Effect of Tibet-medicine Ratanasampil on serum β-amyloid protein and inflamatory cytokine levels in patients with Alzheimer's disease / 中华老年医学杂志

Objective To study the effect of ratanasampil (RNSP) which is Traditional Tibetan Medicine on the levels of serum β-amyloid protein, interleukin and tumor necrosis factor alpha (TNF-α) in patients with mild to moderate Alzheimer's disease (AD). Methods One hundred AD patients were divided into two groups in randomized controlled study, including treatment group (RNSP 1 g/d) and control group (piracetam 2.4 g/d). The treatment lasted 12 weeks. The Mini Mental State Examination (MMSE), Alzheimer' s disease Assessment Scale-cognitive subscale (ADAS-cog) and Activity of Daily Living Scale (ADLs) were taken to evaluate the efficacy. Serum levels of amyloid peptides (Aβ40 and Aβ42 ) were measured by ELISA assay. The radioimmunologic assay was used to determine the serum levels of IL-1β, IL-2, IL-6, IL-8 and TNF-α. Results The scores of MMSE, ADAS-cog and ADL significantly improved at 12 weeks after RNSP treatment (P＜0.01, 0.01, 0.05, respectively), while had no significant changes in piracetam group (P＜0.05).The levels of TNF-α, IL-1β, IL-6 and Aβ42 were significantly lower in RNSP group than in Piracetam group (P＜0.01). There was a decrease trend of the Aβ42/Aβ40 ratio at 12 weeks after RNSP treatment (P＜0. 05, P＜0.01 ). The serum Aβ42 level had strong correlations with TNF-α, IL-1 β and IL-6. There were no significant differences in Aβ40 and IL-8 between RNSP group and piracetam group. No obvious drug side effect happened on the groups. Conclusions The reductions of serum TNF-α, IL-1β and IL-6 levels after RNSP treatment may lead to decrease of Aβ42 production in AD patients. RNSP may decrease the Aβ42/Aβ40 ratio and slow down the progress of AD. It may improve the learning and memory ability in treating patients with mild to moderate AD and is well tolerated and safe.

P300 correlates with neurobehavioral cognitive status in patients with traumatic brain injury / 中华物理医学与康复杂志

Objective To explore the correlation between P300 and cognition, and to analyze its clinical meaning. Methods Thirty patients with traumatic brain injury diagnosed with a definite trauma history were recruited as the experimental group, and 20 normal subjects served as controls. All were examined with event-related potentials and the neurobehavioral cognitive status examination ( NCSE ). After two months of regular rehabilitation treatment, they were examined again with the same methods to observe any changes. Results N200 and P300 latencies in the experimental group were significantly longer compared with the control group, while the NCSE scores in the experimental group were significantly lower than in the control group. After two months of regular treatment, the NCSE scores rose and N200 and P300 latencies were significantly shorter than before. The P300 latencies and the NCSE scores were observed to be significantly correlated (r=-0.679,P≤0.01 ). Stepwise regression and multiva-riate analysis revealed that orientation ability and judgment were the components of the NCSE most closely correlated with the P300 latencies. Conclusion P300 latency can serve for the evaluation of cognition due to its significant correlation with orientation ability and time and space judgment.

Influence of Aphasia on the Cognitive Screening Test in Stroke Patients with Unilateral Cerebral Hemispheric Lesion

OBJECTIVE: To evaluate the influence of aphasia on the cognitive screening test in stroke patients with unilateral cerebral hemispheric lesions. METHOD: We evaluated 51 hemiplegic patients with unilateral cerebral hemispheric lesions using CT or MRI. We divided the subjects into three groups according to the presence of aphasia and motor weakness: right hemiplegic patients with aphasia, right hemiplegic patients without aphasia, and left hemiplegic patients. Functional Independence Measure (FIM), Mini-Mental Status Examination (MMSE) and Neurobehavioral Cognitive Screening (NCSE) Tests were applied in all patients. RESULTS: No differences were observed in motor FIM scores between three groups. Total FIM and cognitive FIM scores of the right hemiplegic patients with aphasia were lower than those of the other two groups. MMSE and several sub-items of NCSE (orientation, attention, comprehension, repetition, naming and calculation) showed the same results. But the mean scores of memory, similarity, and judgement items in NCSE were higher in the left hemiplegic patients than the right hemiplegic patients. No differences were observed in the construction score. CONCLUSION: All three cognitive screening tests used in this study were remarkably influenced by the ability of the language function of the patients. Lack of adequate items to detect right cerebral hemispheric lesions were also noticed.

Comparison of Sensitivity of Neurobehavioral Cognitive Status Examination and Mini-mental State Examination

The neurobehavioral cognitive status examination(NCSE), a screening examination tool that assesses cognitive funtion in a brief but quantitative fashion, is used as an independent test of five major areas: language, constructions, memory, calculation and reasoning. The examination also separately assesses levels of consciousness, orientation, and attention. This instrument quickly identifies the intact areas of functioning, yet provides more detailed assessment in the areas of dysfunction. To determine whether the neuro behavioral cognitive status examination is a more sensitive instrument for the detection of cognitive impairment than the minimental state examination(MMSE), we performed these test simultaneously in 26 patients with stroke. The sensitivities were 88.5% for NCSE and 53.8% for MMSE respectively. The sensitivity of NCSE was derived from two features of its design: the use of independent tests to assess skills within five major areas of cognitive functioning, and the use of graded tasks within each of these cognitive domains.

Neurobehavioral Cognitive Status Examination in Stroke Patients

The Neurobehavioral Cognitive Status Examination(NCSE) is a evaluation tool of which many physicians use to assess the cognitive function of neuropychologic patients in a brief and quantitative fashion. We scored 10 components of NCSE in 45 stoke patients and compared the difference in scores between right hemiplegia and left hemiplegia according to lesion side, and we also compared the difference between patients with cerebral infarction and hemorrhage. This study was intended to know the usefulness of the NCSE in the fields of stroke rehabilitation in which the cognition of patients were very important. The mean scores of the patients caused by infarction was higher than that of the hemorrhage except only repetition of language part, especially the scores of attention and naming were high with statistical significance. The mean scores of the left hemiplegia were higher than that of the right hemiplegia except repetition and calculation but all valuses are not significant. Because the scores of the NCSE are influenced by the language function, it is not so useful in comparing stroke patients according to lesion side. But it is very useful in comparing the difference according to the causes of stroke, infarction or hemorrhage respectively and following up patients intrapersonally as a cognitive evaluation tool.

The Neurobehavioral Cognitive Status Examination(NCSE) / 中国临床心理学杂志

Objective:This article has summarized the second generation cognitive screening exam(NCSE) about it's subtests,methods of use,applicability,characteristics and flaws.