Cognitive Decline in Korean Patients with Neurocognitive Disorder due to Traumatic Brain Injury: A Control for Premorbid Intelligence

OBJECTIVE: Previous studies of cognitive decline in patients with neurocognitive disorder due to traumatic brain injury (NCD-TBI) have often failed to control for baseline factors such as premorbid intelligence. The purpose of the current study was to estimate and compare cognitive function among three groups (controls, complicated mild/moderate TBI, and severe TBI) after controlling for premorbid intelligence.METHODS: Severity of TBI was classified as complicated mild/moderate or severe based on duration of loss of consciousness and brain neuroimaging results. Premorbid intelligence quotients (IQs) were estimated with the Oklahoma Premorbid Intelligence Estimate. There were no differences in premorbid intelligence between the groups, which were also matched for age and education. Current cognitive function was evaluated with the Wechsler Adult Intelligence Scale-Fourth Edition.RESULTS: Comparison of current cognitive function among the three groups indicated significant group differences for all indexes and subtest scores. Processing speed showed the highest effect size. However, only working memory differed significantly between the two NCD-TBI groups.CONCLUSION: The present findings suggest that mental memory manipulation processes seem to be more sensitive to TBI severity than are perceptual-motor processes. Specifically, both auditory rehearsal/discrimination and mental alertness/manipulation will be most strongly influenced by TBI severity.

Cognition of Patients with Juvenile Myclonic Epilepsy / 中国康复理论与实践

Objective To investigate the cognitive function and psychological mental state of patients with juvenile myoclonic epilepsy (JME), and the related risk factors. Methods From September, 2011 to Febrary, 2014, 21 patients with JME and 18 healthy controls matched with age, sex and educational level were assessed with Montreal Cognitive Assessment (MoCA), and Revised Chinese Wechsler Adult Intel-ligence Scale (WAIS-RC) and Symptom Checklist-90 (SCL-90). The risk factors were analyzed with Logistic regression analysis. Results There was no significant difference in the score of MoCA between two groups (t=―1.544, P=0.131). The scores of verbal intelligence quo-tient (VIQ), performance intelligence quotient (PIQ) and full intelligence quotient (FIQ) in WAIS-RC were significantly lower in the patient group than in the control group (t>4.119, P2.480, P<0.05). Logis-tic regression analysis showed that VIQ significantly decreased in patients taking valproic acid (B=―3.064, OR=0.047, 95% CI=0.002~0.920, P=0.044). Conclusion VIQ, PIQ and FIQ decreased in patients with JME. Furthermore, different levels of dysfunction were found in interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation and psychoticism. Taking valproic acid was the risk factor of cognitive decline.

Habilidades cognitivas, contexto rural y urbano: comparación de perfiles WAIS-IV en jóvenes / Cognitive skills, rural and urban context: comparison of WAIS-IV profiles in youth

La reciente estandarización en Chile de la Escala Wechsler de Inteligencia para Adultos (WAIS), en su cuarta versión, obliga a investigar el impacto que condiciones culturales y ambientales pueden tener sobre el rendimiento intelectual de las personas. El presente estudio comparó el desempeño de jóvenes provenientes de sectores rurales y urbanos de la región del Biobío, segmentados según nivel educativo de los padres como variable de aproximación al nivel socioeconómico. Los resultados muestran un efecto de interacción entre el nivel socioeconómico y el lugar de residencia. Comprensión verbal y memoria de trabajo son los constructos que reciben un mayor impacto del nivel socioeconómico. Se espera que futuros estudios contribuyan a la investigación de habilidades cognitivas en sectores rurales y socialmente deprivados de Chile.

The recent standardization of Wechsler Adult Intelligence Scale (WAIS) in its fourth version in Chile forces to test the impact that cultural and environmental conditions can have on people's intellectual performance. The present study compared the performance of young people from rural and urban areas of the Biobío region, segmented by parental education level as proxy variable to socioeconomic status. Results showed an interaction effect between socioeconomic status and place of residence. Verbal Comprehension and Working Memory are the constructs that received a higher impact of the socioeconomic status. Future studies are expected to contribute to research on cognitive abilities in rural and socially deprived sectors in Chile.

