On the use of the P300 as a tool for cognitive processing assessment in healthy aging: A review / O uso do p300 como ferramenta para avaliação do processamento cognitivo em envelhecimento saudável

ABSTRACT Changes in patterns of performance for the cognitive functions of memory, processing speed, and focused attention are expected in old age. Objective: The main goal of this systematic review was to analyze the use of ERP in healthy elderly in studies evaluating the P300 components. Methods: A systematic review was carried out based on recommendations for nursing research on the databases LILACS, PsycINFO, PubMed, SCOPUS and Web of Science. Results: 26 studies involving 940 healthy elderly were identified, most of which sought to identify and determine the influence of age on the P300. Conclusion: Although there is consensus in the literature that P300 latency is significantly longer in elderly with psychiatric disorders compared to healthy elderly, it was not possible to conclude P300 associations with gender, education and other cognitive tests.

RESUMO São esperadas mudanças nos padrões de desempenho nas funções cognitivas de memória, velocidade de processamento e atenção concentrada durante o processo de envelhecimento. Objetivo: O objetivo principal desta revisão sistemática é analisar o uso de ERP em idosos saudáveis nos estudos que avaliaram os componentes do P300. Métodos: Realizou-se uma revisão sistemática com recomendações de estudo para enfermagem nos bancos de dados LILACS, PsycINFO, PubMed, SCOPUS and Web of Science. Resultados: Foram identificados 26 estudos com 940 idosos saudáveis, a maioria procurava identificar e encontrar a influência da idade no P300. Conclusão: Embora haja consenso na literatura de que em idosos com transtornos psiquiátricos a latência P300 é significativamente maior, em relação aos idosos saudáveis não foi possível concluir as associações P300 com gênero, escolaridade e outros testes cognitivos.

Neuropsychological Profile Related with Executive Function of Chinese Preschoolers with Attention-Deficit/Hyperactivity Disorder: Neuropsychological Measures and Behavior Rating Scale of Executive Function-Preschool Version / 中华医学杂志(英文版)

<p><b>Background:</b>Previous studies have found that schoolchildren with attention-deficit/hyperactivity disorder (ADHD) showed difficulties in neuropsychological function. This study aimed to assess neuropsychological function in Chinese preschoolers with ADHD using broad neuropsychological measures and rating scales and to test whether the pattern and severity of neuropsychological weakness differed among ADHD presentations in preschool children.</p><p><b>Methods:</b>The 226 preschoolers (163 with ADHD and 63 controls) with the age of 4-5 years were included and assessed using the Behavior Rating Scale of Executive Function-Preschool Version (BRIEF-P) and a series of tests to investigate neuropsychological function.</p><p><b>Results</b>Preschoolers with ADHD showed higher scores in all domains of the BRIEF-P (inhibition: 30.64 ± 5.78 vs.20.69 ± 3.86, P < 0.001; shift: 13.40 ± 3.03 vs.12.41 ± 2.79, P = 0.039; emotional control:15.10 ± 3.53 vs.12.20 ± 2.46, P < 0.001; working memory: 28.41 ± 4.99 vs.20.95 ± 4.60, P < 0.001; plan/organize: 17.04 ± 3.30 vs.13.29 ± 2.40, P < 0.001) and lower scores of Statue (23.18 ± 7.84 vs.28.27 ± 3.18, P = 0.001), Word Generation (15.22 ± 6.52 vs.19.53 ± 7.69, P = 0.025), Comprehension of Instructions (14.00 ± 4.44 vs.17.02 ± 3.39, P = 0.016), Visuomotor Precision (P < 0.050), Toy delay (P = 0.048), and Matrices tasks (P = 0.011), compared with normal control. In terms of the differences among ADHD subtypes, all ADHD presentations had higher scores in several domains of the BRIEF-P (P < 0.001), and the ADHD-combined symptoms (ADHD-C) group had the poorest ratings on inhibition and the ability to Plan/Organize. For neuropsychological measures, the results suggested that the ADHD-C group had poorer performances than the ADHD-predominantly inattentive symptoms (ADHD-I) group on Statue tasks (F = 7.34, η = 0.12, P < 0.001). Furthermore, the ADHD-hyperactive/impulsive symptoms group had significantly poorer performances compared to the ADHD-C group in the Block Construction task (F = 4.89, η = 0.067, P = 0.003). However, no significant group differences were found between the ADHD-I group and normal control.</p><p><b>Conclusion:</b>Based on the combined evaluation of performance-based neuropsychological tests and the BRIEF-P, preschoolers with ADHD show difficulties of neuropsychological function in many aspects.</p>

