Renata Kochhann

Quality of life, functioning and cognition in bipolar disorder and major depression: A latent profile analysis

This study aimed to identify profiles of functioning and quality of life (QOL) in depression (MDD), bipolar disorder (BD) and healthy adults, as well as the clinical, demographic and cognitive variables associated with each of these profiles. Participants completed the WHODAS 2.0 and WHOQOL-BREF, which were submitted to latent profile analysis. The four cluster solution provided the best fit for our data. Cluster 1 consisted mostly of healthy adults, and had the highest functioning and QOL. Clusters 2 contained older patients with subclinical depressive symptoms and psychiatric comorbidities, whose impairments in QOL and functioning were associated with mood symptoms and several cognitive abilities. Patients with MDD, BDI or BDII with mild to moderate depression, such as those in cluster 3, may benefit more significantly from interventions in cognitive flexibility, inhibition, planning, and sustained attention. Lastly, patients with mood disorders and clinically significant levels of depression, as well as a history of suicide attempts, like those in cluster 4, may benefit from interventions aimed at working memory, inhibitory control, and cognitive flexibility; that is, the three core executive functions. These findings should be further investigated, and used to guide treatments for patients with mood disorders and different patterns of functional impairment.

Verbal and visuospatial executive functions in healthy elderly: The impact of education and frequency of reading and writing

Objective To assess the predictive role of education and frequency of reading and writing habits (FRWH) on the cognitive flexibility, inhibition and planning abilities of healthy elderly individuals. Methods Fifty-seven healthy adults aged between 60 and 75 years with 2 to 23 years of formal education were assessed as to the frequency with which they read and wrote different types of text, as well as their number of years of formal education. Executive functions were evaluated using the Hayling Test and the Modified Wisconsin Card Sorting Test (MWCST). Results Weak to moderate positive correlations were found between education, FRWH and the number of categories completed in the MWCST, while negative correlations were identified between these variables and the number of perseverative and non-perseverative errors on the task. Only the FRWH was significantly correlated with the number of failures to maintain set. Speed and accuracy on the Hayling Test were only correlated with participant education. Both education and FRWH significantly predicted performance on the MWCST, and the combination of these two variables had a greater predictive impact on performance on this task than either of the two variables alone. Variability in scores on the Hayling Test was best accounted for by participant education. Conclusion In this sample of elderly subjects, cognitive flexibility was sufficiently preserved to allow for adequate performance on verbal tasks, but may have benefitted from the additional stimulation provided by regular reading and writing habits and by formal education in the performance of more complex non-verbal tasks.

Contributions of the ecological approach to the neuropsychology of executive functions

Neurocognitive assessment involves several different types of processes, techniques and instruments. Traditionally, clinical and/or standardized methods have been the most extensively used in neuropsychological research and clinical practice. Ecological instruments are characterized by the standardized administration of tasks with similar cognitive demands to those observed in everyday situations. Although executive functions are often required in daily living tasks, the lack of a consensus as to their theoretical defi nition has posed several hurdles to their assessment and rehabilitation. The aim of this paper was to present the contributions of an ecological neuropsychological approach to assessment, rehabilitation, and neuroimaging, while discussing the theoretical implications of these processes on the neuropsychology of executive functions. This was achieved through a non-systematic review of classical and contemporary literature on ecological assessment tools. The use of an ecological approach has contributed to the understanding and assessment of functional impairment, as well as to the development of rehabilitation programs focusing on practical daily living activities, allowing for a clearer understanding of the neural correlates of complex environmental and individual factors, and for a more thorough reassessment of the validity of theoretical models of executive functions .

