Effects of lithium carbonate on the memory and motor speed of bipolar outpatients.

We examined the effect of lithium on the memory and motor speed of 22 outpatients with affective disorders in remission. Patients were assessed weekly over a 5-week period starting at their current lithium dosage, twice during administration of a blind placebo, and twice after their lithium was blindly reinstated. Motor speed was assessed using the finger tapping test. Memory was assessed using the Buschke selective reminding protocol. Mood was assessed at each session to ensure remitted status by clinical interview, the Hamilton Rating Scale for Depression, the Longitudinal Rating of Manic States Scale, and a subjective state questionnaire. Weekly blood samples were also drawn to assess plasma lithium level by means of atomic absorption spectrophotometry. The results indicated that lithium had significant detrimental effect on memory and motor speed: Performance improved when lithium was discontinued and declined when lithium was reintroduced. The implications for patient management and diagnosis in bipolar disorder are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison of cognitive impairments in dementia of the Alzheimer type and depression in the elderly

General cognitive function and specific language and memory processing abilities were compared in dementia of the Alzheimer type (DAT), depressed and normal control subjects. Several tests clearly differentiated between DAT and depressed subjects including a verbal fluency task, several components of a word memory test, an IQ deterioration index, and the Mini-Mental State Examination. The inability of DAT subjects to take advantage of semantic cues in both the verbal fluency and in the memory test contrasted with the performance of depressed and normal subjects, who were able to benefit from semantic cues. Depressed patients displayed deficits compared with normal controls on the more effortful verbal fluency task but not on the memory test. Tasks that are least effortful, rely on semantic associations, and require declarative memory are most likely to discriminate between DAT and depression.     

Noninvasive vascular imaging in the diagnosis and treatment of adventitial cystic disease of the popliteal artery

Depressed geriatric patients show substantial intersubject variability in cognitive performance, which complicates attempts to evaluate the cognitive effects of depression and of antidepressant therapy. This variability may reflect the multiple medications older patients take, many of which have anticholinergic effects. This study examined whether serum anticholinergicity (SA) explained some of the variability in depressed geriatric patients' memory performance. Before starting antidepressant treatment, 36 elderly depressed subjects were given a verbal learning test. At the same time, a blood sample was taken and analyzed by radioreceptor binding assay to determine their SA level. Nineteen of the subjects had detectable levels (mean = 0.28 pmole atropine equivalent). Subjects with an SA of zero showed significantly better delayed recall than did those with a positive SA level. Thus, even very low SA may produce subtle decrements in memory performance, an area of cognition known to be highly sensitive to anticholinergic effects.     

Effects of lithium carbonate on memory and other cognitive functions

The authors studied the effects of lithium carbonate on memory and cognitive function in 16 psychiatric patients, who received lithium for 2 weeks and placebo for 2 weeks in a double-blind cross-over design. At the end of each treatment phase, subjects were administered a battery of memory and cognitive tests. As reported previously, lithium induced slowing of performance on certain of the perceptual motor tests; however, lithium did not cause memory impairment or a change in self-assessment of memory functions.     

Digit symbol performance in mild dementia and depression.

Patients with mild dementia of the Alzheimer's type (DAT), patients with major depression, and normal control subjects completed the Wechsler Adult Intelligence Scale (WAIS) Digit Symbol test and a measure of incidental memory for the digit-symbol pairs. Mild DAT and depressed patients had equivalent deficits in psychomotor speed, but DAT patients recalled fewer digit-symbol items. Although the standard administration of the Digit Symbol test has limited utility in differential diagnosis, the addition of a brief measure of incidental memory may be clinically useful as part of the battery of neuropsychological tests used to distinguish early dementia from depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Lithium in depression: a biochemical study

