Motoric encoding and retention of pictures in Alzheimer's disease.

20 patients with Alzheimer's disease were shown line drawings of common objects on two trials. During the second trial they were asked to pantomime an action for the object and then provided a standard motoric cue or were asked to name it and then provided a standard semantic cue. Semantic cueing served as a stimulus-processing control condition. Memory for pictures was assessed at a 48-hr. delay interval using a yes-no recognition-memory procedure. Discrimination of stimulus pictures from distractors at 48 hours was similar for the motoric and control (semantic) encoding condition. These findings suggest that motoric encoding does not enhance long-term retention of episodic memories for pictures in such patients.

Neuropsychological manifestations of hyponatremia in chronic schizophrenic patients with the syndrome of psychosis, intermittent hyponatremia and polydipsia (PIP).

We examined the neuropsychological sequelae of water intoxication in nine schizophrenic patients with the syndrome of psychosis, intermittent hyponatremia and polydipsia (PIP). Patients were assessed using a standardized test battery on two occasions following laboratory blood work: once during hyponatremia (serum sodium < 130 mmol/l) and once during normonatremia (serum sodium > 136 mmol/l). Results revealed significant deficits during hyponatremia involving complex information processing skills such as mental flexibility and verbal fluency. In contrast, short-term memory was intact and no deficits in sustained attention or visual-motor scanning were observed. Our results underscore the dramatic fluctuations in neuropsychological functioning due to metabolic and osmotic changes during water loading in PIP syndrome patients. In addition, we found that the neuropsychological effects of hyponatremia are remarkably consistent across patients. These complications, if not recognized, are likely to contribute to worsening of psychosis despite appropriate pharmacological treatment while severely limiting patient ability to actively participate in behavioral interventions.

Utilizing neuropsychological measures to predict vocational outcome in a head trauma population.

The present study examined the ability of traditional neuropsychological measures to predict successful vocational training in a severely neurologically impaired population. Eighty head trauma patients were evaluated prior to pre-vocational training which involved cognitive remediation and psychosocially-based intervention. Subjects were approximately 2 years post-injury. Results showed that of the total population studies, 73.8% participated in vocational evaluations, 23.8% did not, and 2.4% of the sample returned to work or college. Neuropsychological assessments were over 77% accurate in predicting whether subjects would successfully complete this vocational evaluation. The most significant predictors were reading comprehension, immediate and delayed verbal memory, level of depression, and dysphasic symptomatology. Issues relating to generalizability of cognitive retraining to the vocational evaluation and/or vocational training setting are discussed. Future considerations for both clinical practice and research include the use of ecologically valid measures.