TWO PATTERNS ОF CT-BRAIN PERFUSION AND DC-POTENTIALS ОF THE BRAIN EVOKED COGNITIVE TASK IN DISCIRCULATORY ENCEPHALOPATHY PATIENTS

In patients with discirculatory encephalopathy the influence of verbal fluency test on the characteristics of cerebral perfusion, DC-potentials of the brain, as well as on blood pressure and heart rate was investigated. Two patterns of responses to the verbal fluency test were observed. The first one is the process of generalized activation, manifested by the reduction of the TTP (time to peak) parameters of brain perfusion, the rise of the DC-potentials in all areas of brain and the modulation of blood pressure and heart rate. The second process, directly connected with cognitive processing, was manifested by the shifts of local characteristics of brain perfusion and DC-potentials in the frontal, temporal and central cortex, especially in the left hemisphere. Correlations were found between the characteristics of cerebral perfusion and DC-potentials on the one hand and the number of words during the verbal fluency test performance on the other hand.

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Abstract 363: Better Control of Blood Pressure in Midlife was Associated with Cognitive Function in Old Age: The Minabe Study in Japan

Hypertension ◽

10.1161/hyp.62.suppl_1.a363 ◽

2013 ◽

Vol 62 (suppl_1) ◽

Author(s):

Akihiko Iwahara ◽

Yuji Uematsu ◽

Mitsuru Siba ◽

Nobuyuki Miyai ◽

Mikio Arita

Keyword(s):

Blood Pressure ◽

Old Age ◽

High Blood Pressure ◽

Antihypertensive Drug ◽

Cognitive Functions ◽

Verbal Fluency ◽

Memory Test ◽

Verbal Fluency Test ◽

Logical Memory ◽

Fluency Test

Several studies show that hypertension in midlife is also related to cognitive impairment in old age. However, the associations between blood pressure and cognitive functions have been inconclusive. In this study, we examined this association in the sexagenarian and the septuagenarian separately to test our hypothesis that different risk factors were related to cognitive decline in each generation respectively. Participants were 1476 community-dwelling persons without dementia (708 men and 768 women). Resting systolic and diastolic blood pressures were measured in the seated position using an automated sphygmomanometer (HEM-907; Omron). The cognitive functions were measured by means of logical memory test, D-CAT (digit cancellation test; neuropsychological test for attention) and verbal fluency test. We asked participants about their use of antihypertensive drug and collected their data about blood pressure measured at a health examination conducted ten years ago. We constructed a series of multiple linear regression models to examine the association of blood pressure with each cognitive function. Separate analyses were conducted for each combination of predictor (SBP, DBP, past SBP, past DBP, and use of antihypertensive drug) and dependent value (logical memory test, D-CAT, and verbal fluency test). Regression models included the following covariates: age, education, gender, and body mass index. Results indicated the following two points: (1) Higher levels of past DBP (β = -.121, p < .05) was associated with decline in logical memory test and higher level of past SBP (β = -.127, p < .05) was associated with decline in verbal fluency test in the sexagenarian, (2) The use of antihypertensive drug was associated with decline in D-CAT (β = -.194, p < .001) and verbal fluency test (β = -.196, p < .05) in the septuagenarian. Our findings suggest that high blood pressure in the past decade is risk factor for cognitive decline in the sexagenarian but is not risk factor in the septuagenarian. The treatment of high blood pressure in midlife is important for the maintenance of cognitive functions. Early control of high blood pressure might reduce the risk of cognitive impairment in old age.

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Blackout

Oxford Cases in Medicine and Surgery ◽

10.1093/oso/9780198716228.003.0009 ◽

2015 ◽

Author(s):

