Kognitivní deficit u schizofrenie je považován za klíčový příznak tohoto závažného duševního onemocnění. V posledních dvou dekádách bylo tomuto tématu věnováno poměrně velké množství literatury, nicméně doposud nebyla nalezena úplná shoda o profilu, dynamice ani příčinách a době vzniku kognitivního deficitu u této skupiny pacientů. Kognitivní deficit u schizofrenie bývá často dáván do souvislosti s přítomností psychopatologie, kvalitou života a úrovní psychosociálního fungování. Objevují se studie snažící se propojit úroveň premorbidního kognitivního fungování s kvalitou kognice po první akutní exacerbaci onemocnění, případně studie věnující se mapování této problematiky u osob s vysokou pravděpodobností vzniku onemocnění. Nemenší díl zaujímají studie týkající se longitudinálního sledování kognitivní výkonnosti u pacientů se schizofrenií, případně studie porovnávající kognitivní výkonnost mezi několika psychiatrickými diagnózami. Předkládaná souhrnná práce si klade za cíl podat ucelenější pohled na neuropsychologický výzkum u schizofrenního onemocnění a na jeho dosavadní zjištění.

Cognitive deficit is recognized as the core symptom of schizophrenia. In the last two decades, there has been a considerable number of literature published on the topic.However, no mutual consent has been reached as to the profile, dynamics, the cause nor the onset of cognitive deficit in schizophrenia patients. Cognitive impairment in schizophrenia is rather often associated with the presence of psychopathology, quality of life, and how cognitive impairment accounts for psychosocial functioning. Some of the previous studies endeavour to establish the connection between the premorbid level of cognitive functioning and the quality of cognition after the first acute exacerbation of the illness. Other studies then pursue to survey the issue in subjects with high probability of the onset of schizophrenia. A fair number of studies deal with the longitudinal research of cognitive performance in patients with schizophrenia or compare cognitive performance in several psychiatric diagnoses. The paper aims to summarize the topic of cognitive impairment in schizophrenia and to present a comprehensive review of neuropsychological research in the field and its existing findings.

• Keywords
• kognitivní funkce, premorbidní fungování, první epizoda schizofrenie,
• MeSH
• Marijuana Abuse MeSH
• Mental Disorders diagnosis   classification   complications   MeSH
• Disease Attributes MeSH
• Cognition * MeSH
• Cognition Disorders * diagnosis   etiology   classification   complications   physiopathology   psychology   MeSH
• Quality of Life MeSH
• Humans MeSH
• Signs and Symptoms MeSH
• Psychopathology MeSH
• Psychotherapy methods   MeSH
• Schizophrenia * diagnosis   classification   complications   therapy   MeSH
• Social Skills * MeSH
• Drug Users MeSH
• Research MeSH
• Check Tag
• Humans MeSH

The aim of this study was to determine the neurocognitive and neuropsychiatric effects of continuous positive airway pressure treatment on patients with obstructive sleep apnea. This cross-sectional, prospective, observational study included 126 patients with sleep apnea. The following tests were performed: the Montreal Cognitive Assessment for the evaluation of cognitive impairment, the Beck Depression Inventory, and the State-Trait Anxiety Inventory, together with the Epworth Sleepiness Scale for the evaluation of neuropsychiatric symptoms and a person's general level of daytime sleepiness. The first measurement did not show neurocognitive impairment or a higher level of depressive and anxiety symptoms in 126 patients with obstructive sleep apnea in comparison to normative standards. After the 3-month treatment indicated for 43 patients with obstructive sleep apnea, we did not find any significant improvement in cognitive performance (p = .213). However, patients with sleep apnea with continuous positive airway pressure treatment did show significantly less daytime sleepiness, anxiety and depressive symptoms (all p < .001). In conclusion, short-term (3 months) treatment of patients with obstructive sleep apnea can substantially alleviate their daytime sleepiness, as well as depressive and anxiety symptoms.