A Case Study of a Machine-Learning Approach in Differential Diagnosis of Schizophrenia: The Predictive Capacity of WAIS-IV / 신경정신의학

OBJECTIVES: Machine learning (ML) encompasses a body of statistical approaches that can detect complex interaction patterns from multi-dimensional data. ML is gradually being adopted in medical science, for example, in treatment response prediction and diagnostic classification. Cognitive impairment is a prominent feature of schizophrenia, but is not routinely used in differential diagnosis. In this study, we investigated the predictive capacity of the Wechsler Adult Intelligence Scale IV (WAIS-IV) in differentiating schizophrenia from non-psychotic illnesses using the ML methodology. The purpose of this study was to illustrate the possibility of using ML as an aid in differential diagnosis. METHODS: The WAIS-IV test data for 434 psychiatric patients were curated from archived medical records. Using the final diagnoses based on DSM-IV as the target and the WAIS-IV scores as predictor variables, predictive diagnostic models were built using 1) linear 2) non-linear/non-parametric ML algorithms. The accuracy obtained was compared to that of the baseline model built without the WAIS-IV information. RESULTS: The performances of the various ML models were compared. The accuracy of the baseline model was 71.5%, but the best non-linear model showed an accuracy of 84.6%, which was significantly higher than that of non-informative random guessing (p=0.002). Overall, the models using the non-linear algorithms showed better accuracy than the linear ones. CONCLUSION: The high performance of the developed models demonstrated the predictive capacity of the WAIS-IV and justified the application of ML in psychiatric diagnosis. However, the practical application of ML models may need refinement and larger-scale data collection.

Loneliness in Elderly Patients with Mild Cognitive Impairment: A Pilot Study

BACKGROUND AND PURPOSE: Loneliness is a significant concern among the elderly, particularly in societies with rapidly growing aging populations. While loneliness may influence neuropsychological function, the exact nature of the association between loneliness and neuropsychological function is poorly understood. METHODS: We evaluated 50 elderly patients with mild cognitive impairment (MCI) and 33 without cognitive dysfunction with respect to demographics, clinical characteristics, cognitive and functional performance, depression scale, and loneliness scale. The associations between loneliness and neuropsychological assessments were evaluated. RESULTS: Although loneliness was not associated with cognitive or functional performance, it was correlated with depression in elderly patients. For elderly patients with MCI, depressive symptoms were reported more frequently in individuals with a high degree of loneliness (p < 0.05). CONCLUSIONS: Neither cognitive performance nor functional performance is associated with loneliness; however, loneliness is associated with depressive symptoms in elderly patients with MCI.

Folate nutrition is related to neuropsychological functions in the elderly

We investigated the nutritional state of B vitamins and the neuropsychological functions in 25 subjects, aged 63.1 +/- 6.3 years, residing in rural areas of Korea. Nutritional states of thiamin, riboflavin, and pyridoxine were assessed enzymatically in the erythrocytes, and folate concentrations were measured microbiologically in the plasma and erythrocytes. A battery of composite neuropsychological test was administered to the subjects. Plasma folate was correlated with the total intelligence score (p=0.049). Folate levels in the erythrocytes were correlated with the performance intelligence scores such as block design (p=0.017) and picture arrangement (p=0.016). The red cell folate was correlated with memory scores such as general memory (p=0.009) and delayed recall (p=0.000). Although it did not reach statistical significance, verbal memory (p=0.053) was highly correlated with the red cell folate. The red cell folate was also correlated positively with the percent of conceptual level response number score (p=0.029), and negatively with the grooved pegboard test score for the non-dominant hand (p=0.010). Fine motor coordination was also influenced by folate nutrition, as finger tapping scores in both hands were significantly correlated with red cell folate (dominant hand; p=0.026, non-dominant hand; p=0.004). Other B vitamins such as thiamin, riboflavin, and vitamin B6 were not as strongly correlated with neuropsychological function test scores as folate was. These results suggest that folate nutrition influences neuropsychological function test scores significantly in humans. Further studies are needed to explore the relationship between folate or other vitamin B nutrition and neuropsychological functions and the implications thereof.