Hugo Farne ◽

Edward Norris-Cervetto ◽

James Warbrick-Smith

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Blood Flow ◽

Cerebral Perfusion ◽

Outlet Obstruction ◽

Autonomic Response ◽

Loss Of Consciousness ◽

Pressure Drops ◽

Long Time ◽

The Brain

Note that the terms ‘syncope’ and ‘loss of consciousness’ are not interchangeable as loss of consciousness can be due to either syncopal or non-syncopal causes. Syncope is a form of loss of consciousness in which hypoperfusion of the brain is the cause (from the Greek syn (together) and kopein (to cut), referring to the fact that the blood flow that joins the brain together with the rest of the body has been cut). Syncopal causes can be subdivided by mechanism as follows: • ‘Reflex’: this is believed to involve activation of a primitive reflex that leads mammals to ‘play dead’ when faced with danger. Their heart rate slows and their blood pressure drops temporarily, reducing cerebral perfusion and leading to syncope. Some people appear to have a low threshold for activating this reflex in specific situations—for example after standing still for a long time, after seeing something frightening (e.g. blood, needles), or when straining (micturition, defecation). • ‘Cardiac’: pathologies causing a reduction in cardiac output (such as arrhythmias or outlet obstruction) can also lead to syncope. • ‘Orthostatic’: orthostatic hypotension basically means low blood pressure on sitting or standing (as opposed to lying flat). When we stand up there is a sudden drop in blood pressure that we compensate for by vasoconstriction, particularly of the ‘capacitance’ veins in the legs. This reduces the intravascular space, enabling us to maintain the pressure. However, this vasoconstriction takes a few seconds, so to prevent a transient fall in blood pressure every time we stand, there is a temporary increase in heart rate. Patients with reduced intravascular volume (e.g. from dehydration) and/or in whom the normal autonomic response (transient tachycardia and peripheral vasoconstriction) to standing is blunted (e.g. due to drugs or autonomic neuropathy) are vulnerable to blackouts. • ‘Cerebrovascular’: these are non-cardiac structural causes of reduced cerebral perfusion, i.e. obstructions to the blood flow between the heart and the brain. They are relatively uncommon. The main causes of a transient loss of consciousness are summarized in Figure 3.1, with the most common in large font. You should also remember that patients may believe they have lost consciousness when in fact they haven’t.

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Astrocytes monitor cerebral perfusion and control systemic circulation to maintain brain blood flow

Nature Communications ◽

10.1038/s41467-019-13956-y ◽

2020 ◽

Vol 11 (1) ◽

Cited By ~ 17

Author(s):

Nephtali Marina ◽

Isabel N. Christie ◽

Alla Korsak ◽

Maxim Doronin ◽

Alexey Brazhe ◽

...

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Blood Flow ◽

Arterial Blood Pressure ◽

Cerebral Perfusion ◽

Brain Perfusion ◽

Brain Blood Flow ◽

Sympathetic Control ◽

Arterial Blood ◽

Control Circuits

AbstractAstrocytes provide neurons with essential metabolic and structural support, modulate neuronal circuit activity and may also function as versatile surveyors of brain milieu, tuned to sense conditions of potential metabolic insufficiency. Here we show that astrocytes detect falling cerebral perfusion pressure and activate CNS autonomic sympathetic control circuits to increase systemic arterial blood pressure and heart rate with the purpose of maintaining brain blood flow and oxygen delivery. Studies conducted in experimental animals (laboratory rats) show that astrocytes respond to acute decreases in brain perfusion with elevations in intracellular [Ca2+]. Blockade of Ca2+-dependent signaling mechanisms in populations of astrocytes that reside alongside CNS sympathetic control circuits prevents compensatory increases in sympathetic nerve activity, heart rate and arterial blood pressure induced by reductions in cerebral perfusion. These data suggest that astrocytes function as intracranial baroreceptors and play an important role in homeostatic control of arterial blood pressure and brain blood flow.

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Cognitive Performance in Euthymic Patients with Bipolar Disorder vs Healthy Controls: A Neuropsychological Investigation

Clinical Practice and Epidemiology in Mental Health ◽

10.2174/1745017901713010071 ◽

2017 ◽

Vol 13 (1) ◽

pp. 71-81 ◽

Cited By ~ 2

Author(s):

M. Carlotta Palazzo ◽

Chiara Arici ◽

Laura Cremaschi ◽

Marta Cristoffanini ◽

Cristina Dobrea ◽

...

Keyword(s):

Bipolar Disorder ◽

Cognitive Impairment ◽

Cognitive Performance ◽

Verbal Fluency ◽

Cognitive Task ◽

Healthy Controls ◽

Verbal Fluency Test ◽

Age Related ◽

Bipolar Patients ◽

Fluency Test

Objectives: Cognitive impairment may affect patients with Bipolar Disorder (BD) beyond the acute episodes, qualifying as a potential endophenotype. However, which cognitive domains are specifically affected in euthymic patients with BD and the potential influence of confounding factors (e.g., age and concomitant pharmacological treatment) are still a matter of debate. The present study was, therefore, conducted to assess cognitive performance across specific domains in euthymic bipolar patients, not older than 50 years (to avoid potential age-related bias) versus healthy controls (HCs). Methods: A cognitive task battery, including the Wisconsin Card Test, Span Attention Test, Tower of London, Trail Making Test, Verbal Fluency Test, Matrices Scores and N-Back, was administered to 62 subjects (30 bipolar patients and 32 matched HCs) and differences between the groups analyzed. Results: Bipolar patients performed significantly worse than HCs in the Span Forward task, in the expression of Verbal Fluency Test (Category) and in the N-Back task (all p<.05), with marginal differences between BD I and BD II patients. Conclusion: The present study pointed out significant differences in terms of cognitive performance between euthymic bipolar patients and HCs, supporting the notion that specific cognitive functions may remain impaired even after the resolution of the acute episodes in subjects suffering from BD. Future studies on larger samples are warranted to confirm the present results and further explore potential differences in cognitive impairment across specific bipolar subtypes.

