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bedside clinical assessment of cognitive functions

Dusan Kolar
Electroconvulsive therapy (ECT) is an effective treatment for mood disorders and a viable treatment option especially when urgency of clinical situation requires a prompt treatment response. After acute series of ECT, the ECT long-term treatment may be considered, although this practice may vary significantly between countries or even within the same country, because there is no universal consensus about its indications, duration and frequency of administration. Continuation or maintenance ECT is common in routine clinical practice and clinicians should be aware of the risks of using ECT long term...
February 2017: Evidence-based Mental Health
Kamalini G Ranasinghe, Katherine P Rankin, Peter S Pressman, David C Perry, Iryna V Lobach, William W Seeley, Giovanni Coppola, Anna M Karydas, Lea T Grinberg, Tal Shany-Ur, Suzee E Lee, Gil D Rabinovici, Howard J Rosen, Maria Luisa Gorno-Tempini, Adam L Boxer, Zachary A Miller, Winston Chiong, Mary DeMay, Joel H Kramer, Katherine L Possin, Virginia E Sturm, Brianne M Bettcher, Michael Neylan, Diana D Zackey, Lauren A Nguyen, Robin Ketelle, Nikolas Block, Teresa Q Wu, Alison Dallich, Natanya Russek, Alyssa Caplan, Daniel H Geschwind, Keith A Vossel, Bruce L Miller
IMPORTANCE: Clearer delineation of the phenotypic heterogeneity within behavioral variant frontotemporal dementia (bvFTD) will help uncover underlying biological mechanisms and improve clinicians' ability to predict disease course and to design targeted management strategies. OBJECTIVE: To identify subtypes of bvFTD syndrome based on distinctive patterns of atrophy defined by selective vulnerability of specific functional networks targeted in bvFTD using statistical classification approaches...
September 1, 2016: JAMA Neurology
Raechelle M Gibson, Srivas Chennu, Davinia Fernández-Espejo, Lorina Naci, Adrian M Owen, Damian Cruse
OBJECTIVE: Some patients diagnosed with disorders of consciousness retain sensory and cognitive abilities beyond those apparent from their overt behavior. Characterizing these covert abilities is crucial for diagnosis, prognosis, and medical ethics. This multimodal study investigates the relationship between electroencephalographic evidence for perceptual/cognitive preservation and both overt and covert markers of awareness. METHODS: Fourteen patients with severe brain injuries were evaluated with an electroencephalographic vibrotactile attention task designed to identify a hierarchy of residual somatosensory and cognitive abilities: (1) somatosensory steady-state evoked responses, (2) bottom-up attention orienting (P3a event-related potential), and (3) top-down attention (P3b event-related potential)...
September 2016: Annals of Neurology
Carolina Pinto Souza, Guiomar Nascimento Oliveira, Maria Paula Foss, Vitor Tumas
The interlocking finger test (ILFT) is a bedside screening test in which the subject must imitate four bimanual finger gestures without symbolic meaning. We assessed the utility of the test in the cognitive evaluation of patients with Parkinson's disease (PD). We evaluated 88 healthy subjects and 101 patients with PD using a simplified motor score of the Unified Parkinson's Disease Rating Scale (UPDRS), Hoehn and Yahr and Schwab and England scales, Geriatric Depression Scale, Pfeffer Functional Activities Questionnaire, Clinical Dementia Rating, Mini-Mental State Examination, clock drawing test, digit span, word list battery of the Consortium to Establish a Registry for Alzheimer's Disease assessment, Frontal Assessment Battery, semantic verbal fluency test, and the ILFT...
July 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Layth Al Tmimi, Marc Van de Velde, Paul Herijgers, Bart Meyns, Geert Meyfroidt, Koen Milisen, Steffen Fieuws, Mark Coburn, Koen Poesen, Steffen Rex
BACKGROUND: Postoperative delirium (POD) is a manifestation of acute postoperative brain dysfunction that is frequently observed after cardiac surgery. POD is associated with short-term complications such as an increase in mortality, morbidity, costs and length of stay, but can also have long-term sequelae, including persistent cognitive deficits, loss of independence, and increased mortality for up to 2 years. The noble gas xenon has been demonstrated in various models of neuronal injury to exhibit remarkable neuroprotective properties...
October 9, 2015: Trials
Emma Beeldman, Joost Raaphorst, Michelle Klein Twennaar, Marianne de Visser, Ben A Schmand, Rob J de Haan
Cognitive impairment is present in approximately 30% of patients with amyotrophic lateral sclerosis (ALS) and, especially when severe, has a negative impact on survival and caregiver burden. Our 2010 meta-analysis of the cognitive profile of ALS showed impairment of fluency, executive function, language and memory. However, the limited number of studies resulted in large confidence intervals. To obtain a more valid assessment, we updated the meta-analysis and included methodological improvements (controlled data extraction, risk of bias analysis and effect size calculation of individual neuropsychological tests)...
