Study of Verbal Working Memory in Patients With Parkinson's Disease.

The authors examined the nature of the working memory deficit in persons with Parkinson's disease (PD). Three hypotheses were tested: a limited storage capacity, an impaired executive component, and a reduction of psychomotor speed. Verbal working memory was assessed in 14 PD patients without dementia and 14 matched control participants. Participants were administered a classical verbal span test, working memory tasks that required either updating or manipulation capacities, and motor and psychomotor speed tasks. Patients' performance was comparable to that of control participants on the verbal span test. However, results on the working memory tasks indicated a deficit in manipulation with normal updating capacities. Motor and psychomotor slowing were found in the patient group, but slowing could not fully account for the impairment observed in the manipulation task. Results indicated that there is a genuine but selective working memory impairment in patients with PD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nonepileptic seizures and childhood sexual and physical abuse

Nonepileptic seizures (NES) must be distinguished from epilepsy to avoid the adverse effects of unnecessary antiepileptic drugs and to initiate appropriate psychiatric treatment. A higher frequency of prior sexual abuse has been suspected in NES, although no prospective controlled study has compared patients with NES and epilepsy. A series of patients with conversion disorder presenting as epilepsy and 140 patients with complex partial epilepsy (CPE) without evidence of conversion were selected from a series of consecutive admissions to a comprehensive epilepsy center. The groups did not differ with respect to age, years of education, race, or marital status, but the percentage of women was greater in the conversion NES group (73.2%) than in the CPE control group (50.7%; p < 0.002). The frequency of a history of sexual or physical abuse was greater in the NES group (32.4%) than in the CPE controls (8.6%; p < 0.000). Severity of sexual but not physical abuse was significantly greater in the NES group relative to controls (p < 0.05). There was a trend for a closer relationship of the perpetrator of sexual abuse to the victim among the NES patients compared with CPE controls (p < 0.1). These results support the impression that childhood abuse is more common among patients with conversion NES than with epilepsy, and suggests that in some cases childhood abuse may be a contributory pathogenetic factor.     

Improved glycemic control in intensively treated type 1 diabetic patients using blood glucose meters with storage capability and computer-assisted analyses

OBJECTIVE: To determine the effect on glycemic control in intensively treated type 1 diabetic patients using a blood glucose meter with storage capability and computer-assisted analyses. RESEARCH DESIGN AND METHODS: Glycemic control was assessed in 22 intensively treated adults with type 1 diabetes for 12 months while using a meter without memory, followed by 12 months while using a meter with memory. Log books were used to assist patients in managing aspects of the diabetes treatment plan during the first 12-month period, and computer-assisted analyses were used when the meter with memory was used. GHb levels were measured monthly throughout the 24 months of observation. RESULTS: The mean GHb level averaged across all patients during the period of memory meter use (6.4%) was significantly lower than that during the period of meter use without memory (6.9%) (P=0.0004). The change in GHb levels from each period-specific baseline level occurred at significantly different slopes (P=0.046) when adjusted for baseline GHb level. In addition, the downward trend in GHb level was greater in those patients who increased the frequency of testing the most (r=-0.54, P=0.01). CONCLUSIONS: Use of a meter with memory in conjunction with computer-generated analyses of stored blood glucose test results can lead to improved glycemic control when used by a group of intensively treated adult diabetic patients. Improvement in glycemic control was related to frequency of blood glucose testing.     

Hemispheric laterality and memory bias for threat in anxiety disorder.

Examined auditory perceptual asymmetries and explicit memory biases for threat in patients with panic disorder and generalized anxiety disorder relative to healthy control Ss. They did not find a greater explicit memory bias for threat in the anxiety patients. However, explicit memory biases for threat were associated with perceptual asymmetry scores; patients with a greater right-ear (left hemisphere) advantage exhibited an explicit memory bias for threat material, whereas patients with a lower right-ear advantage displayed apparent cognitive avoidance of threat material. Memory for threat words was unrelated to perceptual asymmetry in healthy control Ss. These findings suggest that neuropsychological variables may partly determine the degree to which anxiety patients process threatening stimuli. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of distraction on desensitization and reprocessing

The present analogue study of seventy-two students with mild spider anxiety assessed the role of distraction in the desensitization and reprocessing of aversive information. Accessing different components of Baddeley's model of short-term memory, three treatment groups involving distraction tasks and one control group maintaining focussed exposure were compared in a pre-test post-test experimental design. The results indicated that all groups experienced a similar reduction in both self-report and heart-rate measures of anxiety. However, at the follow up phase, the groups containing a distraction task showed an increase in anxiety levels significantly greater than that for the control condition. No differences were reported between any of the distraction groups.     