Rehabilitation of lexical and semantic communicative impairments: An overview of available approaches

Lexical-semantic impairments are common consequences of acquired neurological damage. However, little is known about the benefits of existing treatment methods for this type of language impairment. Objective To evaluate current research into lexical-semantic interventions for adults with dementia, TBI or stroke. Methods The PubMed, PsycInfo and SCOPUS databases were searched for studies related to rehabilitation, neurological conditions, communicative and lexical-semantic skills published between 2004 and 2014. Results Twenty-eight of the 453 abstracts found were selected for the review based on the PRISMA method. Most of the studies described treatments for anomia. Semantic tasks were the most commonly used, followed by phonological and gestural strategies. Interventions were individual and involved formal tasks, although the number, frequency and duration of sessions varied between studies. Conclusion Although lexical-semantic interventions lead to improvements in language abilities, they are still poorly described in the literature, and must be further investigated in terms of their efficacy, effectiveness and long-term effects.

The predictive role of daily cognitive stimulation on executive functions in bipolar disorder

This study aimed to estimate the predictive role of clinical and demographic variables on the three core executive functions (EF) - working memory (WM), inhibitory control (IC) and cognitive flexibility (CF) - in bipolar disorder (BD). The sample consisted of 38 patients with BD type I, 39 with BD type II, and 106 control participants with no mood disorders. Subjects completed the Hayling Test, Trail Making Test, Digit Span Backwards, Sentence Word Span Test, and Stroop Color-Word Test. Composite scores for WM, IC and CF were calculated, and their correlations with clinical and demographic variables were analyzed. Stepwise hierarchical regression models including all significant correlates, gender, and diagnosis, revealed that the frequency of reading and writing habits (FRWH), IQ and diagnosis predicted 38.1% of the variance in IC. Diagnosis and IQ predicted 24.9% of the variance in WM scores. CF was predicted by the FRWH only, which accounted for 7.6% of the variance in this construct. These results suggest that daily cognitive stimulation through reading and writing make a significant positive contribution to executive functioning in BD, even in the absence of continued education. These and other forms of routine cognitive stimulation should be further emphasized in intervention programs for BD.

Logopenic aphasia or Alzheimer's disease Different phases of the same disease?

The logopenic variant of Primary Progressive Aphasia, or logopenic aphasia, is a the most recently described variant of Primary Progressive Aphasia and also the least well defined. This variant can present clinical findings that are also common to Alzheimers disease, given they both share the same cytopathologic findings. This article reports the clinical case of a patient for whom it proved difficult to define a clinical diagnosis, being split between the logopenic variant and Alzheimers disease at different phases of the disease. Using this case as an example and drawing on the latest evidence from the literature on the logopenic variant, we postulate the hypothesis that this variant may present as an initial symptom of Alzheimers disease in some atypical cases.

Variability in neurocognitive performance: Age, gender, and school-related differences in children and from ages 6 to 12.

ABSTRACT Cognitive development in children presents peculiarities according to groups of age, gender, and type of school. Few studies have been investigating the effects of all these factors. The aim of this study was to investigate the main effects and the interactions of age, gender, and type of school in 419 children from ages 6 to 12 years old evaluated by the Child Brief Neuropsychological Assessment Battery (NEUPSILIN-Inf). Older children, children in private schools and girls presented better results. Interactions between all three independent variables were observed in different cognitive domains. The results highlight both the heterogeneity and the influence of multiple factors in children’s neuropsychological development.

Clustering and switching in unconstrained, phonemic and semantic verbal fluency: the role of age and school type

ABSTRACT We investigated the role of age and school type on clustering and switching in verbal fluency tasks (VFTs) with Brazilian children. The children were administered unconstrained, phonemic and semantic VFTs with a duration of 150 or 120 s, respectively. Both age and school type influenced all variables and in terms of performance over time. Older children and private school students outperformed the remainder of the sample, with the first 30 s of each VFT usually being the most productive. Although the size of the clusters produced did not differ between groups, the types of clusters did show some variations, with semantic clusters being the most frequent. Our results revealed strong correlations between switching ability and word production in all three VFTs. In conclusion, the executive functions known as planning and cognitive flexibility play a crucial role in word production by organising and facilitating the recall of lexical information from memory.

