Neuropsychological performance in OCD: a study in medication-naïve patients.

BACKGROUND: Obsessive-compulsive disorder (OCD) is associated with impairments in multiple neuropsychological domains but the findings are rather inconsistent across studies. One potential reason for poor replication is the confounding influence of medications. There is limited research on neuropsychological performance in medication-naïve, never treated OCD patients. METHODS: In this study, we assessed 31 medication-naïve, never-treated, DSM-IV OCD patients free of comorbid major depression and 31 healthy controls individually matched for age, gender and years of education, with tests of attention, executive function, memory reasoning and visuo-spatial function. RESULTS: Medication-naïve OCD patients did not significantly differ from healthy controls on most neuropsychological tests. Patients performed somewhat poorly only on the highest goal hierarchy of the Tower of London (TOL) test (p=0.001, effect size=0.68). CONCLUSIONS: It is intriguing to find that symptomatic, drug-naïve OCD patients did not significantly differ from healthy controls on most neuropsychological tests. Our finding of medium effect size on TOL highest goal hierarchy test suggests that brain regions outside the affective orbitofrontal loop may also be perhaps involved in OCD. This finding however needs replication because of modest effect size. Future studies should focus on studying medication-naïve, co-morbidity-free patients and relatives using symptom dimensions for consistent and robust findings.

Hypoxia: can neuropsychological rehabilitation attenuate neuropsychological dysfunction.

Anoxia and hypoxia may be caused by a number of events - heart attack, strangulation, anesthetic accidents, or poisoning. Cognitive dysfunction in hypoxia is well described. The purpose of the study was to examine the efficacy of neuropsychological rehabilitation in hypoxic brain damage. Single-case pre post intervention study design was adopted. The neuropsychological profile was compared pre- and post-neuropsychological rehabilitation. A 30-year-old woman with diagnosis of post- hypoxic encephalopathy underwent cognitive retaining every day for 1 hour. She had a total of 138 sessions over a period of 7 months. Results indicated improvement of cognitive functions post cognitive retraining in most of the cognitive domains. This improvement was also found to have a generalization effect in her every day functioning. Cognitive retraining was found to be useful in hypoxic brain damage. Cognitive retraining combined with other adjunct therapy was found to have significant impact on the patient and the family members. the significant others.