Computerized online cognitive training of children with attention deficit hyperactivity disorder / 中华实用儿科临床杂志

Objective To evaluate the therapeutic effect of computerized online cognitive training for children with attention deficit hyperactivity disorder (ADHD).Methods Fifteen children with ADHD recruited from Department of Neurology in the Children's Hospital Affiliated to Capital Institute of Pediatrics received computerized online cognitive training including attention training,visual spatial training and memory training.Cognitive neuropsychological test battery (choice reaction time,mental rotation,word semantic,simple subtraction,working memory and visual tracing) was used to assess the cognitive function in pre-training and post-training stages,such as basic response ability,reaction speed,visuo-spatial cognitive ability,semantic comprehension,calculation fluency,working memory and attention ability.Paired-samples t test was used to make comparison of the cognitive test results between pre-training condition and post-training condition.Results All the correction scores of cognitive tests were transformed to percentile scores.Paired-samples t test results showed that the ADHD children got higher scores in the post-training condition than in the pre-training condition in working memory test [(52.00 ± 20.77) ％ vs (39.73 ± 23.64) ％,t =2.72,P ＜ 0.05].There was no significant training effect in choice reaction time,mental rotation,sentence completion,simple subtraction and visual tracing(all P ＞ 0.05).Conclusions Computerized online cognitive training can significantly improve the working memory of children with ADHD,and has no side effects on other cognitive functions.It need to further expand the sample size and follow up the training effect for a long-term.

Risk Factors for Delirium after Spine Surgery in Elderly Patients

OBJECTIVE: Postoperative delirium is a common complication in the elderly after surgery but few papers have reported after spinal surgery. We analyzed various risk factors for postoperative delirium after spine surgery. METHODS: Between May 2012 and September 2013, 70 patients over 60 years of age were examined. The patients were divided into two groups : Group A with delirium and Group B without delirium. Cognitive function was examined with the Mini-Mental State Examination-Korea (MMSE-K), Clinical Dementia Rating (CDR) and Global Deterioration Scale (GDS). Information was also obtained on the patients' education level, underlying diseases, duration of hospital stay and laboratory findings. Intraoperative assessment included Bispectral index (BIS), type of surgery or anesthesia, blood pressure, fluid balance, estimated blood loss and duration of surgery. RESULTS: Postoperative delirium developed in 17 patients. The preoperative scores for the MMSE, CDR, and GDS in Group A were 19.1+/-5.4, 0.9+/-0.6, and 3.3+/-1.1. These were significantly lower than those of Group B (25.6+/-3.4, 0.5+/-0.2, and 2.1+/-0.7) (p<0.05). BIS was lower in Group A (30.2+/-6.8 compared to 35.4+/-5.6 in group B) (p<0.05). The number of BIS <40 were 5.1+/-3.1 times in Group A, 2.5+/-2.2 times in Group B (p<0.01). In addition, longer operation time and longer hospital stay were risk factors. CONCLUSION: Precise analysis of risk factors for postoperative delirium seems to be more important in spinal surgery because the surgery is not usually expected to have an effect on brain function. Although no risk factors specific to spinal surgery were identified, the BIS may represent a valuable new intraoperative predictor of the risk of delirium.

A 6 Months Follow-Up of Cognitive Function in Urban Community Elderly

OBJECT: The purpose of this study was to measure the natural changes of cognitive function over 6 months and to determine which cognitive tests were valuable for early detection of dementia in community dwelling elderly. METHOD: Cognitive functions were measured in 94 elderly registered at the Public Welfare Center in Gwacheon, the urban community of Kyunggido. After 6 months, same cognitive functions were re-measured in 54 elderly. The measures were Korean version of Mini-Mental State Examination (MMSE-K), Subtests of Korean Version of Memory Assesment Scales (KMAS), Verbal Fluency Test, Clock Drawing Task, Wechsler Digit Substitution Test and Wechsler Similarity Test. RESULTS: The mean age was 73.61+/-5.97 year. Most part of the tests were influenced by education, but not by age and sex. Of the MMSE-K subtests, the score of memory registration and memory recall declined after 6 months. The score of delayed recall of K-MAS declined, too. Decreased score was also observed in 'country' of the category verbal fluency test and 'n' of phonemic verbal fluency test, Wechsler digit substitution test and Wechsler similarity test. But, score decline was not statistically significant. Three persons were diagnosed as dementia after 6 months. And, they acquired low scores in above cognitive function tests in first cognitive function tests. CONCLUSION: Memory registration and memory recall of MMSE-K, delayed recall of K-MAS, verbal fluency test, Wechsler digit substitution test and Wechsler similarity test were sensitive to cognitive decline. The results suggest that these cognitive function tests could be applied to detect minimal changes of cognitive function in community dwelling elderly.