Investigação dos domínios cognitivos de pacientes com síndrome de williams usando as escalas wechsler / Investigation of cognitive domains in williams syndrome's patients using wechsler's scales

A Síndrome de Williams (SW) é uma doença de etiologia genética, causada por microdeleções na região do cromossomo 7q11.23. Pacientes com SW podem apresentar QI verbal significativamente superior ao executivo, o que explicaria o déficit recorrente nas habilidades visoespaciais e a preservação de aspectos das habilidades verbais. O estudo teve como objetivo analisar o perfil cognitivo de uma série de casos de pacientes com SW, utilizando a Escala Wechsler de Inteligência. A amostra foi composta por dez pacientes. Os resultados apontam para um padrão de desempenho semelhante entre os participantes na escala verbal, porém o QI de execução teve maior correlação com o QI total. Foi observada uma discrepância entre habilidades verbais e não verbais em 40% dos participantes.

Williams Syndrome (WS) is a disease of genetic etiology caused by micro-deletions at the 7q11.23 region. WS's patients may present verbal IQ significantly higher than the performance one, which could explain the recurrent deficit in visuospatial abilities and the preservation of some verbal skills. The study aimed at analyzing the cognitive profile of a case series including WS patients, using Wechsler's Intelligence Scale. The sample was composed of ten patients. The results showed a similar pattern of performance among participants in the verbal scale; however, the performance IQ was more associated with total IQ. We observed a discrepancy between verbal and nonverbal abilities in 40% of the participants.

Viabilidade da estimativa de QI a partir dos subtestes Vocabulário e Cubos da WAIS-III / Viability of IQ estimates based on Vocabulary and Block Design WAIS III subtests

Objetivou-se avaliar a viabilidade de estimar o Quociente de Inteligência (QI) de adultos por meio de duas estratégias que utilizam uma forma curta constituída pelos subtestes Vocabulário e Cubos da Escala Wechsler de Inteligência para Adultos (WAIS-III). Participaram do estudo 77 homens e mulheres, com idade média de 39,1 anos (dp=13,4). Foi aplicada a WAIS-III e questionários para cumprir os critérios de inclusão dos participantes sem prejuízos neurológicos e psiquiátricos. Para avaliar a concordância entre as duas estratégias de estimar o QI, utilizou-se o método estatístico proposto por Bland e Altman. Como resultado, encontrou-se que as estimativas de QI geradas pelas duas estratégias apresentam concordância com a medida do QI realizada pela aplicação da escala completa apenas em alguns dos casos avaliados. Sugere-se cautela na utilização dessas estratégias para estimar o QI de adultos.

The aim of this study was to evaluate the feasibility of estimating the Intelligence Quotient (IQ) in adults based on two strategies that use Vocabulary and Block Design subtests of Wechsler Adult Intelligence Scale (WAIS-III). Seventy-seven men and women participated of the study, with mean age of 39.1 (sd=13.4). WAIS-III subtests were administered and questionnaires were used to verify inclusion criteria for participants without neurological or psychiatric impairments. A statistical method proposed by Bland and Altman was used to evaluate the agreement between both strategies to estimate IQ. Results suggest that IQ estimates derived from both strategies only agree with the IQ derived from the full battery in a few cases of the sample. Considering these findings, caution is suggested when using these strategies to estimate adults' IQ.

Impact of Antiepileptic Drugs on Cognitive Function of Epilepsy Patients / 中国康复理论与实践

@#Objective To evaluate the cognitive impairment in epilepsy patients with Topiramate (TPM) or Valproate (VPA) treatment by using WAIS-CR. Methods30 untreated epilepsy patients were divided into two groups receiving TPM or VPA, respectively. All the patients were examined with WAIS-CR before and 3 months after treatment. ResultsThe IQ of TPM group decreased 3 months after treatment (P<0.05). ConclusionTPM may impair the cognitive function in epileptics reflected by decreased IQ.

