COGNITIVE PSYCHOPATHOLOGY IN SCHIZOPHRENIA: COMPARING MEMORY PERFORMANCES WITH OBSESSIVE-COMPULSIVE DISORDER PATIENTS AND NORMAL SUBJECTS ON THE WECHSLER MEMORY SCALE-IV

Background: Memory system turns out to be one of the cognitive domains most severely impaired in schizophrenia. Within the theoretical framework of cognitive psychopathology, we compared the performance of schizophrenia patients on the Wechsler Memory Scale-IV with that in matched patients with Obsessive-compulsive disorder and that in healthy control subjects to establish the specific nature of memory deficits in schizophrenia. Subjects and methods: 30 schizophrenia patients, 30 obsessive-compulsive disorder patients and 40 healthy controls completed the Wechsler Memory Scale-IV. Schizophrenia symptom severity was assessed by the Positive and Negative Syndrome Scale (PANSS). Performances on memory battery including Indexes and subtests scores were compared by a One-Way ANOVA (Scheffé post-hoc test). Spearman Rank correlations were performed between scores on PANSS subscales and symptoms and WMS-IV Indexes and subtests, respectively. Results: Schizophrenia patients showed a memory profile characterized by mild difficulties in auditory memory and visual working memory and poor functioning of visual, immediate and delayed memory. As expected, schizophrenia patients scored lower than healthy controls on all WMS-IV measures. With regard to the WMS-IV Indexes, schizophrenia patients performed worse on Auditory Memory, Visual Memory, Immediate and Delayed Memory than Obsessive-compulsive disorder patients but not on Visual Working Memory. Such a pattern was made even clearer for specific tasks such as immediate and delayed recall and spatial recall and memory for visual details, as revealed by the lowest scores on Logical Memory (immediate and delayed conditions) and Designs (immediate condition) subtests, respectively. Significant negative correlations between Logical Memory I and II were found with PANSS Excitement symptom as well as between DE I and PANSS Tension symptom. Significant positive correlations between LM II and PANSS Blunted affect and Poor rapport symptoms as well as DE I and PANSS Blunted affect and Mannerism and Posturing symptoms, were found too. Conclusions: Memory damage observed in schizophrenia patients was more severe and wider than that of patients with obsessive-compulsive disorder, except for visual working memory. Memory dysfunction, mainly related to episodic memory damage and reduced efficiency of central executive, is intimately connected to the specific psychopathological processes characterizing schizophrenia. Implications for therapeutics and cognitive remediation techniques are discussed

CONSCIOUS ATTENTION DEFECT AND INHIBITORY CONTROL DEFICIT IN PARKINSON’S DISEASE-MILD COGNITIVE IMPAIRMENT: A COMPARISON STUDY WITH AMNESTIC MILD COGNITIVE IMPAIRMENT MULTIPLE DOMAIN

Background: Frontal/executive dysfunction commonly occurs in Parkinson\u27s disease - Mild Cognitive Impairment (PD-MCI patients). However, to date, the number of studies comparing PD-MCI and MCI patients of other etiologies are too small. The present study aims at clarifying the attention/working memory and executive dysfunction of PD-MCI patients in comparison to amnestic MCI multiple domain patients with first extended then abbreviated structural brain changes suggesting preclinical Alzheimer’s Disease. Subjects and methods: 40 PD-MCI patients and 40 amnestic MCI multiple domain (aMCI+) patients were diagnosed according to the International guidelines. 22 healthy subjects were also recruited as control group. The groups were assessed by a wide neuropsychological battery, including measures of attention/working memory (Digit Span and Stroop Test), executive functions (Tower of London-Drexel Version -TOLDX- and Brixton Test), language (Boston Naming Test and Category Fluency), memory (Prose Recall and Pairs Associates Learning), and visuospatial function (Street\u27s Completion Test and Constructive Apraxia Test). Performances were compared by non parametric tests. Spearman correlations were performed to explore association between neuropsychological measures of attention/working memory and executive functions in PD-MCI group. Results: The PD-MCI patients performed worse on Digit Span and Stroop Interference/Error than aMCI+ and controls. AMCI+ patients, in turn, showed a greater deficit on TOLDX Initiation Time and on Violation Time than PD-MCI and controls. Both PDMCI and aMCI+ patients reported lower scores on Stroop Interference/Time than controls. Moreover, aMCI+ patients performed worse then controls on Brixton Test. Positive correlations between Digit Span and Stroop Interference/Error, Stroop Interference/Error and TOLDX Execution Time, Total Time and Violation Time, Stroop Interference Time and TOLDX Move Score and Total Time were found in PD-MCI group. Conclusion: PD-MCI patients mainly present a conscious attention defect and an inhibitory control deficit than aMCI+. PDMCI patients with deficits in attention/working memory domain should undergo specific cognitive trainings in order to improve cognitive abilities and prevent Parkinson\u27s Disease Dementia onset

Can physical and cognitive training based on episodic memory be combined in a new protocol for daily training?

