Assessment of physical activity and cognitive function and their potential correlation in convalescent patients of cerebrovascular disease.

Physical activity (PA) is known to influence cognitive function. However, the impact of PA on patients with cerebrovascular disease (CVD) has not yet been elucidated. PA and cognitive function have not been measured simultaneously over time, which makes it difficult to evaluate their relationship. The purpose of this study was to investigate the change in the amount of PA recorded by ActiGraph GT3X-BT and six test scores of cognitive function, and the relationship between them in 15 patients with CVD (six women and nine men; 78.0 ± 11.6 years old). Results showed an increase in the amount of PA and scores of cognitive tests, and a significant decrease in the duration of sedentary behavior during the four months (p < 0.05). There were significant correlations between PA Energy Expenditure (PAEE) and Raven's Colored Progressive Matrices test (RCPM) (r = 0.536, p < 0.0001). There were significant correlations between PAEE and Symbol Digit Modalities Test (SDMT) (r = 0.271, p = 0.036). There were significant correlations between sedentary behavior and RCPM (r = -0.606, p < 0.0001). There were significant correlations between sedentary behavior and SDMT (r = -0.355, p = 0.005). There were significant correlations between Light PA (LPA) and RCPM (r = 0.603, p < 0.0001). There were significant correlations between LPA and SDMT (r = 0.362, p = 0.005).

Development of a cognitive function test using virtual reality technology: examination in healthy participants.

We developed a virtual reality test to assess the cognitive function of Japanese people in near-daily-life environment, namely, a virtual shopping test (VST). In this test, participants were asked to execute shopping tasks using touch panel operations in a "virtual shopping mall." We examined differences in VST performances among healthy participants of different ages and correlations between VST and screening tests, such as the Mini-Mental State Examination (MMSE) and Everyday Memory Checklist (EMC). We included 285 healthy participants between 20 and 86 years of age in seven age groups. Therefore, each VST index tended to decrease with advancing age; differences among age groups were significant. Most VST indices had a significantly negative correlation with MMSE and significantly positive correlation with EMC. VST may be useful for assessing general cognitive decline; effects of age must be considered for proper interpretation of the VST scores.

A virtual shopping test for realistic assessment of cognitive function.

BACKGROUND: Cognitive dysfunction caused by brain injury often prevents a patient from achieving a healthy and high quality of life. By now, each cognitive function is assessed precisely by neuropsychological tests. However, it is also important to provide an overall assessment of the patients' ability in their everyday life. We have developed a Virtual Shopping Test (VST) using virtual reality technology. The objective of this study was to clarify 1) the significance of VST by comparing VST with other conventional tests, 2) the applicability of VST to brain-damaged patients, and 3) the performance of VST in relation to age differences. METHODS: The participants included 10 patients with brain damage, 10 age-matched healthy subjects for controls, 10 old healthy subjects, and 10 young healthy subjects. VST and neuropsychological tests/questionnaires about attention, memory and executive function were conducted on the patients, while VST and the Mini-Mental State Examination (MMSE) were conducted on the controls and healthy subjects. Within the VST, the participants were asked to buy four items in the virtual shopping mall quickly in a rational way. The score for evaluation included the number of items bought correctly, the number of times to refer to hints, the number of movements between shops, and the total time spent to complete the shopping. RESULTS: Some variables on VST correlated with the scores of conventional assessment about attention and everyday memory. The mean number of times referring to hints and the mean number of movements were significantly larger for the patients with brain damage, and the mean total time was significantly longer for the patients than for the controls. In addition, the mean total time was significantly longer for the old than for the young. CONCLUSIONS: The results suggest that VST is able to evaluate the ability of attention and everyday memory in patients with brain damage. The time of VST is increased by age.

Momentary changes in the cardiovascular autonomic system during mental loading in patients with panic disorder: a new physiological index "rho(max)".