• MeSH
• Middle Aged MeSH
• Humans MeSH
• Neurocognitive Disorders etiology   pathology   MeSH
• Neuropsychological Tests standards   MeSH
• Sleep Apnea, Obstructive physiopathology   MeSH
• Prospective Studies MeSH
• Cross-Sectional Studies MeSH
• Continuous Positive Airway Pressure methods   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

The American Psychiatric Association has recently published the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The DSM-IV category "Dementia, Delirium, Amnestic, and Other Cognitive Disorders" has undergone extensive revision. DSM-5 has renamed this category as "Neurocognitive Disorders" (NCD), which now covers three entities: delirium, major NCD, and mild NCD. The DSM-IV version of mild NCD resembles the DSM-5 version in name only. DSM-IV defined mild NCD based on a single criterion, whereas DSM-5 defines mild NCD by using several cognitive and related criteria. The main difference between mild NCD and the Key International Symposium criteria of mild cognitive impairment (MCI) is that the research work that led to the construct of MCI primarily involved elderly study participants (even though age was not part of the definition of MCI), whereas mild NCD includes acquired cognitive disorders of all age groups. DSM-5 essentially discusses the epidemiology and diagnostic markers of mild NCD by drawing congruence between MCI and mild NCD. The DSM-5 definition of mild NCD is anchored on four criteria and two specifiers. The four criteria refer to cognitive changes, functional activities, and exclusion of delirium and competing mental disorders. The two specifiers are the presumed etiologies of mild NCD and the presence or absence of behavioral problems. While the category "mild NCD" may improve reliability of diagnoses, it has yet to withstand scientific scrutiny to be considered a valid construct. This article reviews the DSM-5 criteria for mild NCD, compares them with the Key International Symposium MCI criteria, and discusses the pros and cons of the mild NCD construct.

• MeSH
• Dementia classification   diagnosis   MeSH
• Diagnostic and Statistical Manual of Mental Disorders MeSH
• Diagnosis, Differential MeSH
• Mental Health statistics & numerical data   MeSH
• Geriatric Assessment methods   MeSH
• Cognitive Dysfunction classification   diagnosis   MeSH
• Humans MeSH
• Neuropsychological Tests standards   MeSH
• Psychiatric Status Rating Scales standards   MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Review MeSH
• Research Support, N.I.H., Extramural MeSH

BACKGROUND: Idiopathic generalized epilepsy (IGE) is one of the most common epilepsies and is believed to have a strong genetic origin. Patients with IGE present largely heterogeneous neurocognitive profiles and might show some neurocognitive impairments. Furthermore, IGE siblings may demonstrate worse results in neuropsychological tests as well. In our study, we aimed to map the neurocognitive profile both in patients with IGE and the siblings. We also sought to establish a neurocognitive profile for each IGE syndrome. METHODS: The research sample included 110 subjects (IGE n = 46, biological siblings BS n = 16, and healthy controls n = 48) examined. Subjects were neuropsychologically examined in domains of intelligence, attention, memory, executive, and motor functions. The data obtained from the examination were statistically processed to determine whether and how IGE patients (including distinct syndromes) and the siblings differed neurocognitively from healthy controls (adjusted z-scores by age, education, and gender, and composite z-scores of cognitive domains). Data on anti-seizure medication, including defined daily doses, were obtained and included in the analysis. RESULTS: IGE patients and their biological siblings performed significantly worse in most of the neuropsychological tests than healthy controls. The neurocognitive profile of composite z-scores showed that IGE and biological siblings had equally significantly impaired performance in executive functions. IGE group also demonstrated impaired composite attention and motor function scores. The profile of individual IGE syndromes showed that JAE, JME, and EGTCS had significantly worse performance in composite execution score and motor function score. JAE presented significantly worse performance in intelligence and attention. JME exhibited significantly worse composite score in the attention domain. Anti-seizure medication, depression, and quality of life were unrelated to cognitive performance in IGE group. The level of depression significantly predicted the overall value of quality of life in patients with IGE, while cognitive domains, sociodemographic, and clinical factors were unrelated. CONCLUSION: Our study highlights the importance to consider the neurocognitive profile of IGE patients that can lead to difficulties in their education, acceptance, and management of coping strategies. Cognitive difficulties of IGE siblings could support a hypothesis that these impairments emerge from heritable traits.