June 2016: Journal of Neurology, Neurosurgery, and Psychiatry
Marina de Tommaso, Angela Nuzzi, Anna Rita Dellomonaco, Vittorio Sciruicchio, Claudia Serpino, Claudia Cormio, Giovanni Franco, Marisa Megna
Huntington's disease (HD) is an inherited neurodegenerative disorder characterised by motor impairment, cognitive decline and psychiatric disorders. Dysphagia is a pathologic condition that increases morbidity and mortality of the affected people. Our aim was to evaluate dysphagia in a group of HD patients in view of motor, cognitive and functional decline. Thirty-seven genetically confirmed HD patients were submitted to clinical evaluations of swallowing. Bedside Swallowing Assessment Scale (BSAS) was used...
2015: European Neurology
Ezequiel Gleichgerrcht, Julius Fridriksson, Leonardo Bonilha
The ability to name objects or abstract entities is an essential feature of speech and language, being commonly considered a central component of normal neurologic function. For this reason, the bedside testing of naming performance is part of the neurologic examination, especially since naming impairments can signify the early onset of a progressive disease or the occurrence of a more established problem. Modern neuroscience research suggests that naming relies on specific and distributed networks that operate in concert to support various processing stages, spanning from object recognition to spoken words...
July 21, 2015: Neurology
Donald R Royall, Teruyuki Matsuoka, Raymond F Palmer, Yuka Kato, Shogo Taniguchi, Mayu Ogawa, Hiroshi Fujimoto, Aiko Okamura, Keisuke Shibata, Kaeko Nakamura, Shutaro Nakaaki, Hiroyuki Koumi, Masaru Mimura, Kenji Fukui, Jin Narumoto
OBJECTIVE: "δ", a latent variable constructed from batteries that contain both cognitive and functional status measures, can accurately diagnose dementia relative to expert clinicians. The minimal assessment needed is unknown. METHODS: We validated 2 δ homologs in a convenience sample of elderly Japanese persons with normal cognition (NC), mild cognitive impairment (MCI), and dementia (n = 176). The latent δ homolog "d" (for dementia) was constructed from Instrumental Activities of Daily Living (IADL) and Japanese translations of the Executive Clock-Drawing Task (CLOX), Frontal Assessment Battery (FAB), and Executive Interview (EXIT25)...
September 2015: Neuropsychology
Ryuta Kawashima, Deborah Lewis Hiller, Sheryl L Sereda, Michelle Antonczak, Kara Serger, Denise Gannon, Shinji Ito, Hiroshi Otake, Daisaku Yunomae, Akihito Kobayashi, Christopher Muller, Hiroyuki Murata, Stephanie FallCreek
OBJECTIVES: The purpose of this study was to examine the beneficial effects on cognitive function by a cognitive intervention program designed for dementia care called Learning Therapy in Japan and SAIDO Learning in the United States (hereinafter "SAIDO Learning," as appropriate). SAIDO Learning is a working memory training program that uses systematized basic problems in arithmetic and language, including reading aloud, as well as writing. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTION: Twenty-three nursing home residents with dementia were assigned as an intervention group, and another 24 people with dementia at another nursing home were assigned as a control group...
January 2015: Journal of the American Medical Directors Association
Marie-J Brouillette, Nancy Mayo, Lesley K Fellows, Elena Lebedeva, Johanne Higgins, Edgar T Overton, Beau M Ances, Lisa Koski
OBJECTIVE: Existing screening tools for HIV-Associated Neurocognitive Disorders (HAND) may lack the accuracy required for clinical use. We hypothesized that the diagnostic accuracy of the Montreal Cognitive Assessment (MoCA) as a screening tool for HAND might be improved with a stronger scoring methodology. DESIGN: Two hundred HIV-positive participants aged 18-65 years completed the MoCA and a battery of neuropsychological tests. METHODS: HAND diagnosis was established according to the Frascati criteria, and an NPZ-8 score was also calculated...
May 15, 2015: AIDS
Peter B Forgacs, Mary M Conte, Esteban A Fridman, Henning U Voss, Jonathan D Victor, Nicholas D Schiff
OBJECTIVE: Standard clinical characterization of patients with disorders of consciousness (DOC) relies on observation of motor output and may therefore lead to the misdiagnosis of vegetative state or minimally conscious state in patients with preserved cognition. We used conventional electroencephalographic (EEG) measures to assess a cohort of DOC patients with and without functional magnetic resonance imaging (fMRI)-based evidence of command-following, and correlated the findings with standard clinical behavioral evaluation and brain metabolic activity...
December 2014: Annals of Neurology
Emma Schleiger, Nabeel Sheikh, Tennille Rowland, Andrew Wong, Stephen Read, Simon Finnigan
This study analysed correlations between post-stroke, quantitative electroencephalographic (QEEG) indices, and cognition-specific, functional outcome measures. Results were compared between QEEG indices calculated from the standard 19 versus 4 frontal (or 4 posterior) electrodes to assess the feasibility and efficacy of employing a reduced electrode montage. Resting-state EEG was recorded at the bedside within 62-101 h after onset of symptoms of middle cerebral artery, ischaemic stroke (confirmed radiologically)...