BACKGROUND: Although panic disorder (PD) is suggestive of autonomic nervous system dysfunction, especially in the cardiovascular autonomic system (CAS), the results in many previous studies are still controversial. Using a new physiological index which could well reflect emotional reaction to visual stimuli (Yoshizawa, M., Sugita, N., Tanaka, A., Abe, K., Yambe, T., Nitta, S., 2001. Quantiatative Physioligical Evaluation of Three Dimensional Images. The Seventh International Conference on Virtual Systems and Multumedia, 25-27.), we studied momentary changes in the CAS in patients with PD during audiovisual stimulation (AS) as mental loading. METHODS: During AS, exposed to a video of imaginary experiences such as driving a motor vehicle or diving into the sea, blood pressure (BP) and heart rate (HR) were measured in 12 remitted patients with PD and 19 age- and sex-matched normal controls (NC). We used the maximum cross-correlation coefficient (rho(max)) from the BP to the HR, whose frequency components were limited to around 0.1 Hz. RESULTS: The rho(max) was an available index which could detect the momentary changes in the CAS during AS in both groups. The two-way ANOVA disclosed significant group and time effects on the rho(max). The momentary response to emotional stimuli in the PD patients was slower than that in the NC subjects. LIMITATIONS: Antidepressants have a potential impact on the autonomic variables in this study. CONCLUSIONS: These findings suggest that there may be a dysfunction of the CAS in remitted PD patients and that the dysfunction may be one of the trait markers of PD. To confirm these findings, however, further studies with a large sample size are required.

Pupillary light reflex in panic disorder. A trial using audiovisual stimulation.

BACKGROUND: Although many previous studies reported abnormalities of autonomic function in patients with panic disorder (PD), almost all targets in those studies primarily focused on cardiovascular autonomic functions. In the present study, we determined whether PD patients exhibited abnormalities in the pupillary autonomic nervous system (ANS). METHODS: Before and after audiovisual stimulation (AS), which induced mental stress through exposure to video images of high stress experiences, such as driving motor vehicles, the pupillary light reflex (PLR) was measured by infrared pupillometer in 13 remitted PD patients and twenty age- and gender-matched normal controls (NC). RESULTS: Before and after AS, there were no significant differences in initial pupillary diameters in dark conditions (D1), pupillary diameters at maximum constriction (D2) or constriction ratios (CR: (D1-D2)/D1) between PD and NC subjects. However, the CR ratio (CR before/CR after) was significantly higher in the PD group than in the NC. CONCLUSIONS: These findings suggest that even remitted PD patients may have a dysfunctional PLR regulation with experimental stressors such as AS.

Economic slump and suicide method: preliminary study in Kobe.

During the recent half decade, Japan's suicide rate at approximately 25 deaths per 100 000 people has been one of the highest rates in the world. From the perspective of suicide prevention by restricting access to suicidal means, the aim of the present study was to examine what kind of suicidal method increased during prolonged economic slump. During 21 years (1981-2001), for all suicide victims (5161 cases) the gender, age, and suicide methods were investigated. The yearly full unemployment rate was also used as a representative socioeconomic factor during the same periods in Japan using government statistics, and the relationship between methods of suicide and full unemployment rate was investigated. Pearson's correlation suggested that there was a significant correlation only for hanging rate (r = 0.736, P < 0.001), but not for the percentages of other methods of suicide. This finding that unemployed persons may have a susceptibility towards certain suicide methods could help in the prevention of suicides. Mental health in Japan should be given more attention, especially for the working population, and social programs offering help should be considered widely.

Blink rate variability in patients with panic disorder: new trial using audiovisual stimulation.

Several lines of evidence have implicated central dopaminergic pathways in the modulation of spontaneous blink rate (BR). Furthermore, previous studies have indicated a relationship between spontaneous BR and anxiety and/or depression. However, to our knowledge, there is no report on the examination of BR in a group of patients with panic disorder (PD). During the conditions of rest and with audiovisual stimulation, exposed to a video of imaginary experiences, such as driving a motor vehicle or diving into the sea, BR was examined in 11 male patients with PD and compared with the BR of 16 age-matched normal controls. The BR was significantly higher in PD patients relative to normal controls under both conditions. In particular, the PD group had a higher BR score during the sea scene as relaxation compared with the normal controls. In conclusion, although the sample size was small the present preliminary study, these findings suggest that BR may have potential for application in the assessment of anxiety state, which is consistent with previous studies.