• MeSH
• Epilepsy, Generalized * MeSH
• Immunoglobulin E MeSH
• Quality of Life MeSH
• Humans MeSH
• Neuropsychological Tests MeSH
• Siblings * psychology   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

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

Narušení kognitivních funkcí patří mezi základní projevy onemocnění schizofrenií. Jedná se o jádrový příznak, který vykazuje vysokou stabilitu v čase a má významnou souvislost s psychosociálním fungováním a kvalitou života nemocných. Intervence jsou proto cíleny na zlepšení úrovně kognitivního fungování, například formou kognitivní remediace. Současný výzkum se zaměřuje na identifikaci účinných faktorů remediace a jejich standardizované měření, jakož i sledování těchto efektů v čase. Americký národní ústav pro výzkum měření a léčení za účelem zlepšení kognice u schizofrenie (NIMH-MATRICS: Measurement and Treatment Research to Improve Cognition in Schizophrenia) podnítil iniciativu zvanou MATRICS. Výsledkem činnosti iniciativy MATRICS byl vznik konsorcia MATRICS, které ve snaze sjednotit výzkumné snahy vytvořilo Standardní baterii pro vyšetření kognitivních funkcí u schizofrenie (MCBB: MATRICS Consensus Cognitive Battery). Testový materiál MCBB dosud nebyl kompletně převeden do češtiny. Náš článek zahrnuje detailní přehled všech testů zahrnutých do baterie MCBB, hodnotí stav jejich použitelnosti v české verzi, dále popisuje vývoj pilotní studie MCBB, která zahrnuje překlad, zpětný překlad administrace, skórování a vyhodnocení všech testů. Její význam spočívá především ve frekvenční studii pro Hopkinsův verbální test učení (HVLT-R) a konstrukci české verze HVLT-R-Cz včetně paralelních verzí pro opakovaná vyšetření. HVLT-R je efektivní nástroj pro opakované vyšetření verbální paměti a sledování vývoje paměťového deficitu v čase. HVLT-R dosud nebyl k dispozici v češtině, což znemožňovalo přesnou replikaci celé baterie MCBB. Zpřístupnění české verze MCBB tak umožňuje použít tento nástroj v klinické i výzkumné praxi pro stanovení míry kognitivního deficitu, vývoj a sledování kognice v čase a v neposlední řadě pro interpretaci efektivity remediace a jako standardní mezinárodně srovnatelné měřítko pro klinický výzkum schizofrenie.

Cognitive deficits are considered to be core features of schizophrenia. These deficits are present before the onset of clinical symptoms and could be detected also in patients who are in clinically remitted state. Cognitive worsening may have a significant influence on their psy-chosocial functioning and quality of live. The aim of treatment interventions is to improve the level of cognitive functioning in patients with schizophrenia, e.g. by cognitive remediation. The current research strives to identify the most efficient factors of remediation. The National Institute of Mental Health (NIMH) initiative called Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) was designed to stimulate the development of the MATRICS Consensus Cognitive Battery (MCCB). Even though MCBB quickly gained popularity throughout the world, the test material for the Czech adaptation of the MCBB has so far not been completely available. Our pilot study provides MATRICS Initiative officially approved adaptation of administration, scoring and interpretation of all tests in the battery. Moreover, we performed a pilot study of the Hopkins Verbal Learning Test-Revised and were able to construct empirically derived Czech version (HVLT-R-Cz) based on a verbal frequency study. The test is for the first time available in Czech. One of the principal postulates of the MCBB is the suitability of tests for repeated measurements. This was the reason for the construction of the HVLT-R-Cz parallel version. MCBB in its original and concurrently adapted Czech version opens new horizons for the usage of the MCBB in the Czech Republic. MCBB Czech version can be used in schizophrenia research and also in clinical practice for standardized estimation of the cognitive deficits, its evolution over time and evaluation of the efficacy of cognitive remediation.

• MeSH
• Cognition Disorders * diagnosis   psychology   MeSH
• Humans MeSH
• Neuropsychological Tests * standards   MeSH
• Schizophrenic Psychology MeSH
• Schizophrenia * diagnosis   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH
• Review MeSH

In opiate addicts with various duration of drug use neurocognitive impairments as well as a number of typical physical changes occurring in the brain were registered. The opiate addicts' cerebral hemodynamics and higher brain functions were examined by drug use duration and patient's age.