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Letter Verbal Fluency in Spanish-, Basque-, and Catalan-Speaking Individuals: Does the Selection of the Letters Influence the Outcome?

Journal of Speech Language and Hearing Research ◽

10.1044/2019_jslhr-l-18-0365 ◽

2019 ◽

Vol 62 (7) ◽

pp. 2400-2410

Author(s):

Laiene Olabarrieta-Landa ◽

Itziar Benito-Sánchez ◽

Montserrat Alegret ◽

Anna Gailhajanet ◽

Esther Landa Torre ◽

...

Keyword(s):

Frontal Lobe ◽

Verbal Fluency ◽

Native Language ◽

Spanish Speakers ◽

Crucial Step ◽

Verbal Fluency Test ◽

Performance Differences ◽

Frontal Lobe Functioning ◽

Selection Of ◽

Fluency Test

Purpose The aim of this study was to compare Basque and Catalan bilinguals' performance on the letter verbal fluency test and determine whether significant differences are present depending on the letters used and the language of administration. Method The sample consisted of 87 Spanish monolinguals, 139 Basque bilinguals, and 130 Catalan bilinguals from Spain. Participants completed the letter verbal fluency test using the letters F, A, S, M, R, P, and E. Results Bilinguals scored higher on the letter verbal fluency test when they were tested in Spanish than in Basque or Catalan. No performance differences were found according to native language or dialects within Basque participants. Catalans with Spanish as their native language scored lower on the letter F compared to those who grew up speaking Catalan and Spanish. The suggested letters to use with Basque speakers are A, E, and B; the suggested letters to use with Catalan speakers are P, F, and M; and the suggested letters to use with Spanish speakers are M, R, and P. Conclusion Selecting appropriate stimuli depending on the language of testing is the first crucial step to assess verbal fluency and thus possible frontal lobe functioning impairment.

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The Effects of a Caffeine Placebo and Experimenter Expectation on Blood Pressure, Heart Rate, Well-Being, and Cognitive Performance

European Psychologist ◽

10.1027//1016-9040.6.1.15 ◽

2001 ◽

Vol 6 (1) ◽

pp. 15-25 ◽

Cited By ~ 18

Author(s):

Harald Walach ◽

Stefan Schmidt ◽

Yvonne-Michelle Bihr ◽

Susanne Wiesch

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Cognitive Task ◽

Well Being ◽

Control Group ◽

Double Blind ◽

Main Effect ◽

The Difference ◽

Being There ◽

To Receive

We studied the effect of experimenter expectations and different instructions in a balanced placebo design. 157 subjects were randomized into a 2 × 4 factorial design. Two experimenters were led to expect placebos either to produce physiological effects or not (pro- vs. antiplacebo). All subjects except a control group received a caffeine placebo. They were either made to expect coffee, no coffee, or were in a double-blind condition. Dependent measures were blood pressure, heart rate, well-being, and a cognitive task. There was one main effect on the instruction factor (p = 0.03) with the group “told no caffeine” reporting significantly better well-being. There was one main effect on the experimenter factor with subjects instructed by experimenter “proplacebo” having higher systolic blood pressure (p = 0.008). There was one interaction with subjects instructed by experimenter “proplacebo” to receive coffee doing worse in the cognitive task than the rest. Subjects instructed by experimenter “antiplacebo” were significantly less likely to believe the experimental instruction, and that mostly if they had been instructed to receive coffee. Contrary to the literature we could not show an effect of instruction, but there was an effect of experimenters. It is likely, however, that these experimenter effects were not due to experimental manipulations, but to the difference in personalities.