Interrelationships of conversion, psychogenic pain, and dissociative disorder symptoms.

Among 29 male hysterics, psychogenic pain and conversion symptoms were positively correlated but were inversely related to dissociative symptoms. This suggests that conversion and pain disorders be merged into 1 diagnosis and that dissociative disorders be considered a separate, although related, entity. Data support the DSM-II scheme for hysteria better than its DSM-III counterpart. (2 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical study on fungus lipid-reducing capsule in regulating lipometabolic disorder

The patients with lipometabolic disorder were randomly divided into control group (70 cases), Fungus Lipid-reducing Capsule (FLC) treated group (70 cases), augmented treated group (90 cases). The results shown that: (1) TC and TG were reduced markedly in all three groups. The reducing extent in the treated group was greater than that in the control group (P < 0.01). HDL-C was increased markedly in all three group. The increasing extent in the treated group was greater than that in the control group (P < 0.05). These results indicated that the effectiveness of FLC was higher than that of control drug in the treatment of hyperlipidemia. (2) FLC had obvious effect in improving hemorheology indexes. (3) The therapeutic effect of TCM Syndrome-type indicated that FLC could activate the Spleen, remove Dampness and nourish the Liver and Kidney.     

Remembering and knowing: Two different expressions of declarative memory.

Amnesic patients and a control group were given a recognition test 10 min after studying words. For each recognized word, participants indicated whether they remembered it (R) or whether simply they knew that the word was presented but had no recollections about it (K). The patients were impaired for both R and K responses, performing like a control group tested after 1 week. Another control group was tested both 10 min and 1 week after study. The proportion of words initially eliciting an R response and later eliciting a K response exceeded the proportion of K responses that shifted to R responses. These data are accounted for if items initially eliciting R responses can also elicit K responses. We conclude that the R–K distinction does not reflect the operation of explicit and implicit memory but reflects instead a distinction within declarative memory. Thus, K responses depend on brain structures damaged in amnesia; R responses depend on these same structures and also on the frontal lobes for contextual information. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brain representation of object-centered space

We examined the ability of preoperative memory performance to distinguish between patients who had been diagnosed as having left (LTLE, n = 31), right (RTLE, n = 37), and extra-(ETLE, n = 17) temporal lobe focal epilepsy. All patients eventually underwent surgical resections. Analyses indicated that the ETLE group performed better than the RTLE group on nonverbal memory measures and better than the LTLE group on verbal memory measures. Discriminant function analyses indicated that use of a combination of measures that assess different aspects of memory were of significant value in distinguishing between patients with focal TLE and ETLE. This approach, as compared the use of single measures, improved classification rates of all three groups. The best single predictor of group membership, an index of verbal learning, yielded a 47% overall correct classification rate, with sensitivities ranging from 25 to 59%, and performed at worse than chance levels in classifying RTLE patients. A multivariate approach, which included an index of verbal and nonverbal learning, incidental nonverbal memory, and consolidation of organized and rote verbal material, yielded a 65% correct classification rate, with sensitivities ranging from 57 to 75%. This compares favorably with the other noninvasive techniques for lateralizing epileptogenic lesions.     

Prospective memory and apolipoprotein e in healthy aging and early stage Alzheimer's disease.