• MeSH
• Hemodynamics * drug effects   MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Brain * drug effects   MeSH
• Opiate Alkaloids * adverse effects   MeSH
• Tomography, X-Ray Computed MeSH
• Opioid-Related Disorders * MeSH
• Check Tag
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH

• MeSH
• Antineoplastic Agents, Alkylating therapeutic use   MeSH
• Dacarbazine analogs & derivatives   MeSH
• Glioma mortality   therapy   MeSH
• Radiotherapy, Conformal * MeSH
• Humans MeSH
• Brain Neoplasms mortality   therapy   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Letter MeSH
• Comment MeSH

Úvod a cíl: Kognitivní dysfunkci před operačním zákrokem lze považovat za geriatrický syndrom. Křehcí starší dospělí s kognitivní dysfunkcí podstupující operaci mají zvýšené riziko vzniku pooperačních komplikací, včetně rozvoje perioperační neurokognitivní poruchy. Primárním cílem studie Pooperační kognitivní dysfunkce jako geriatrický syndrom bylo porovnat korelaci mezi testy kognitivních funkcí před výkonem a po výkonu a zhodnotit sociální anamnézu a křehkost pomocí Škály geriatrické křehkosti. Metodika: Studie byla prospektivní, monocentrická a observační. Zahrnovala jednu kohortu pacientů 65 let a starších. Výzkum probíhal v letech 2020–2023. Předoperační a pooperační testování probíhalo v anesteziologické ambulanci nebo na oddělení nemocnice. Designem studie byla komparace tří kognitivních testů před operačním zákrokem a po něm. Křehkost byla zhodnocena Škálou geriatrické křehkosti. V rámci sociální anamnézy se hodnotily typ ubytování (dům, byt, instituce), přítomnost schodů nebo výtahu a existence spolubydlícího. Výsledky: Studii dokončilo 164 respondentů. Mezi typem ubytování a sociální anamnézou nebyla prokázána statisticky významná závislost. Při hodnocení závislosti mezi typem ubytování a Clinical frailty scale byla prokázána statisticky významná zavislost při rozdělení typu ubytování na dvě kategorie, dům/byt vs. instituce. Pacienti žijící doma měli výrazně nižší hodnoty Clinical frailty scale (medián 3,5 vs. 5). Také byl prokázán statisticky významný rozdíl mezi pacienty, kteří mají doma schody, a pacienty žijící s výtahem, p = 0,019. Závěr: Předoperační zhodnocení kognitivních funkcí a sociální anamnézy by mělo být běžnou součástí předanestetického vyšetření. Může napomoci ke zhodnocení seniora v riziku. V konečném důsledku vede ke zvýšení bezpečnosti pacienta, respektování jeho autonomie a snazší komunikaci s příbuznými.

Introduction and aim: Cognitive dysfunction before operation could be seen as geriatric syndrome. Older frailty adults with cognitive dysfunction undergoing operation are at higher risk of developing postoperative compilations, including perioperative neurocognitive disorder. The primary aim of the study Postoperative cognitive dysfunction as geriatric syndrome was to determine correlations between preoperative and postoperative scores on three cognitive tests, assessing social anamnesis and Clinical frailty scale. Methodology: The study was prospective, monocentric, and observational. One cohort of patients were examined, age 65 years or older. Research was carried out in 2020-2023. Pre- operative and postoperative testing took place in the anaesthesiology outpatient clinic or in the hospital ward. The study design consisted of a descriptive comparison of three cognitive tests before and after surgery. Frailty was assessed with Clinical frailty scale. Social anamnesis consisted of type of accommodation (house, flat, institution), presence of stairs or elevator and existence of a roommate. Results: The study finished 164 patients. The study finished 164 respondents. There was no significant correlation between social anamnesis and type of accommodation. When type of accommodation was divided into two groups (house/flat vs. institution) strong correlation was found. Patients living at home had lower Clinical scale (median 3.5 vs. 5). Significant difference was also found between patients with having stairs at home and patients with elevator, p = 0.019. Conclusion: Assessments of cognitive functions and frailty should be a routine part of the preanesthesia examination. Assessment could help to identify seniors at risk. It should lead to higher levels of patient’s safety, acceptance of patient’s autonomy and to easier communication with families.

