ObjectiveTo compare the cerebral protective effect of unilateral and bilateral antegrade selective cerebral perfusion during total aortic arch replacement, particularly with respect to neuropsychological outcome.MethodsFrom June 2003 to March 2004, 16 patients who underwent total aortic arch replacement were randomly allocated to one of two methods of brain protection: unilateral antegrade selective cerebral perfusion (unilateral group, n =8) or bilateral antegrade cerebral perfusion (bilateral group, n =8). Preoperative and postoperative neurological examination, brain computed tomography(CT) scan, and cognitive function tests were performed.ResultsAll patients survived the operations and were discharged from hospital. No new brain infarction occurred. Transient neurologic dysfunction occurred in 1 patient of each group. There were no intergroup differences in the scores of preoperative and post operative cognitive function ( P gt;0.05).ConclusionBoth methods of brain protection for patients undergoing total aortic arch replacement result in favorable and similar effect of brain protection in term of cognitive function provided the circle of Willis is patent and collateral flow is adequate.
Objective To investigate the cognitive functions in people at high risk for schizophrenia.Methods Two hundred and twenty-two people at high risk for schizophrenia and 331 normal controls were assessed with 14 neuropsychological tests. Results The results of some neuropsychological tests in people at high risk for schizophrenia were worse than those in the normal controls. These tests included information, arithmetic, digital symbol, block design, logical memory, visual memory, Stroop test, verbal fluency, tower of Hanoi, WCST and CPT (Plt;0.01). The time for trail making test A in was longer in the group at high risk for schizophrenia than in the control group (Plt;0.05).Conclusion People at high risk for schizophrenia have general cognitive deficits. Attention and executive function may represent the genetic endophenotype for schizophrenia.
【摘要】 目的 探讨轻度认知功能障碍的心理学特点及其危险因素。 方法 由神经专科医生采集2009年9-12月在神经内科门诊就诊患者106例的临床资料，进行简易智能量表（MMSE）、听觉词语测验（AVLT）、画钟测验（CDT）、日常生活功能量表（ADL）、Hamilton 抑郁量表（HDRS）及临床痴呆评定量表（CDR）等神经心理测试。根据检查结果分为MCI组与对照组。 结果 MCI组受教育年限低于对照组（Plt;0.05），高血压病、糖尿病、脑卒中史高于对照组（Plt;0.05）。Logistic多因素回归分析显示受教育年限和高血压病史与MCI密切相关。MCI组MMSE总分、CDT得分、AVLT即刻记忆、延迟记忆及长时延迟再认显著低于对照组，ADL评分及HDRS评分高于对照组（Plt;0.05）。 结论 高血压病是MCI的危险因素，较高的受教育年限是MCI的保护因素。MCI患者在多个神经心理学领域受损。【Abstract】 Objective To investigate the neuropsychological characteristics of mild cognitive impairment (MCI) and its risk factors. Methods The clinical data of 106 patients in our neurologic department from september to December 2009, were collected by neurologists,and tested them by Chinese version of the mini-mental state examination (MMSE) , auditory verbal learning test (AVLT) , clock drawing test (CDT)、activities of daily living (ADL)、Hamilton depression rating scale (HDRS) and clinical dementia rating scale (CDR). All subjects were divided into MCI patients group and the control group. Results Educational level was significantly lower and hypertension, diabetes mellitus and stroke history were significantly more in patients with MCI than the control. The factors associated with MCI in logistic regression analysis were lower educational level and hypertension. The scores of MMSE、CDT and AVLT of MCI were significantly lower than those of the control, and the scores of ADL and HDRS were significantly higher than those of the control (Plt;0.05). Conclusion Hypertension is the risk factor and high educational level is the protective factor for MCI. MCI patients are impaired in multiple neuropsychological domains.