Background: Cognitive training (CT) is defined as guided practice on a set of standard tasks designed to stimulate particular cognitive functions. Recent studies have shown that physical exercise is beneficial for cognitive activity in older adults and patients with degenerative diseases. Aims: The main objective of the present study is to create a new cognitive tool able to provide training for cognitive functions that take advantage of the physical activity involved in the execution of the task. A study concerning the application of a new CT tool for episodic memory is presented and divided in two parts. The first one aims at developing a new sensorized device, called SmartTapestry, for physical and cognitive training. The second part aims at understanding its technical viability and level of sensitivity in stimulating the same cognitive domain covered by the standardized tests, despite the introduction of the physical activity variable. Methods: The SmartTapestry device was tested with a total of 53 subjects, 29 healthy subjects and 24 subjects suffering from mild cognitive impairment. Results and discussions: The results show a good correlation between the two approaches (p < 0.005), suggesting that SmartTapestry can stimulate the same cognitive functions of traditional cognitive tasks, with the addition of physical exercise. Conclusions: The results of this study may be useful in designing ecological and combined cognitive-physical tools, which can be used daily at home, reducing the presence of clinical staff, to train at the same time the brain and the body so as to improve the cognitive treatments efficacy

Post-operative cognitive dysfunction and short-term neuroprotection from blueberries: a pilot study.

BACKGROUND: General anesthesia may be a risk factor for postoperative cognitive impairment, which could be counteracted by neuroprotective compounds. The aims of this study were to determine cognitive functions impaired by general anesthesia and to test blueberry juice as a neuroprotective agent against neuropsychological dysfunctions induced by general anesthesia. METHODS: Twenty-six patients undergoing elective major surgery were randomized into two groups, receiving either 500 milliliters/day of blueberry juice within 14 preoperative days (G1) or to a control group (G0). Neuropsychological tests were performed around 20 days before surgery (T0), as well as both 3 hours (T1) and 24 hours (T2) postsurgery. All the scores were statistically analyzed to find significant differences between groups and within the three times. RESULTS: The control (G0) group showed a significant decrease in the performance of Prose Memory (p < 0.001), Attentional Matrices (p < 0.01) and Trail Making Test Part B (p < 0.01) after general anesthesia. Significant differences were reported in the Prose Memory test, T0 versus T1 (p < 0.01), T0 versus T2 (p < 0.001); in the Trail Making Test Part B, T0 versus T2 (p < 0.01); and the Attentional Matrices test, and T0 versus T2 (p < 0.001). The G1 group did not show any decrease in the performance of the three tests. CONCLUSIONS: General anesthesia induces a shortterm impairment of verbal memory and selective and divided attention. Blueberry compounds may prevent these neuropsychological deficits through a neuroprotective action in patients undergoing general anesthesia

Parkinson's disease mild cognitive impairment: application and validation of the criteria

Dementia in Parkinson's disease (PD) is a serious health issue and a major concern for many patients. In most cases mild cognitive impairment (MCI) is considered a transitional stage between normal cognitive functioning and dementia which is of potential importance in the early identification of patients at risk for dementia. Recently, the Movement Disorder Society (MDS) proposed diagnostic criteria for MCI in PD (PD-MCI). These criteria comprise two operationalizations: Level I (based on an abbreviated assessment) and Level II (based on comprehensive neuropsychological evaluation permitting MCI subtyping). These criteria need to be validated. This paper describes a project aiming to validate the MDS PD-MCI criteria by pooling and analyzing cross-sectional and longitudinal neuropsychological databases comprising ≥5,500 PD patients and ≥1,700 controls. After applying the MDS PD-MCI Level I and Level II criteria, rates of conversion to PD-dementia and predictive variables for conversion to PD-dementia will be established. This study will also assist in identifying whether revisions of the PD-MCI criteria are required