BACKGROUND: Perioperative neurocognitive disorders are often neglected and undiagnosed. There are known risk factors for these disorders (e.g., higher levels of frailty, cognitive decline before surgery). However, these factors are usually not assessed in the daily clinical setting. One of the main reasons for this lack of examination is the absence of a suitable cognitive function test that can be used in acute clinical settings. The primary aim of this study was to determine correlations between preoperative and postoperative scores on three cognitive tests (the Mini Mental State Exam (MMSE), the Clock Drawing Test (CDT) and the Test of Gestures (TEGEST). METHODS: This was a prospective, monocentric, observational study that included one cohort of patients aged 65 years and older. Patients underwent acute or elective surgical operations. Preanaesthesia tests were administered. After the operation, the patients completed the same tests between the 2nd postoperative day and discharge. Preoperative and postoperative cognitive test scores were assessed. RESULTS: This study included 164 patients. The arithmetic mean age was 74.5 years. The strongest correlations were observed between MMSE scores and TEGEST scores (r = 0.830 before and 0.786 after surgery, P < 0.001). To compare the MMSE and the TEGEST, the MMSE was divided into 2 categories-normal and impaired-and good agreement was found among 76.2% of the participants (κ = 0.515). If the TEGEST scoring system was changed so that scores of 4-6 indicated normal cognition and scores of 0-3 indicated cognitive impairment, the level of agreement would be 90.8%, κ = 0.817. Only 5.5% of the patients had impaired MMSE scores and normal TEGEST scores, whereas 3.7% of the respondents normal MMSE scores and impaired TEGEST scores. CONCLUSION: According to our results, the TEGEST is a suitable option for assessing cognitive functioning before surgery among patients who are at risk of developing perioperative neurocognitive disorders. This study revealed that it is necessary to change the rating scale for the TEGEST so that scores of 4-6 indicate normal cognition and scores of 0-3 indicate cognitive impairment. In clinical practice, the use of the TEGEST may help to identify patients at risk of perioperative neurocognitive disorders.
- MeSH
- Risk Assessment methods MeSH
- Cognitive Dysfunction diagnosis psychology etiology MeSH
- Humans MeSH
- Neurocognitive Disorders * diagnosis psychology MeSH
- Neuropsychological Tests MeSH
- Perioperative Period MeSH
- Postoperative Complications diagnosis psychology etiology MeSH
- Prospective Studies MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Mental Status and Dementia Tests MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Observational Study MeSH
OBJECTIVES: To evaluate the coherence values of the cortical bands in patients with first episode schizophrenia and schizoaffective disorder during the performance of a mental arithmetic task. METHOD: We analysed EEG coherence in the resting state and subsequently while counting down from 200 in steps of 7 in 32 first episode schizophrenia patients (SZ), 32 patients with first episode schizoaffective disorder (SA) and 40 healthy controls (HC). RESULTS: Task performance in HC is characterised by decreased coherence in the alpha bands and increased coherence in the beta 2 and gamma bands in frontal sites. In SZ, coherence decreases in the alpha band, whereas in SA it substantially increases in the alpha, beta1, beta 2 and gamma bands. CONCLUSIONS: Despite no differences in performance on a behavioural level, SA patients demonstrate a paradoxical increase in both low and fast frequency bands during the performance of a mental arithmetic task, while, patients with SZ show a decreased coherence in the alpha band, presumably alluding to the excessive excitatory (in SA) and inhibitory (in SZ) mechanisms in cognitive processing. SIGNIFICANCE: The current study provides evidence for the distinction of neurophysiological mechanisms of cognitive processing between SZ and SA.