The present study examined whether prospective memory performance discriminates healthy aging from very mild dementia of the Alzheimer type (DAT) and individuals at risk for DAT because of the presence of the apolipoprotein E (ApoE) ε4 allele. Four groups (young subjects, young-old control subjects, old-old control subjects, and subjects with very mild DAT) engaged in an event-based prospective memory task wherein they responded to a specific word embedded in a general knowledge test. Results indicated that prospective memory performance was clearly impaired in the very mild DAT group relative to the healthy older control groups. Moreover, prospective memory performance appears to capture unique variance in discriminating these 2 groups above and beyond standard retrospective memory tests. However, prospective memory was not affected by ApoE status in the young-old control group and, contrary to predictions, the ε4+ old-old control subjects showed better performance than did the ε4- subjects. In contrast to the healthy individuals, in the very mild DAT group, ε4+ subjects showed deficits in performance relative to the ε4- subjects. Discussion focuses on prospective memory as a cognitive indicator of early stage DAT. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Does variability increase with age? An archival study of cognitive measures.

It is often asserted that older people are more variable than younger people; however, the published data do not always support this statement. To examine directly the applicability of the assertion, measures of reaction time (RT), memory, and intelligence from studies published in Psychology and Aging and the Journal of Gerontology from 1986 to 1990 were examined. The coefficients of variability calculated from data published in studies in which a group of younger people was compared with a group of older people indicated that variability was greater among older participants on measures of RT, memory, and fluid intelligence but not crystallized intelligence. Further examination of data bearing on relative variability is indicated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intact text-specific implicit memory in patients with Alzheimer's disease.

The ability of patients with Alzheimer's disease (AD) to acquire and retain text-specific knowledge was investigated in a rereading study. Ten AD patients (aged 59–84 yrs) and 10 normal control Ss read 2 passages 3 times, each as quickly as possible, and answered recognition memory questions after the 3rd reading of each passage. The AD patients had poor explicit memory as evidenced by impaired recognition memory for the passages. In contrast, normal decreases in the times required for successive readings of each passage for AD patients indicated intact implicit memory for the passages. The absence of facilitation across passages indicated that the rereading effect was text specific, suggesting that AD patients may retain the ability to form certain kinds of implicit new associations. Alternative accounts of the mechanism underlying text-specific priming, and of the nature of intact and impaired implicit memory in AD, are considered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Modeling the immediate free recall impairment of patients with surgical repair of anterior communicating artery aneurysm.

Free recall of 8 patients with clinical memory impairment following surgical repair of anterior communicating artery (ACoA-I) aneurysms was compared with free recall of 11 clinically normal ACoA patients (ACoA-N) and with 19 matched controls. Words were studied at 1-, 4-, and 8-s presentation times. The ACoA-I patients recalled fewer words on the free recall task (3.69?±?0.96) than the ACoA-N patients (5.18?±?1.32) or the control subjects (5.86?±?1.28). The ACoA-N group recalled fewer words than controls only at the longest presentation time. Tests of nonlinear regression models based upon the search of associative memory theory indicated that ACoA-I memory impairment was associated with a large disruption of the formation and/or strengthening of contextual associations and with a slight reduction in the number of words rehearsed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measurement of personality traits and their relation to patient satisfaction with complete dentures

1. There was a high incidence of the personality traits of hypochondriasis, depression, hysteria, and manifest anxiety in the 70 complete denture patients of this study. 2. Most patients in this study were satisfied with the complete dentures received. 3. There was no significant relationship between the personality traits of hypochondriasis, depression, hysteria, and manifest anxiety and the degree of patient satisfaction with dentures. 4. There was no significant relationship between the personality traits of hypochondriasis, depression, hysteria, and manifest anxiety and the techinical quality of dentures. 5. There was no significant relationship between the technical quality of complete dentures and the degree of patient satisfaction with the same dentures.     

Risky decision making assessed with the gambling task in adults with HIV.