Comparison of Neuropsychological Deficits between Depressed Episode and Remission in First-onset Patients with Major Depressive Disorder

OBJECTIVES: The purpose of this study was to investigate 1) the neuropsychological deficits with major depressive disorder(MDD) in depressed state and 2) the changes of neuropsychological dysfunctions during depressed episodes and remitted periods in the MDD group. METHODS: 12 patients with MDD and 70 normal controls who were diagnosed and classified by DSM-IV and SCID-IV interview participated in this study. The psychopathology was measured using the Hamilton rating scale for depression(HAM-D) and Brief Psychiatric Rating Scale(BPRS). The memory function, executive function, and sustained attention were measured by a trained psychologist using the Korean version of Memory Assessment Scale(K-MAS), Wisconsin Card Sorting Test(WCST), and Vigilance(VIG) and Cognitrone (COG) in Vienna Test System. After 6 weeks of treatment, we retested the cognitive tests in order to measure the cognitive functions in remitted states. RESULTS: Patients with MDD achieved significantly lower score in sentence immediately recall, verbal memory score and total memory score of the K-MAS, total errors of the WCST, response time of Vigilance and response time at "Yes" response of Cognitrone than normal controls at baseline. After 6 weeks of medication, the psychiatric symptoms in the patient group were attenuated, and most of the neuropsychological functions including attention, memory, and frontal/executive function were improved except for response time of Cognitrone. CONCLUSIONS: This study provides evidence for distinct neuropsychological deficits in patients with MDD on their depressed states and remitted periods. The impairment on response time remains after remission, and this would be a trait marker of major depressive disorder.

Memory Functions in Schizophrenic Patients / 신경정신의학

OBJECTIVES: The purpose of this study was to investigate memory functions in schizophrenic patients. METHODS: The participants were 45 schizophrenic patients and 27 normal controls. The Rey-Kim Memory Test (RKMT) was used as the testing instrument. RESULTS: 1) Schizophrenic patients showed a significantly lower Memory Quotient (MQ) compared with control participants. Their memory impairment was more severe relative to their intelligence impairment. 2) Memory deficits in schizophrenic patients were most pronounced in retrieval phase compared with encoding or retention phase. 3) Both verbal and visual memory were impaired in schizophrenic patients. 4) There were qualitative as well as quantitative individual differences in memory functions among schizophrenic patients. CONCLUSION: Memory impairment in schizophrenia represents a selective cognitive deficit. Its clinical presentation is similar to 'frontal amnesia' in that retrieval deficit is most pronounced.

Neuropsychological Functioning and Dimensions of Symptoms in Schizophrenia / 대한정신약물학회지

OBJECTIVES: On the basis of the relationship between positron emission tomography and symptom profiles in schizophrenia by Liddle et al, the authors attempted to investigate the related brain regions associated with clinical symptoms by studying the correlations between the performance of neuro-psychological tests likely to reflect functioning of dorsolateral preftontal, orbitofiontal or cingulate, parietal, and temporal cortices and 3 dimensions (psychotic or reality distortion, negative, and disorganization) of symptoms. METHODS: 41 subjects with a confirmed diagnosis of schizophrenia were scored for each of the three dimensions by Positive and Negative Syndrome Scale. Subjects performed 12 neuropsychological tests designed to measure impairment in specific areas of the brain. RESULTS: According to partial co-rrelations to remove possible confounding variables, the neuropsychological correlates of psychotic(reality distortion) and disorganization dimensions were some tests considered to be related to dorsolateral prefrontal and parietal lobes, and cingulate and dorsolateral preliontal cortices, respectively. CONCLUSION: The results support a part of hypotheses, a specific relation between disorganization and cingulate cortex. In addition our results suggest the possibile relations between a psychotic dimension and functions of dorsolateral prefrontal and parietal lobes, and between a disorganization one and functions of cingulate and dorsolateral prefrontal cortices. The authors believe that our study supports different neural circuits associated with each of dimensions of symptoms, particularly psychotic and disorganization, in schizophrenia.