Two groups of depressed subjects, one with a history of recurrent depression, the other with a history of persistent apathy, were given lithium carbonate 1,200 mg q.i.d. and supplementart potassium 1,200 mg t.d.s. for 1 week. Measurements were made before and after the lithium treatment of total body water (tritium space), extracellular fluid (sulphate space), total exchangeable sodium (Nae) and total exchangeable potassium (Ke) using sodium-24 and potassium-42 multiple isotope dilution techniques. Prior to treatment when compared with a group of normal subjects, both depressed groups showed changes in body fluid volumes and electrolyte levels. Total body water, intracellular fluid and intracellular potassium were lowered, while electrolyte levels. Total body water, intracellular fluid and intracellular potassium were lowered, while intracellular sodium was raised. After treatment with lithium the values in the apathetic group showed little change but the group with recurrent depression showed a significant increase in intracellular fluid (p less than 0.025), Ke (p less than 0.001), intracellular potassium (p less than 0.025) and a significant decrease in Nae (p less than 0.05). There was a marked increase in mood in the group with recurrent depression but not in the apathetic group following lithium treatment. These findings suggest that recurrent depression, both in clinical improvement, mood and also correction of water and also correction of water and electrolyte disturbances arise, but not in patients with long-standing apathy.     

Reduced benzodiazepine sensitivity in patients with panic disorder: comparison with patients with obsessive-compulsive disorder and normal subjects

OBJECTIVE: The authors sought to replicate their previous finding of reduced response to diazepam in patients with panic disorder, to test whether this effect was specific for panic disorder, and to determine whether this reduced response was merely an artifact of resistance to sedation from anxiety-related overarousal. METHOD: The effects of four increasing intravenous doses of diazepam on saccadic eye movement velocity and accuracy (the latter being a saccadic variable that is unaffected by sedation), short-term memory, and self- and observer-rated sedation were assessed in 18 patients with panic disorder, 15 patients with obsessive-compulsive disorder, and 14 normal comparison subjects. The ratios of effect to blood level areas under the curve for both ascending and descending limbs of the effect/blood level curves were compared for each variable. RESULTS: Patients with panic disorder showed significantly less diazepam effect on saccadic velocity and accuracy for the ascending limb of the blood level curve than comparison subjects. Patients with obsessive-compulsive disorder showed similar differences from comparison subjects but only for saccadic velocity. There were no group differences in diazepam effects on memory and sedation. CONCLUSIONS: Patients with panic disorder are less sensitive than comparison subjects to diazepam. Although this difference is not an artifact of resistance to sedation, it may not be specific for panic disorder but rather may reflect a more nonspecific aspect of anxiety disorders.     

Selective reminding procedure in depression and dementia.

Patients with mild dementia of the Alzheimer's type (DAT), patients with major depression, and normal elderly control subjects were administered a verbal learning task using the selective reminding procedure. Depressed patients were impaired on total recall and the proportion of items retained from one trial to the next without reminding and did not benefit from imagery in retaining items over consecutive trials. The DAT patients were impaired on all measures derived from the test, including storage and recognition memory. With the exception of the ability to benefit from imagery, all of the measures distinguished depressed and mild DAT patients. These findings are consistent with deficient encoding in DAT and performance deficits as a function of effortful cognitive processing in depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive complaints in elderly depressed and pseudodemented patients.

The cognitive complaints of 11 patients with depressive pseudodementia were compared with those of 22 patients with depression alone. Pseudodemented subjects were defined as depressed inpatients showing reversible cognitive impairment as measured by the Mini-Mental State Examination (MMSE); subjects with depression alone had no such impairment. For each group, cognitive complaints were highly correlated with depressive symptoms and were not related to MMSE scores. The pseudodemented group had significantly higher cognitive complaint scores, complaining more of difficulties with concentration and recent memory. Groups did not differ significantly in complaints of difficulties with remote memory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

No short-term changes of cognitive performance and mood after single doses of two different lithium retard preparations

This double-blind crossover study investigated the effects of single doses of lithium carbonate (36.6 mval), lithium-sulfate (36 mval), and placebo within the first six hours after administration. The subjects were nine healthy volunteers. The target variables were physical complaints, mood, memory, visuomotor speed, and time estimation. Subjects showed no significant impairment of performance in the cognitive tests and no subjective changes of well-being under lithium. Therefore, it seems that lithium-induced alterations of memory and mood reported in the literature develop very slowly and do not appear after a single dose.     

