Subacute effects of sertraline on attentional and executive functions in depression
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Abstract
Objectives: Delirium is a neuropsychiatric syndrome frequently observed in the elderly
population (Korevaar, van Munster & de Rooij, 2005). The aim of this study was to
determine if patients with delirium show measurable deficits in attentional functioning in
comparison to a cognitively-impaired and cognitively-unimpaired group Subjects and
Methods: A battery of tests that measured general cognitive functioning and attentional
processing were administered to 20 delirium, 18 Alzheimer’s dementia and 19 cognitivelyunimpaired
patients over the age of 65 Results: Using non-parametric measures it was
shown delirium participants significantly differed from dementia and cognitively-unimpaired
controls in all attentional tasks Conclusions: It is concluded attentional deficits are a key
feature of delirium and in future could form the basis of a neuropsychological marker of this
syndrome.
Verbal fluency test
Attention deficits
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Neuropsychological impairment is prominent in patients with depression, but it is unclear whether deficits persist after clinical response. This study aimed to investigate neuropsychological functions in the course of the illness. Depressive patients were investigated in the acute state and after clinical response using an extensive neuropsychological test battery. After clinical response, there was only a partial improvement in learning and memory and there were no changes regarding working memory, executive functions, and attention. Transient impairments in visual learning and memory suggest a depression-related state effect. The continuing deficits in attention, working memory, and executive function might be considered a trait marker.
Depression
Neuropsychological Assessment
Neuropsychological test
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Background Subjective cognitive decline (SCD) is the sense of deterioration in cognitive functioning in terms of memory, executive function, attention, etc. SCD is reported by nearly 70% of the population. Very intensive research on the predictive role of SCD in the development of dementia and determinants SCD did not bring common solutions. For exploration of the phenomenon, studies were undertaken in order to identify: a) on the basis of which factors a high level of SCD can be predicted, and b) whether these factors have similar prognostic value for two types of SCD, i.e. concerning executive function (SED) and memory (SMD). Participants and procedure The study involved 274 Polish people aged 18 to 84 years (M = 53.23, SD = 16.8). For the evaluation of SCD three methods were used: memory self-assessment scales (ProCog and MARS), and an executive functions self-assessment scale (DEX-S). Subtests of the WAIS-PL to assess cognitive function were used, and GDS-15 or BECK II to assess the severity of depressive mood. In the first stage, two separate cluster analyses (k-means method) were performed: the first related to the results of the memory self-assessment scale (ProCog and MARS), the second to the subjective difficulty of executive functions (DEX-S). In step II a logistic regression analysis of the forward selection with the likelihood ratio and interaction effects was performed – separately for the two types of self-reports. Results The results indicate that higher depressed mood increases the likelihood of both the SMD and SED. Higher efficiency attention-al processes reduce the possibility of formulating the SED, and higher efficiency of the delayed memory, abstract thinking, or certain aspects of language functions reduces the possibility of SMD. Conclusions There are two independent mechanisms of SCD – emotional and cognitive.
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Event Abstract Back to Event Impaired attentional and executive performance associated with cognitive complaints in head trauma T. Isoviita1, S. Liimatainen2, M. Wäljas2, A.K Solbakk3, P. Dastidar2, S. Soimakallio2, J. Öhman2, A. Ylinen1, S. Carlson1 and Kaisa Hartikainen1, 2* 1 Tampere University, Finland 2 Tampere University Hospital, Finland 3 Rikshospitalet University Hospital, Norway The frontal lobes are susceptible to injury after head trauma due to their location, extensive connections to other brain areas and their relatively large size. Many of the cognitive and neuropsychiatric symptoms associated with mild head injury are thought to reflect frontal dysfunction. Even though most mild head injury patients recover fully some remain symptomatic. Cognitive symptoms such as distractibility, impaired attention and memory are common complaints. Objective detection of frontal dysfunction underlying subjective symptoms remains a challenge. Traditional neuropsychological tests may not be sensitive to mild frontal dysfunction. The aim of this study was to objectively detect mild frontal dysfunction assumed to underlie persistent cognitive complaints. We created a reaction time test that engages simultaneously many frontally mediated executive functions such as inhibition of distraction, changing mental sets, controlled attention, working memory and response inhibition in a go-no go task. Eighteen patients with mild to moderate head injury participated in this study. Patients who had been admitted to Tampere University Hospital emergency room due to a head injury were recruited. On admission a CT examination was performed within a few hours and a detailed MRI examination 3 weeks post-injury. Extensive neuropsychological testing was performed within 2 weeks of admission and a follow up neurological examination at 3 to 6 months. The executive RT tests were performed at about 6 months after the head injury. Patients were divided into two groups, symptomatic and asymptomatic depending on admitting or denying any persisting symptoms on a questionnaire at the time of testing. This study showed that patients with subjective symptoms performed worse in the RT test engaging multiple executive functions than those who did not report symptoms. Both reaction time and accuracy distinguished symptomatic from asymptomatic subjects. This test was able to distinguish symptomatic and asymptomatic subjects by reaction times at sensitivity of 62,5 % and specificity of 80 % and by number of errors at sensitivity of 82,5 % and specificity of 70 %. When both reaction times and errors were taken into account the test reached sensitivity of 100 % with 70 % specificity. This study shows that a reaction time test that engages many executive, and presumed frontal, functions can be a useful tool in assessing persistent symptoms caused by mild to moderate head injury. Tests that tap into specific executive and attentional domains can add valuable information to traditional neuropsychological assessment, MRI and clinical examination. Frontal lobe dysfunction is one of many possible reasons for cognitive complaints. Yet, in this study a combined test of different aspects of attentional and executive function was excellent in separating symptomatic from asymptomatic subjects. For further insight into frontal lobe dysfunction underlying symptoms, ERP and fMRI studies with similar tasks are warranted. Conference: 10th International Conference on Cognitive Neuroscience, Bodrum, Turkey, 1 Sep - 5 Sep, 2008. Presentation Type: Poster Presentation Topic: Neuropsychiatric Disorders Citation: Isoviita T, Liimatainen S, Wäljas M, Solbakk A, Dastidar P, Soimakallio S, Öhman J, Ylinen A, Carlson S and Hartikainen K (2008). Impaired attentional and executive performance associated with cognitive complaints in head trauma. Conference Abstract: 10th International Conference on Cognitive Neuroscience. doi: 10.3389/conf.neuro.09.2009.01.409 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 17 Dec 2008; Published Online: 17 Dec 2008. * Correspondence: Kaisa Hartikainen, Tampere University, Tampere, Finland, kaisa.hartikainen@live.com Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers T. Isoviita S. Liimatainen M. Wäljas A.K Solbakk P. Dastidar S. Soimakallio J. Öhman A. Ylinen S. Carlson Kaisa Hartikainen Google T. Isoviita S. Liimatainen M. Wäljas A.K Solbakk P. Dastidar S. Soimakallio J. Öhman A. Ylinen S. Carlson Kaisa Hartikainen Google Scholar T. Isoviita S. Liimatainen M. Wäljas A.K Solbakk P. Dastidar S. Soimakallio J. Öhman A. Ylinen S. Carlson Kaisa Hartikainen PubMed T. Isoviita S. Liimatainen M. Wäljas A.K Solbakk P. Dastidar S. Soimakallio J. Öhman A. Ylinen S. Carlson Kaisa Hartikainen Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. 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Executive dysfunction
Head trauma
Neuropsychological test
Continuous performance task
Closed head injury
Neuropsychological Assessment
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Endophenotype
Neurocognitive
Mnemonic
Executive dysfunction
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