ABSTRACT
The cerebellum is increasingly recognised for its role in modulation of cognition, behaviour, and affect. The present study examined the relation between structural cerebellar damage (grey matter volume (GMV), white matter hyperintensities (WMHs), lacunar infarcts (LIs) and microbleeds (MBs)) and measures of cognitive, psychological (i.e. symptoms of depression and apathy) and general daily functioning in a population of community-dwelling older persons with mild cognitive deficits, but without dementia. In 194 participants of the Discontinuation of Antihypertensive Treatment in Elderly People (DANTE) Study Leiden, the association between cerebellar GMV, WMHs, LIs and MBs and measures of cognitive, psychological and general daily functioning was analysed with linear regression analysis, adjusted for age, sex, education and cerebral volume. Cerebellar GMV was associated with the overall cognition score (standardised beta 0.20 [95% CI, 0.06-0.33]). Specifically, posterior cerebellar GMV was associated with executive function (standardised beta 0.18 [95% CI, 0.03-0.16]). No relation was found between vascular pathology and cognition. Also, no consistent associations were found on the cerebellar GMV and vascular pathology measures and psychological and general daily functioning. In this population of community-dwelling elderly, less posterior cerebellar GMV but not vascular pathology was associated with worse cognitive function, specifically with poorer executive function. No relation was found between cerebellar pathology and psychological and general daily functioning.
Subject(s)
Cerebellum/pathology , Cognition Disorders/pathology , Gray Matter/pathology , Activities of Daily Living , Aged , Aged, 80 and over , Blood Vessels/pathology , Cognition , Cognition Disorders/psychology , Cognitive Dysfunction/pathology , Cognitive Dysfunction/psychology , Executive Function , Female , Humans , Independent Living , Magnetic Resonance Imaging , Male , Middle Aged , Neuropsychological TestsABSTRACT
Epileptic disorders can manifest themselves with symptoms of anxiety and panic. In clinical practice it is not always easy to achieve a correct diagnosis. The subject of this case study is an adult with symptoms of anxiety and panic who was referred to the mental health care service but who was diagnosed as having epilepsy when subjected to a supplementary examination. Psychological and in particular anxiety symptoms in epilepsy are discussed. The psychiatrist needs to consider the possibility of epilepsy in a patient presenting with anxiety symptoms.
Subject(s)
Anxiety Disorders/diagnosis , Epilepsy/diagnosis , Epilepsy/psychology , Adult , Anxiety Disorders/etiology , Diagnosis, Differential , Epilepsy/complications , Humans , Male , Panic Disorder/diagnosis , Panic Disorder/etiologyABSTRACT
The Location Learning Test is a neuropsychological test that can be used to assess memory for object locations. The test has originally been developed for the assessment of visuo-spatial memory impairment in patients with dementia. However, ceiling effects may be present in other patient groups. This study has examined the applicability of a modified administration procedure with a shorter presentation duration and longer delay. The test was administered in a group of stroke patients (n = 105), a group of patients with diabetes (n = 93), as well as a group of healthy volunteers (n = 97). The results indicate that the Location Learning Test can be used to discriminate the diabetes and stroke patients from the control group. Furthermore, differences between patients with a left and a right-hemisphere stroke were found. The test has a high correlation with another memory test. The performance of the group healthy volunteers was used to calculate normative data for use in clinical practice.
Subject(s)
Diabetes Mellitus/psychology , Memory/physiology , Mental Recall , Space Perception , Stroke/psychology , Adolescent , Adult , Aged , Aged, 80 and over , Case-Control Studies , Diabetes Mellitus/physiopathology , Female , Humans , Male , Middle Aged , Pattern Recognition, Visual , Stroke/physiopathologyABSTRACT
Diabetes mellitus seems to be associated with gradually developing end-organ damage to the central nervous system. This relatively unknown complication of both diabetes type 1 and type 2 can be referred to as 'diabetic encephalopathy'. Measurable manifestations are electrophysiological and structural changes and limitations in the cognitive functioning. The mechanisms responsible for this diabetic encephalopathy are only partially known. Chronic metabolic and vascular changes seem to play an important role. The effects of diabetes on the brain are most distinct in the elderly. This may be the consequence of interactions between the mechanisms that underlie the ageing of the brain, dementia and the origin of diabetic complications. At present there are few leads for the targeted diagnostics and treatment of individual patients.