Breakfast, blood glucose, and cognition

This article compares the findings of three studies that explored the role of increased blood glucose in improving memory function for subjects who ate breakfast. An initial improvement in memory function for these subjects was found to correlate with blood glucose concentrations. In subsequent studies, morning fasting was found to adversely affect the ability to recall a word list and a story read aloud, as well as recall items while counting backwards. Failure to eat breakfast did not affect performance on an intelligence test. It was concluded that breakfast consumption preferentially influences tasks requiring aspects of memory. In the case of both word list recall and memory while counting backwards, the decline in performance associated with not eating breakfast was reversed by the consumption of a glucose-supplemented drink. Although a morning fast also affected the ability to recall a story read aloud, the glucose drink did not reverse this decline. It appears that breakfast consumption influences cognition via several mechanisms, including an increase in blood glucose.     

Rate of forgetting in dementia and depression.

Patients with mild dementia of the Alzheimer's type (DAT), patients with major depression, and normal control subjects were examined for rate of forgetting line drawings of common objects after the groups had been equated for acquisition by the variation of stimulus exposure time. Depressed and DAT patients demonstrated learning impairments, but only the DAT group showed rapid forgetting in the first 10 min after learning to criterion. This finding suggests that some form of deficient consolidation contributes to memory loss in DAT but not in depression and implicates the disruption of different psychobiological mechanisms in these disorders. The rate of forgetting paradigm may be clinically useful for distinguishing patients with early DAT from elderly depressed patients with memory deficits. (53 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Opposing effects of DHEA replacement in elderly subjects on declarative memory and attention after exposure to a laboratory stressor

Aging is accompanied by a continuous decline of the adrenal steroid hormone DHEA and its ester DHEAS. Results from studies in rodents have demonstrated that DHEA(S) administration can enhance memory in several test paradigms. However studies from this laboratory did not find positive effects of DHEA treatment on cognitive performance in young and elderly humans. With respect to a possible mechanism of DHEA activity, effects on several neurotransmitter receptors as well as a possible antiglucocorticoid action are discussed. For high levels of glucocorticoids, a disruptive effect on hippocampal mediated memory is documented in rodents and humans. Therefore it was speculated that, if an antiglucocorticoid action of DHEA would underlie the observed beneficial effects of DHEA on memory, these effects might only be detectable if subjects are stressed (and therefore have high cortisol levels). To test this hypothesis 75 elderly women and men participated in a placebo controlled experiment. Subjects took DHEA (50 mg/day) or placebo for 2 weeks (double blind). Thereafter they participated in a standardized psychosocial laboratory stressor (Trier Social Stress Test; TSST). Before and after stress exposure subjects completed two declarative memory tests (visual-verbal and spatial) as well as one attention test. In addition recall of visual material learned before stress was assessed after stress. Baseline DHEAS levels were significantly lower compared with young adults. DHEA replacement increased DHEAS levels into ranges found in young subjects. DHEA-substituted subjects showed a trend towards a larger cortisol stress response. In the visual memory test subjects under DHEA recalled less items after stress which they had learned before stress. In the attention test however subjects under DHEA performed better than subjects from the placebo group after stress. No interaction between stress and DHEA was found for the spatial memory task. The effects of DHEA substitution on memory and attention after stress exposure seem to be heterogenous. While recall of previously learned material seems to be impaired, attention is enhanced. These results do not support the idea of a direct antiglucocorticoid or anti-stress effect of DHEA on hippocampal mediated memory functions.     

A Comparison of Attentional Biases and Memory Biases in Women With Social Phobia and Major Depression.

Cognitive processes play an important role in the etiology and maintenance of anxiety and depression. Current theories differ, however, in their predictions regarding the occurrence of attentional biases and memory biases in depression and anxiety. To allow for a systematic comparison of disorders and cognitive processes, 117 women (35 with generalized social phobia, 27 with major depression, and 55 healthy controls) participated in a test of visual attention (visual search), an explicit memory test (free recall), and an implicit memory test (anagram solving). Both clinical groups exhibited attentional biases for disorder-related words, whereas only depressed participants showed clear evidence of explicit and implicit memory biases. The implications of these results for competing theories are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Autobiographical memory in the euthymic phase of recurrent depression.