ObjectivesTo explore the characteristics of cognitive deficits of Benign epilepsy of childhood with centrotemporal spikes (BECTS).MethodsA total of 61 BECTS patients who visited Neurology Clinic of Xuanwu Hospital Capital Medical University between September 2010 to December 2019 and 60 healthy controls were enrolled in our study. All patients and healthy controls performed a series of neuropsychological tests to assess their cognitive function in the "Multi-dimensional psychology" of Beijing Normal University, including attention; memory; arithmetic calculation; language processing; executive function; visuospatial processing; visual perception; psychomotor speed. Lastly, independent sample t-test and friedman test were performed on the scores of BECTS group and controls using SPSS 20.0 and we conducted a multi-factor comprehensive analysis of correlation between clinical criteria and cognitive dysfunction in BECTS.ResultsCompared with 60 healthy controls, the as group got an average score of 19.56±2.91 in Paired Association Learning Test (P<0.001), (23.67±9.50) in Word Discrimination Test (P=0.017), (61.45±13.14) in Object Quantity Perception Task (P=0.040), (6.54±1.47) in Digit Span Test (P<0.001), (5.79±5.90) in Vocal Perception Test (P<0.001), (35.10±2.33) in Taylor Complex Figure Test (P<0.001) and (700.34±493.053) (P=0.008) in Choice Reaction Time Test. The results of these tests are inferior to the control group and the remaining 10 tests are of no statistical significance. There were 36 children with onset of seizure before 8 years of age. Compared with the patients experienced onset of illness at a later age, the 36 patients exhibited lower scores in most of the neuropsychological tests including Visual Tracking Task, Spatial Memory Task, Simple Subtraction Task, Number Comparison Test, Language Rhyme Test, Word Discrimination Testand Visual Perception Task (P<0.05). 34 patients received monotherapy, and 27 received a combination of 2 or 3 anti-epileptic drugs. The scores of attention, memory, visual perception and reaction tests in the multi drug treatment group were lower than those in the single drug treatment group (P<0.05).ConclusionsChildren with BECTS have impairment in attention, vocal perception, visual perception, memory and psychomotor speed. The younger the age of onset, the more severe the cognitive impairments. The degree of cognitive deficitsinchildren treated with multi drugs was more serious than that of children treated with single drugs.
Aphasia is one of the common disabling lesions and sequelae in stroke patients. In post-stroke aphasia patients, impairments of non-verbal cognitive domain often occur, which seriously affect daily social contact and quality of life. Cognitive neuropsychological rehabilitation is a neuropsychological rehabilitation based on the development of cognitive neuropsychological theory. It is currently applied in the field of rehabilitation of brain cognitive function, opening up a new way for evaluation and treatment of post-stroke aphasia. This paper introduces the general features of the application of cognitive neuropsychological rehabilitation, expounds the evaluation model and treatment principles of cognitive neuropsychological rehabilitation, and discusses its application in the evaluation and treatment of post-stroke aphasia, so as to provide ideas for the linguistic and non-linguistic cognitive rehabilitation of post-stroke aphasia.
ObjectiveTo analyze of the extent of neuropsychological damage in post-traumatic epilepsy patients. MethodsOne hundred and thirty-five patients treated at the Department of Neurosurgery, the 904th Hospital of PLA from January 2016 to December 2018 were analyzed retrospectively, including 94 males and 41 females, with an average age of (32.94 ± 9.51) years. They were divided into 3 groups: 40 patients with post-traumatic epilepsy (epilepsy group): 53 trauma patients without post-traumatic epilepsy (trauma group) and 42 patients with health examination (control group). Neuropsychological assessment using the following scales: Mini-mental State Examination (MMSE): Montreal Cognitive Assessment-Basic (MoCA-B): Audio Verbal Memory Test (AVMT): Rey-Osterrieth Complex Figure Test (CFT): Trail Making Test (TMT): Hamilton Depression Scale (HAMD): Activity of Daily Living (ADL). ResultsThe results of one-way ANOVA showed that there was significant difference between all scales of epilepsy group, trauma group and control group (P<0.01). MMSE and MoCA-B scores: Compared with trauma group, epilepsy group decreased significantly, but there was no significant difference between groups (P>0.05); Memory and spatial structure ability: AVMT short/long delayed memory, CFT recall and copy test results showed that epilepsy group decreased more significantly than trauma group, and there was statistical significance between groups (P<0.05); Executive ability: TMT-A and TMT-B showed that epilepsy group spent longer time than trauma group, and there was significant difference between groups (P<0.01); Depressive symptoms: HAMD scale showed significant difference between epilepsy group and trauma group (P<0.01): while there was no statistical difference between trauma group and control group (P>0.05); Activity of daily living: ADL scale results showed that there was no significant difference between epilepsy group and trauma group (P>0.05). ConclusionPost-traumatic epilepsy can aggravate the cognitive impairment of patients, mainly in the decline of memory, spatial structure and executive ability, and prone to depressive symptoms. At the same time of treating epilepsy seizures, patients with post-traumatic epilepsy should be screened and assessed early in neuropsychology to improve their quality of life and return to society as soon as possible.