Cognitive performance in patients with Mild Cognitive Impairment and Alzheimer's disease with white matter hyperintensities: An exploratory analysis

ABSTRACT. Background: White matter hyperintensities (WMH) are commonly associated with vascular dementia and poor executive functioning. Notwithstanding, recent findings have associated WMH with Alzheimers disease as well as other cognitive functions, but there is no consensus. Objective: This study aimed to verify the relationship between WMH and cognitive performance in Mild Cognitive Impairment (MCI) and Alzheimers disease (AD) patients. The study also sought to identify cognitive and demographic/cultural factors that might explain variability of WMH. Methods: The sample was composed of 40 participants (18 MCI and 22 AD patients) aged ≥ 65 years. Spearmans correlation was performed among cognitive performance (memory, language, visuospatial ability, and executive function) and WMH evaluated by the Fazekas and ARWMC scales. Two stepwise linear regressions were carried out, one with cognitive and the other with demographic/cultural variables as predictors. Results: Only naming showed significant correlation with ARWMC. Fazekas score exhibited significant correlation with all cognitive domains evaluated. Fazekas score was better predicted by episodic visual memory and age. Conclusion: This study found that the most relevant cognitive profile in MCI and AD patients with WMH was related to episodic memory. And, without taking clinical aspects into consideration, age was the best predictor of WMH.

DEFICITS IN UNCONSTRAINED, PHONEMIC AND SEMANTIC VERBAL FLUENCY IN HEALTHY ELDERS, MILD COGNITIVE IMPAIRMENT AND MILD ALZHEIMER’S DISEASE PATIENTS

Pradeep J. Nathan, Rosemary A. Abbott, Yen Ying Lim, Samantha Galluzzi, Moira Marizzoni, Cristina Bagnoli, Claudio Babiloni, David Bartres-Faz, Regis Bordet, Mira Didic, Lucia Farotti, Gianluigi Forloni, Jorge Jovicich, Camillo Marra, Jose Luis Molinuevo, Flavio Nobili, Jeremie Pariente, Lucilla Parnetti, Pierre Payoux, Jean-Philippe Ranjeva, Paolo Rossini, Peter Schonknecht, Tilman Hensch, Andrea Soricelli, Magda Tsolaki, Pieter Jelle Visser, Jens Wiltfang, Olivier Blin, Giovanni B. Frisoni, Inventiv Health & University of Cambridge, Cambridge, United Kingdom; 2 Cambridge Cognition, Cambridge, United Kingdom; The Florey Institute, The University of Melbourne, Parkville, Australia; IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy; 5 Department of Physiology and Pharmacology, University of Rome, Rome, Italy; Universitat de Barcelona and IDIBAPS, Barcelona, Spain; Department of Pharmacology, University of Lille Nord de France, Lille, France; 8 Service de Neurologie et Neuropsychologie, Marseille, France; 9 University of Perugia, Perugia, Italy; 10 IRCCS, Istituto di Ricerche Farmacologiche Mario Negri,, Milan, Italy; University of Trento, Trento, Italy; Catholic University, Rome, Italy; Alzheimer’s Disease Unit and Other Cognitive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Italy; 14 University of Genoa, Italy, Genoa, Italy; 15 Department of Neurology, CMRR and Inserm U825, Toulouse, France; Universit e de Toulouse, Toulouse, France; CIC-UPCET, CHU La Timone, AP-HM, UMR CNRS-Universite de la Mediterranee, Marseille, France; Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany; Fondazione SDN per la Ricerca e l’Alta Formazione in Diagnostica Nucleare, Naples, Italy; 20 Aristotle University of Thessaloniki, Thessaloniki, Greece; 21 Department of Neurology, Alzheimer Centre, VU Medical Centre, Amsterdam, Netherlands; University of Duisburg-Essen, Essen, Germany; Mediterranean Institute of Cognitive Neurosciences, Marseille, France; 24 University Hospitals, Geneva, Switzerland. Contact e-mail: Pradeep.Nathan@ inventivhealth.com