarabine (AC), etoposide, thioguanine, dexamethasone, idarubicin and daunorubicin. Patients in remission after induction were randomized to a second induction course (Arm A) or a 3-drug combination of fludarabine, AC, and idarubicin (Arm B). Course 3 for patients with related donors was bone marrow transplantation (BMT); for those without donors, high dose AC/l-asparaginase. After Course 3 patients without donors were randomized to 14 infusions of Interleukin 2 (IL2) over 18 days or follow-up. CNS prophylaxis was intrathecal AC. Eligibility included all subtypes of de novo AML except acute promyelocytic leukemia and AML in patients with Down syndrome. CCG-2961 opened in Oct.1996 and closed in Dec. 2002. The DSMC suspended the study between Oct. 1999 and May 2000 while the 2961 Committee developed supportive care policies to reduce treatment-related mortality (TRM). CCG-2961 enrolled 900 de novo patients aged 3 days to 21 years, with 495 and 405 patients accruing pre-and post suspension respectively. Remission induction rate is 88.5%. With median follow-up of 3.6 years (range: 0 – 8.1 years), event-free survival (EFS) at 3 years is 44±3% and survival (OS) 57±3%. Disease-free survival (DFS) following Course 2 Arms A and B are not different, although relapse is significantly higher in Arm A (7.3% .vs. 3.1% P=0.018) and TRM more common in Arm B (7.9% vs.4.2% P=0.059), despite 7 less days of neutropenia in Arm B (P&lt;0.001). DFS is 65±9% for patients with a donor versus 50±5% for patients without a donor (P=0.005); respective OS, 74±8% and 66±5% (P=0.221). However, among 98 patients in CR1 with t(8;21) or inv(16) cytogenetics, outcomes in those without and with a donor were no different: DFS (61±12% vs. 72±18%, P = 0.49) and OS (78±10% vs. 77±17%, l P= 0.85). DFS with and without IL2 is 55±9% and 60±8%(P=0.606). Outcomes improved progressively over time. EFS pre- and post-suspension are 41±4% and 47±5%(P=0.038); OS, 52±5% and 63±5%(P=0.005); TRM is 17±3% pre- and 12±3% post-suspension (P=0.039). Factors predictive of inferior EFS are age &gt;17 years, Afro-American and Hispanic ethnicity, body mass index &lt;10th or &gt;95th percentile for age, absence of related marrow donor, WBC &gt; 50,000/mm3, karyotype with −7/7q, −5/5q- or &gt; cytogenetic 5 abnormalities, FLT3/ITD, &gt;15 % morphologic blasts on day 14 or &gt;0.5% immunologically detectable blasts at the end of induction. CCG-2961 confirms the efficacy and high TRM of intensively timed therapy. Neither fludarabine nor IL2 increases DFS or OS, and availability of a donor does not improve outcomes in those with favorable cytogenetics.

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