• MeSH
• Anesthesia adverse effects   MeSH
• Surgical Procedures, Operative adverse effects   MeSH
• Home Environment MeSH
• Frailty diagnosis   epidemiology   MeSH
• Humans MeSH
• Neurocognitive Disorders * diagnosis   etiology   MeSH
• Perioperative Period * adverse effects   MeSH
• Postoperative Complications epidemiology   MeSH
• Aged MeSH
• Statistics as Topic MeSH
• Severity of Illness Index MeSH
• Mental Status and Dementia Tests statistics & numerical data   MeSH
• Check Tag
• Humans MeSH
• Aged MeSH
• Publication type
• Clinical Study MeSH
• Observational Study MeSH

Úvod a cíl: Perioperační neurokognitivní porucha (PND) zastřešuje zhoršení kognitivních funkcí v předoperačním a perioperačním období. Zavedení diagnostiky a hodnocení kognitivních dysfunkcí v perioperačním období do praxe se dostalo do popředí zájmu v souvislosti s narůstajícím počtem geriatrických pacientů. Bylo vedeno snahou o co nejrychlejší zotavení pacienta po operaci a zachování kvality života. Cílem této práce je informovat o prvních výsledcích pilotní studie, která hodnotí kognitivní funkce před operačním výkonem a po něm. Metodika: Pilotní studie hodnotí pomocí tří testů kognitivní funkce u seniorů nad 65 let před operací a po ní. Použitými testy jsou Mini Mental State Exam (MMSE), test kreslení hodin a TEGEST test. Výsledky: Do pilotní studie bylo zařazeno celkem 36 pacientů, testování dokončilo 25 z nich. Výsledky testů jsou rozděleny do 4 kategorií podle výsledků MMSE na pásmo normálu, lehkou kognitivní poruchu, středně těžkou a těžkou kognitivní poruchu. Nejvíce pacientů (14) bylo v pásmu normálu, kde výsledek testu kreslení hodin nesouhlasil s ostatními testy v polovině případů. V kategorii lehká kognitivní porucha bylo 9 pacientů, výsledek testů hodin neodpovídal ostatním testům v jednom případě. Ve skupině středně těžká kognitivní porucha byl zařazen 1 pacient, stejně tak v pásmu těžké kognitivní poruchy. Závěr: Z časového hlediska jsou vhodnými testy TEGEST a test kreslení hodin, MMSE je pro klinickou praxi časově náročný.

Introduction and aim: Perioperative neurocognitive disorder stands for impairment in cognitive function in preoperative and postoperative period. Introduction of diagnostic and evaluation of cognitive function into clinical practise came to the fore because of increasing number of geriatric patients. The main goals were fast patient's recovery after surgery and maintaining quality of life. Nowadays there are no standardized or recommended tests for evaluation cognitive function for perioperative neurocognitive disorder. Main aim of this work is to inform about first results of pilot study which is evaluating cognitive function before and after surgery. Methodology: Pilot study evaluates cognitive functions before and after operation in patients above 65 years old with three tests. These tests are Mini Mental State Exam (MMSE), clock drawing test and TEGEST test. Results: 36 patients were included in the study, 25 of them finished testing after operation. The test results were divided into 4 categories according to Mini-Mental State Exam to normal range, mild, moderate, and severe dementia. The highest number of patients were in normal range (14), where the results of clock drawing test didn't correlate in with the results of other two test in half of the cases. In category mild dementia were 9 patients, in 1 patient result of clock drawing test didn't correlate with other two tests In terms of time suitable for clinical practise could be TEGEST test and clock drawing test, MMSE seems to be time consuming for preoperative evaluation.

• MeSH
• Cognitive Dysfunction diagnosis   etiology   MeSH
• Humans MeSH
• Neuropsychological Tests MeSH
• Pilot Projects MeSH
• Postoperative Cognitive Complications * diagnosis   etiology   MeSH
• Postoperative Complications MeSH
• Postoperative Period MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Mental Status and Dementia Tests MeSH
• Check Tag
• Humans MeSH
• Aged, 80 and over MeSH
• Aged MeSH