The authors investigated autobiographical memory specificity in subjects who formerly had depression. In 122 euthymic patients with at least two previous major depressive episodes, memory specificity was significantly impaired compared to matched control participants but not related to residual symptoms and illness characteristics, was not differentially affected by cognitive therapy, and was also not predictive of relapse/recurrence during the 2-year follow-up. However, memory specificity was associated with age, education, and immediate and delayed memory recall. The results suggest that memory specificity may reflect a global cognitive impairment that remains in patients who (formerly) had depression but does not constitute a trait marker for vulnerability for relapse/recurrence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Salt-dependent renal effects of an angiotensin II antagonist in healthy subjects

This study was designed to evaluate in healthy volunteers the renal hemodynamic and tubular effects of the orally active angiotensin II receptor antagonist losartan (DuP 753 or MK 954). Losartan or a placebo was administered to 23 subjects maintained on a high-sodium (200 mmol/d) or a low-sodium (50 mmol/d) diet in a randomized, double-blind, crossover study. The two 6-day diet periods were separated by a 5-day washout period. On day 6, the subjects were water loaded, and blood pressure, renal hemodynamics, and urinary electrolyte excretion were measured for 6 hours after a single 100-mg oral dose of losartan (n = 16) or placebo (n = 7). Losartan induced no significant changes in blood pressure, glomerular filtration rate, or renal blood flow in these water-loaded subjects, whatever the sodium diet. In subjects on a low-salt diet, losartan markedly increased urinary sodium excretion from 115 +/- 9 to 207 +/- 21 mumol/min (P < .05). The fractional excretion of endogenous lithium was unchanged, suggesting no effect of losartan on the early proximal tubule in our experimental conditions. Losartan also increased urine flow rate (from 10.5 +/- 0.4 to 13.1 +/- 0.6 mL/min, P < .05); urinary potassium excretion (from 117 +/- 6.9 to 155 +/- 11 mumol/min); and the excretion of chloride, magnesium, calcium, and phosphate. In subjects on a high-salt diet, similar effects of losartan were observed, but the changes induced by the angiotensin II antagonist did not reach statistical significance. In addition, losartan demonstrated significant uricosuric properties with both sodium diets.(ABSTRACT TRUNCATED AT 250 WORDS)     

Effects of intentional versus incidental learning on explicit and implicit tests of memory.

In Experiment 1, subjects monitored and responded to the termination of words displayed for 1, 3, or 6.5 sec. Anticipation of an unspecified memory test facilitated subsequent recognition memory, but not priming of word-fragment completion. In Experiment 2, subjects repeated the words aloud for the duration of each word's exposure. Recognition memory was facilitated by anticipation of either a recognition memory test or a fragment-completion test on the studied words, as well as by lengthened rehearsal duration. Priming of fragment-completion was facilitated only by anticipation of a fragment-completion test on the studied words. The results indicate that subjects can adopt encoding strategies which enhance performance on implicit memory tests. A transfer-appropriate processing account applies most parsimoniously to the data. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Phototherapy and lithium prophylaxis

A random sample of patients (n = 43) had been investigated to detect any difference in response of bright light therapy in lithium-treated inpatients (n = 18) suffering from depression. Only 27% of the lithium-based inpatients respond to bright light therapy, but 73% of patients respond who were not treated with lithium. We conclude that lithium therapy reduces the chance of achieving t remission of depression by bright light therapy.     

Early Assessment of Dementia: The Contribution of Different Memory Components.

A broad memory test battery (reflecting explicit and implicit memory functioning) was administered to a heterogeneous sample of initially nondemented, community-dwelling elderly subjects. To examine the profile of preclinical dementia, subjects were tested twice: At baseline, all subjects were nondemented according to Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) criteria; 2 years later, a subgroup had developed dementia. Performance of the preclinically demented subjects was best characterized, relative to that of cognitively impaired subjects who did not develop dementia 2 years later, by an inability to benefit at recall from semantic relations and by absent repetition priming effects. The authors conclude that in addition to testing episodic memory functioning, it is important to be aware of semantic and implicit memory deficits in the early assessment of dementia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)