- MeSH
- Adult MeSH
- Intelligence Tests MeSH
- Cognition * MeSH
- Humans MeSH
- Mathematics MeSH
- Adolescent MeSH
- Brain Waves * MeSH
- Psychotic Disorders physiopathology MeSH
- Schizophrenia physiopathology MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
The altered regulation of autonomic response to mental stress can result in increased cardiovascular risk. The laboratory tests used to simulate the autonomic responses to real-life stressors do not necessarily induce generalized sympathetic activation; therefore, the assessment of regulatory outputs to different effector organs could be important. We aimed to study the cardiovascular sympathetic arousal in response to different mental stressors (Stroop test, mental arithmetic test) in 20 healthy students. The conceivable sympathetic vascular index--spectral power of low frequency band of systolic arterial pressure variability (LF-SAP) and novel potential cardio-sympathetic index--symbolic dynamics heart rate variability index 0V% were evaluated. The heart and vessels responded differently to mental stress--while Stroop test induced increase of both 0V% and LF-SAP indices suggesting complex sympathetic arousal, mental arithmetic test evoked only 0V% increase compared to baseline (p<0.01, p<0.001, p<0.01, respectively). Significantly greater reactivity of LF-SAP, 0V%, heart rate (HR) and mean arterial pressure (MAP) were found in response to Stroop test compared to mental arithmetic test potentially indicating the effect of different central processing (0V%, LF-SAP: p<0.001; HR, MAP: p<0.01). The different effectors' sympathetic responses to cognitive stressors could provide novel important information regarding potential pathomechanisms of stress-related diseases.
- MeSH
- Arousal * MeSH
- Arterial Pressure * MeSH
- Cardiovascular System innervation MeSH
- Cognition MeSH
- Humans MeSH
- Linear Models MeSH
- Mathematical Concepts MeSH
- Young Adult MeSH
- Nonlinear Dynamics MeSH
- Stress, Psychological etiology physiopathology psychology MeSH
- Heart Rate * MeSH
- Stroop Test MeSH
- Sympathetic Nervous System physiopathology MeSH
- Healthy Volunteers MeSH
- Check Tag
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Comparative Study MeSH
OBJECTIVE: To evaluate the spectral power of the cortical bands in patients with first episode schizophrenia and schizoaffective disorder at rest and during the performance of a mental arithmetic task. METHODS: We analyzed EEG spectral power (SP) in the resting state and subsequently while counting down from 200 in steps of 7, in 32 first episode schizophrenia patients (SZ), 32 patients with first episode schizoaffective disorder (SA) and healthy controls (HC, n=40). Behavioral parameters such as accuracy and counting speed were also evaluated. RESULTS: Both SZ and SA patients were slower in counting than HC, no difference was obtained in the accuracy and counting speed in the patient groups. In the resting state patients showed elevated midline theta power, off-midline anterior beta 2 power and decreased central/posterior alpha power. The SA group occupied an intermediate position between the schizophrenia patients and controls. In task performance patients lacked a typical increase of midline theta, left anterior beta 2, and anterior gamma power; however, schizoaffective patients demonstrated a growing trend of power in the gamma band in left anterior off-midline sites similar to HC. Moreover, alpha power was less inhibited in schizoaffective patients and more pronounced in schizophrenia patients indicating distinct inhibitory mechanisms in these psychotic disorders. CONCLUSIONS: Patients with SA demonstrate less alteration in the spectral power of bands at rest than SZ, and present spectral power changes during cognitive task performance close to the controls. SIGNIFICANCE: Our study contributes to the present evidence on the neurophysiological distinction between schizophrenia and schizoaffective disorder.