Decision making was assessed using a laboratory gambling task in 67 adults with the Human Immunodeficiency Virus (HIV+) and in 19 HIV-seronegative (HIV-) control participants. Neurocognitive test performance across several domains was also analyzed to examine potential cognitive mechanisms of gambling task performance. As predicted, the HIV+ group performed worse on the gambling task, indicating greater risky decision making. Specifically, the HIV+ group selected more cards from the "risky" or disadvantageous deck that included relatively large payoffs but infrequent large penalties. The control group also selected such risky cards but quickly learned to avoid them. Exploratory analyses also indicated that in the HIV+ group, but not in the control group, gambling task performance was correlated with Stroop Interference performance and long delay free recall on the California Verbal Learning Test, suggesting the role of inhibitory processes and verbal memory in the poorer gambling task performance in HIV. These findings indicate the usefulness of the gambling task as a laboratory tool to examine risky decision making and cognition in the HIV population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neuropsychologic effects of carotid endarterectomy

This study assessed neuropsychologic changes after internal carotid endarterectomy using a design that limited the confounding effects of surgical and anesthesiological stress. Twenty-eight patients (mean age = 65.9 years, SD = 8.4, range 45-79), underwent extensive neuropsychological assessment before and on the seventh day after carotid endarterectomy for symptomatic carotid stenosis greater than 75%. A similarly assessed control group of 30 patients underwent elective orthopaedic surgery. A third cognitive assessment was performed 4 months postoperatively on a subgroup of the study patients. No significant cognitive change occurred in the control group. The study patients showed significant improvement in verbal memory, constructive abilities, verbal attainment, and visual attention; a trend towards further improvement of verbal functions was evident at the late postoperative assessment. No side-specific cognitive change was observed. In conclusion, carotid endarterectomy performed for currently accepted indications significantly improves several cognitive functions.     

Memory-guided saccadic eye movements: effects of cerebellar disease

We compared the accuracy of oblique, memory-guided saccades if the eye is stationary or moves horizontally during the memory period. We studied 11 patients with cerebellar disease and 11 age-matched control subjects. Normal subjects showed similar accuracy of saccades for both conditions. In contrast, all patients showed greater errors if the eye moved horizontally during the memory period; however, errors of both vertical and horizontal components of memory-guided saccades were similar. Thus, inaccuracy of memory-guided saccades could not be simply attributed to failure to internally monitor change in horizontal gaze during the memory period. Instead, we propose that the greater saccadic errors which occurred when gaze changed during the memory period reflected a disruption of predictive mechanisms governing eye movements.     

Short-term and working memory differences in language/learning disabled and normal adults

Fifteen adults who reported a childhood history of speech-language and/or learning disability (L/LD) were tested on two verbal memory tasks. Their performance on sentence repetition and reading span measures was compared with that of a matched control group who reported no childhood history of L/LD. Results indicated statistically significant group performance differences on both short-term and working memory tasks. This suggests that verbal memory difficulties may be a longterm component of L/LD.     

Diamorphine-bupivacaine mixture compared with plain bupivacaine for analgesia

We have studied the efficacy of two extradural infusions (10 ml h-1) in 50 patients in active labour. Patients in the diamorphine group (n = 25) received 0.0625% plain bupivacaine 6.25 mg h-1 mixed with 0.005% diamorphine 0.5 mg h-1 and those in the control group (n = 25) received 0.125% plain bupivacaine 12.5 mg h-1. Both groups received intermittent "top-ups" of 0.25% bupivacaine 10 ml when indicated. Although median pain scores during the infusion were similar in both groups, patients in the diamorphine group indicated greater satisfaction with the infusion (88% very satisfied, compared with 52% in the control group (P < 0.02)). There were no differences in the incidence of hypotension, instrumental vaginal delivery, number of "top-ups", duration of the second stage or extent of motor block. However, patients in the diamorphine group had a high incidence of pruritus (44%, compared with 0% in the control group (P < 0.01)).     

Brain attack. Acute therapeutic interventions. Free radical scavengers and antioxidants

This study used tests of content memory (item recognition of words and abstract designs), context memory (order recognition of verbal and nonverbal items), and working memory (recognition at a short retention interval) to examine patterns of performance in 27 schizophrenic patients, 52 chronic alcoholic patients, and 66 healthy control participants. When performance was age- and IQ-adjusted the schizophrenia group was significantly impaired in item and order recognition of verbal and nonverbal material; the alcoholic group was impaired only in order recognition for both material types. Item- and order-recognition deficits in the schizophrenia group were greatest at the shortest retention intervals, a pattern previously observed in patients with Parkinson's disease, suggesting a prominence of a working memory deficit in schizophrenia.