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Association of verbal fluency test with progression to dementia in non‐demented older adults

Geriatrics and Gerontology International ◽

10.1111/ggi.14230 ◽

2021 ◽

Author(s):

Hiroyuki Umegaki ◽

Yusuke Suzuki

Keyword(s):

Older Adults ◽

Verbal Fluency ◽

Verbal Fluency Test ◽

Fluency Test

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Are schizophrenics neuropsychologically impaired affected psychotics? Neuropsychological performance and personality traits in relatives

Acta Neuropsychiatrica ◽

10.1017/s0924270800035511 ◽

2000 ◽

Vol 12 (3) ◽

pp. 104-104

Author(s):

R.M. Murray ◽

CM. Gilvarry ◽

A. Russell ◽

D. Hemsley

Keyword(s):

Personality Traits ◽

Verbal Fluency ◽

Neuropsychological Deficits ◽

Verbal Fluency Test ◽

Schizophrenia Spectrum ◽

Schizophrenic Patients ◽

Adult Reading ◽

Trail Making ◽

National Adult Reading Test ◽

Fluency Test

Neuropsychological deficits are found in both schizophrenic patients and their relatives, and some studies have shown similar, but less severe, deficits in affective psychotic patients and their relatives. We set out to establish – whether schizophrenia spectrum personality traits are more common in the relatives of schizophrenic patients than relatives of affective psychotic patients; – what is the relationship between spectrum personality traits and neuropsychological deficits in these relatives.Relatives were interviewed using the International Personality Disorder Examination (IPDE), and also completed the National Adult Reading Test (NART), the Trail Making Test (TMT: Parts A and B) and Thurstone's Verbal Fluency Test (TVFT). Spectrum personality traits were equally common in the 129 relatives of schizophrenic and 106 relatives of affective psychotic patients. Relatives of psychotic patients who themselves had high paranoid traits had lower NART scores than those without such personality traits (p=0.007);similarly, those with high schizoid personality traits took longer to complete the TMT, part B than those without such traits (p=0.0l); and relatives with high schizotypal traits generated significantly fewer words on the verbal fluency test than those without such traits (p=0.04).

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Attenuation of Haemodynamic Response to Placement of Mayfield Skull Pin Head Holder - Comparison of Dexmedetomidine Versus Propofol Infusion - A Randomized Interventional Trial Done in a Tertiary Centre in Central Kerala

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/486 ◽

2021 ◽

Vol 8 (29) ◽

pp. 2639-2643

Author(s):

Sruthy Unni ◽

Ranju Sebastian ◽

Elizabeth Joseph ◽

Remani Kelan Kamalakshi ◽

Jamsheena Muthira Parambath

Keyword(s):

Blood Pressure ◽

Nervous System ◽

Stress Response ◽

Intracranial Pressure ◽

Cerebral Perfusion ◽

Perfusion Pressure ◽

Neurosurgical Procedures ◽

Sympathetic Nervous ◽

The Brain ◽

Group 1

BACKGROUND Anaesthesia for neurosurgery requires special considerations. The brain is enclosed in a rigid cranium, so the rise in intracranial pressure (ICP) which impairs cerebral perfusion pressure (CPP), results in irrepairable damage to various vital areas in the brain. Stable head position is required in long neurosurgical procedures. This is obtained with the use of clamps which fix the head rigidly. This is done usually under general anaesthesia because it produces intense painful stimuli leading to stimulation of sympathetic nervous system which in turn causes release of vasoconstrictive agents. This can impair perfusion in all organ systems. The increase in blood pressure due to sympathetic nervous system causes increase in blood flow. This causes increases in intracranial pressure which result in reduction in cerebral perfusion pressure once the auto regulatory limits are exceeded. We compared the effects of dexmedetomidine 1 µgm/kg and propofol 100 µgm/kg given as infusion over a period of 10 minutes before the induction of anaesthesia and continued till 5 minutes after pinning to attenuate the stress response while cranial pinning. In this study, we wanted to compare the effects of dexmedetomidine and propofol as infusion to attenuate the stress response while cranial pinning in patients undergoing neurosurgical procedures. METHODS This is a randomized interventional trial. Patients were divided into 2 groups of 20 each. Group 1 receiving dexmedetomidine and group 2 receiving propofol, both drugs given as infusion. Haemodynamic variables were monitored before and after cranial pinning. Data was analysed using IBM statistical package for social sciences (SPSS) statistics. The parameters recorded were analysed with the help of a statistician. RESULTS The two groups were comparable in demographic data. Incidence of tachycardia between group 1 and 2 showed that tachycardia to pinning was better controlled with propofol than dexmedetomidine (P < 0.05) which is statistically significant. There is no statistically significant difference in blood pressure values between group 1 and 2 after pinning. CONCLUSIONS From our study, we came to a conclusion that propofol was superior to dexmedetomidine in attenuating the heart rate response to cranial pinning. The effect of propofol and dexmedetomidine was comparable in attenuating the blood pressure response to cranial pinning. KEYWORDS Cranial Pinning, Dexmedetomidine, Propofol

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