- MeSH
- Alpha Rhythm physiology MeSH
- Beta Rhythm physiology MeSH
- Adult MeSH
- Electroencephalography * MeSH
- Cognition physiology MeSH
- Middle Aged MeSH
- Humans MeSH
- Brain Mapping MeSH
- Mathematics * MeSH
- Adolescent MeSH
- Young Adult MeSH
- Rest physiology MeSH
- Task Performance and Analysis * MeSH
- Psychotic Disorders physiopathology MeSH
- Schizophrenia physiopathology MeSH
- Case-Control Studies MeSH
- Theta Rhythm physiology MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
OBJECTIVES: Cognitive disorders and dementia occur in 19 to 42% of patients with spinocerebellar ataxia type 2 (SCA2). Neuropsychological tests can reveal executive dysfunction, impaired visual and verbal memory, tongue and speech impairment, attention disorders and impaired verbal fluency. METHODS: We performed psychiatric and neuropsychological examinations in 12 patients diagnosed with genetically confirmed SCA2 and 12 healthy volunteers matching the patients in age, gender, and length of education. The level of motor impairment was determined using the brief ataxia rating scale (BARS). The neuropsychological examination focused on testing executive functions, short-term visual and verbal memory, attention, psychomotor tempo, visual motor coordination, learning ability and comprehension ability. The tests were divided into two subgroups according to the difficulty of motor tasks. The cognitive abilities composite score (CACS) was determined by calculating the arithmetic mean of T scores of the respective tests. RESULTS: Patients with SCA2 had significantly lower CACSs (p=0.00005) compared to the healthy volunteers. Patients exhibited impaired performance in both difficult and simple motor tests. The severity of cognitive impairment was related to the age at the onset of the disease (p=0.002) but not to the duration or to the overall BARS score. CONCLUSIONS: Compared to healthy volunteers, patients with SCA2 exhibited significantly worse cognitive performance in all areas tested, including the tests of simple motor tasks. Moreover, the cognitive performance of patients worsened as the difficulty of the motor tasks increased.
- MeSH
- Adult MeSH
- Executive Function MeSH
- Cognition physiology MeSH
- Cognition Disorders etiology psychology MeSH
- Middle Aged MeSH
- Humans MeSH
- Neuropsychological Tests MeSH
- Memory physiology MeSH
- Attention physiology MeSH
- Psychomotor Performance physiology MeSH
- Spinocerebellar Ataxias complications genetics psychology MeSH
- Learning physiology MeSH
- Age of Onset MeSH
- Visual Perception physiology MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
OBJECTIVES: To investigate if the increased pain threshold in women with bulimia nervosa (BN) may be due to chronic stress-induced analgesia. METHODS: We measured thermal pain threshold latency, blood pressure and heart rate in 21 women with BN and 21 healthy women (HW) under six consecutive conditions: rest I, mental arithmetic task, rest II, eating sweet food, rest III, cold-pressor test. RESULTS: Thermal pain threshold latency was longer in BN than in HW in all six conditions. It increased during mental arithmetic test and remained increased during the rest of the experiment in both groups. In the BN group, the increase of pain threshold during mental arithmetic was positively correlated with illness duration. The differential modulation of pain threshold by stress in BN and HW could not be explained by autonomic system reactivity. In HW, the pain threshold increased more during eating and blood pressure increased more during mental stress; in BN, the pain threshold was highest in the mental stress condition and blood pressure was most increased during eating. During the cold pressor test, women with BN showed smaller blood pressure increase and tolerated the cold for shorter time than HW. CONCLUSION: The observed marked modulation of pain threshold by experimental stress suggests that stress-induced analgesia is unlikely to account for baseline pain insensitivity in BN. Increased pain threshold in BN is a stable yet incompletely understood phenomenon, which may be related to the predisposition to or maintenance of the disorder.
- MeSH
- Analysis of Variance MeSH
- Pain physiopathology psychology MeSH
- Bulimia Nervosa physiopathology psychology MeSH
- Time Factors MeSH
- Dietary Sucrose administration & dosage MeSH
- Blood Pressure MeSH
- Humans MeSH
- Young Adult MeSH
- Cold Temperature MeSH
- Rest physiology psychology MeSH
- Perception physiology MeSH
- Task Performance and Analysis MeSH
- Pain Threshold MeSH
- Eating physiology psychology MeSH
- Stress, Psychological physiopathology MeSH
- Heart Rate MeSH
- Check Tag
- Humans MeSH
- Young Adult MeSH
- Female MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- MeSH
- Dopamine diagnostic use MeSH
- Emotions physiology MeSH
- Research Support as Topic MeSH
- Hemodynamics physiology drug effects MeSH
- Humans MeSH
- Adolescent MeSH
- Defense Mechanisms physiology MeSH
- Task Performance and Analysis physiology MeSH
- Ventricular Function physiology drug effects MeSH
- Check Tag
- Humans MeSH
- Adolescent MeSH
- Publication type
- Comparative Study MeSH