Terapeuticas noffarmacologicas en jovenes y adutos con discapacidad, desde la atencion primaria de salud / Non pharmacologic therapeutics in young and adults with incapacity from Primary Health Care

Buscando mejorar la calidad de vida en un grupo de jóvenes y adultos con discapacidad, se decide crear un taller comunitario compuesto por 15 miembros, en el cual se aplican técnicas de enfoque multidisciplinario, que han garantizado la plena reinserción social de los miembros que componen este colectivo. Para este artículo se realiza un corte longitudinal a lo largo de 3 años que muestra la evolución satisfactoria de este grupo a partir de la aplicación de las diferentes terapias establecidas.

In order to improve the quality of life of several disabled persons, a community group was created with 15 members, in which several multidisciplinary techniques were applied to guarantee the full social reinsertion of the participants. This article describes results of the work done during 8 years, showing the satisfactory evolution of the group due to the application of the different established therapies.

Neuropsychological Assessment In Epilepsy Surgery – Preliminary Experience In A Rural Tertiary Care Hospital In North East Malaysia

We present our preliminary experience in neuropsychological testing in epilepsy surgery patients to demonstrate how these tests contributed to decide the laterality of epileptic focus, and to assess the effect of surgery on patient’s cognitive function and quality of life. Preoperative neuropsychological tests consisting of Wechsler Adult Intelligence Scale-III (WAIS) for IQ, Wechsler Memory Scale-III (WMS) for memory and patients’ quality of life (QOLIE 31) were administered to refractory epilepsy patients under evaluation for surgical treatment. These tests were repeated one year after surgery and we studied any changes in trends. A total of seven patients were recruited in this study between July 2004 and July 2006. The aetiologies of refractory epilepsy were pure mesial temporal sclerosis (MTS) in five patients, dysembryogenic neuroepithelial tumour (DNET) in one and dual lesion of cavernous angioma with ipsilateral MTS in one. The preoperative neuropsychological tests were all in concordance to MRI finding, and showed good contralateral function; five lateralises to the right and two to the left. The post-operative Engel seizure count (median 8.00, IQR 7.00–8.75), general IQ (88 vs. 79), performance IQ (94 vs. 79), verbal memory (89 vs. 71), non-verbal memory (88 vs. 75) and QOLIE (53.14 vs. 44.71) were better compared to preoperative values. The verbal IQ (84 vs. 84) was unchanged. Neuropsychological tests are useful as ancillary investigations to determine the laterality of seizure focus and integrity of function in the contralateral temporal lobe. Following successful surgical treatment, there is a trend towards improvement in memory, IQ and quality of life scores in this small group of patients.

Postoperative Cognitive Dysfunction in Adult Patients: Risk Factor and Its Influence on Clinical Outcome / 中国康复理论与实践

@#Objective To investigate the influence of postoperative cognitive dysfunction (POCD) to clinical outcome in adult patients and the risk factor. Methods 122 patients after operation on chest were surveyed with Wechsler Adult Intelligence Scale-Revised China (WAIS-RC) within 3 d before operation and on the 7th day after operation. Their pulmonary functions were measured before discharged. Their time on bed, total time in hospital, time after operation in hospital, time in intensive care unit and spending for therapy were investigated. Results 45 patients were finally diagnosed as POCD (POCD group) 7 d after operation. Before operation, the age, the body weight index, the smoking index and the number of risk factor of angiosclerosis in the POCD group were all higher than those whose cognitive function were normal (normal group) (P<0.05). The sores of insight, count, digit scope, vocabulary, figure collocation, figure patch of WAIS-RC in POCD group were obviously lower than those in normal group (P<0.05). Every index of pulmonary function in POCD group was lower than those in normal group(P<0.05). The time keeping on bed, total time in hospital, time after operation in hospital, time in intensive care unit and spending for therapy in POCD group all exceeded those in normal group (P<0.05).Conclusion The adult patients with POCD may spend more time and money for therapy in hospital, and their pulmonary functions may be recovered poorly.