October 2014: International Journal of Psychophysiology
Takeshi Ohnuma, Hiroyuki Hashidate, Tatsuki Yoshimatsu, Tsutomu Abe
PURPOSE: This study aimed to develop a questionnaire to evaluate indoor life-space mobility and assess its validity in community-dwelling older adults certified as needing support or care. METHODS: The participants included 37 community-dwelling older adults undergoing home-visit rehabilitation (mean age: 78.5±7.0 years). We developed a questionnaire to assess the degree of indoor life-space mobility (home-based life-space assessment (Hb-LSA)), evaluating the functional status (life-space assessment (LSA), time spent away from bed, functional independence measure (FIM), bedside mobility scale (BMS)), physical function (hand grip power (HGP), 30-second chair stand (CS-30), one-leg standing (OLS)) and cognitive status (mental status questionnaire (MSQ))...
2014: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Thomas P Beresford
The psychological adaptive mechanism (PAM) model for systematic clinical assessment can be applied in any human setting in which individuals adapt to the conditions of their lives. This report focuses on applying the PAM assessment technique to the stress and anxiety of physical illness. To do so, we must consider maturity of PAMs simultaneously in relation to the cognitive functioning of the brain as assessed either in the office or at bedside. After considering case examples to illustrate this application, the discussion proceeds to include larger patient groups to which clinical PAM assessment might be applied, with special reference to cognitive function...
May 2014: Journal of Clinical Psychology
Vida Demarin, Sandra Morovic
Aging is often associated with some cognitive impairment. Greater population life expectancy is one explanation for increased incidence of cognitive impairment cases. Large numbers of people with cognitive impairment and dementia is becoming one of the most important medical and social problems worldwide. Therefore, prevention of cognitive impairment is an imperative. Dementia includes a heterogeneous group of disorders, the most common being Alzheimer's disease and vascular dementia. Most cardiovascular risk factors, such as hypertension, diabetes mellitus, hypercholesterolemia, atrial fibrillation, and smoking, are not exclusively risk factors for vascular dementia, but also for Alzheimer's disease...
2014: Journal of Alzheimer's Disease: JAD
Shinichiro Maeshima, Aiko Osawa, Fumitaka Yamane, Shoichiro Ishihara, Norio Tanahashi
OBJECTIVE: A high incidence of dysphagia is seen during the acute phase of cerebral haemorrhage; however, there have been only rare reports of dysphagia caused by thalamic haemorrhage. We studied cases of thalamic haemorrhage during the acute period after hospitalization and examined the relationships between the frequency of dysphagia, stroke focus and haematoma volume. METHODS: There were 113 subjects in this study, selected from 247 patients with thalamic haemorrhage who visited our rehabilitation centre...
2014: European Neurology
Marsha E Bates, Jennifer F Buckman, Gerald T Voelbel, David Eddie, Jason Freeman
Neuropsychological and cognitive deficits are observed in the majority of persons with alcohol and drug use disorders and may interfere with treatment processes and outcomes. Although, on average, the brain and cognition improve with abstinence or markedly reduced substance use, better understanding of the heterogeneity in the time-course and extent of cognitive recovery at the individual level is useful to promote bench-to-bedside translation and inform clinical decision making. This study integrated a variable-centered and a person-centered approach to characterize diversity in cognitive recovery in 197 patients in treatment for a substance use disorder...
2013: Frontiers in Psychiatry
Anna Willard, Christian J Lueck
PURPOSE OF REVIEW: Studying eye movements can provide insight into how the normal brain works, how diseases affect eye movements, and how eye movement abnormalities can be used to study diseases and/or their treatments. In this review, we concentrate on recent studies looking at abnormalities of saccades in various diseases. RECENT FINDINGS: Various saccadic abnormalities have been found in Parkinson's disease, Huntington's disease, dementia, cerebellar disease, schizophrenia, and several other conditions...
February 2014: Current Opinion in Neurology
Rebecca Meister, Mary Princip, Jean-Paul Schmid, Ulrich Schnyder, Jürgen Barth, Hansjörg Znoj, Claudia Herbert, Roland von Känel
BACKGROUND: Posttraumatic Stress Disorder (PTSD) may occur in patients after exposure to a life-threatening illness. About one out of six patients develop clinically relevant levels of PTSD symptoms after acute myocardial infarction (MI). Symptoms of PTSD are associated with impaired quality of life and increase the risk of recurrent cardiovascular events. The main hypothesis of the MI-SPRINT study is that trauma-focused psychological counseling is more effective than non-trauma focused counseling in preventing posttraumatic stress after acute MI...
October 11, 2013: Trials
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