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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cognitive disorders in the course of mental illnesses are one of the most important and most difficult therapeutic problems related to those illnesses and they regard attention, memory, learning and sensory modulation. The limited number of nicotinic receptors (subtypes alpha7 and alpha4beta2) seems to cause the incidence and exacerbation of cognitive deficits in such patients. In patients with schizophrenia, the impairment of cognitive processes is also a side-effect of neuroleptics. The characteristics and intensity of the negative effect of antipsychotics on cognitive functions depends on the pharmacological action of those drugs and on the effect on dopamine and serotoninergic receptors in particular. Cognitive function deficits observed in various mental illnesses can be modified with the use of nicotine. A cholinergic neurotransmission system is a common transmission system in the central nervous system. The effect of nicotine on other neurotransmission systems--the dopaminergic and glutaminergic systems--seems to be significant for their efficacious cognitive effects in combination with antipsychotic drugs. Nicotine may also alleviate symptoms of depression, as it amplifies serotoninergic and noradrenergic neuronal activity. When studies on treating cognitive disorders with nicotine are carried out, nicotine's interactions with other drugs used in therapy of those disorders must be taken into account as well as the effect of this substance on neurotransmission systems.
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PMID:Interactions of nicotine and drugs used in the treatment of mental illnesses with respect to cognitive functions. 2111 96

A prospective study of 45 cases of unipolar depression was conducted with the aim to examine the hypothesis that cognitive disorder predisposes to depression. The data indicated that the absence of the cognitive disorder during remission was statistically significant in 41 cases who remitted. Of the latter, 27 were free from cognitive disorder, while 14 continued with it. This fails to support the causal role of the cognitive disorder. It was also observed that those with persisting cognitive disorder in remission ran the risk of early relapse. It is suggested that persistence of cognitive disorder in remission could be a predictor of early relapse and offers the possibility of using cognitive behavioural therapy for such select cases.
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PMID:COGNITIVE DISORDER AND DEPRESSION: (An Analysis of the Causal Relationship and Susceptibility to Relapses). 2192 84

Mental disorders are characterized by disturbances of thought, perception, affect and behavior, which occur as a result of brain damage. Recognizing and treating these conditions is necessary not only for psychiatrists but for all physicians. Disorder of mental function is one of the most common associated conditions in intensive care unit (ICU) patients. However, disturbances of mental function often remain unrecognized. In ICU patients, different types of mental function disorders may develop. They range from sleep disorders, severe depression, anxiety, posttraumatic stress disorder (PTSD) to cognitive disorders including delirium. The causes of mental dysfunction in ICU patients can be divided into environmental and medical. Cognitive disorders are related to mental processes such as learning ability, memory, perception and problem solving. Cognitive disorders are usually not prominent in the early postoperative period and in many cases are discovered after hospital discharge because of difficulties in performing everyday activities at home or at work. The etiology of postoperative cognitive impairment is unclear. Older age, previous presence of cognitive dysfunction, severity of disease, and polypharmacy with more than four drugs are some of the risk factors identified. Delirium is a multifactorial disorder. It is an acute confusional state characterized by alteration of consciousness with reduced ability to focus, sustain, or shift attention. It is considered as the most common form of mental distress in ICU patients. Nearly 30% of all hospitalized patients pass through deliriant phase during their hospital stay. Delirium can last for several days to several weeks. Almost always it ends with complete withdrawal of psychopathological symptoms. Sometimes it can evolve into a chronic brain syndrome (dementia). The causes are often multifactorial and require a number of measures to ease the symptoms. Delirious patient is at risk of complications of immobility and confusion, leading to a high prevalence of irreversible functional decline. An interdisciplinary approach to delirium should also include family or other caregivers. In the diagnosis of delirium, several tests are used to complement clinical assessment. Among the most commonly used are the Confusion Assessment Method (CAM-ICU) and Clinical Dementia Rating (CDR) test. Depression is a common disorder among patients treated at ICU and occurs due to the impact of the disease on the body and the quality of life, independence, employment and other aspects of life. Depression can interfere with the speed of recovery, affects the postoperative quality of life, and in a certain number of patients may lead to suicidal thoughts and intentions. Phobias and generalized anxiety are the most common anxiety disorders. Generalized anxiety disorder is characterized by strong, excessive anxiety and worry about everyday life events. PTSD is delayed and/or protracted response to a stressful event or situation, extremely threatening or catastrophic nature, which is outside the common experience of people and would hit or traumatize almost all people. Treatment of delirium and other disorders is causal. The causes of psychosis are often multifactorial and require a number of measures to ease symptoms. The primary objective of prevention is appropriate therapy and correction of potential imbalances possibly underlying disturbances, stabilization of vital functions as well as early return to daily activities. Doctors and other medical staff must be aware of the importance and consequences of behavioral and emotional disorders in critically ill patients. Additional research is needed to discover the ways to prevent and/ or reduce the frequency and severity of the consequences and treatment of cognitive and emotional disorders.
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PMID:[Perioperative disorders of mental functions]. 2308 91

The diagnosis of pseudodementia may be difficult in a patient with a history of major depressive disorder. Clinical case history. A 70-year-old man with a history of major depressive disorder, in remission for 3 years, presented with confusion, agitation and cognitive disorder. The differential diagnosis included depression with pseudodementia, drug-induced dementia or Alzheimer disease. Mild cognitive improvement was noted after discontinuation of simvastatin. After 9 months of treatment for depression, the patient had remission that was sustained for >1 year, with mild residual difficulty remembering words of songs. The differential diagnosis of dementia includes major depressive disorder and adverse events from simvastatin.
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PMID:Pseudodementia caused by severe depression. 2324 83

Work disability is common in multiple sclerosis (MS) and cognitive disorder discriminates disabled from employed patients. Our goal was to develop and validate an online vocational status monitoring tool measuring negative work events and use of accommodations. We enrolled 52 employed patients completing an online survey and a clinical examination including tests of motor function, cognitive abilities, and depression. The survey recorded a wide range of reported work problems. Regression models predicting negative work events, and use of accommodations, retained measures of ambulation, cognition, and depression. These data provide preliminary support for the validity of online vocational monitoring in MS.
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PMID:Negative work events and accommodations in employed multiple sclerosis patients. 2384 11

The purpose of this study was to identify the factors that influence activities of daily living (ADL) in the elderly with probable dementia. The participants were 152 older adults who voluntarily visited a hospital to participate in a national dementia free screening programme. General characteristics, health-related characteristics, ADL, Mini-Mental State Examination Korean Consortium (MMSE-KC) and the Geriatric Depression Scale (GDS) score were evaluated in this study. The data were analysed using independent t-tests, Pearson's correlation and stepwise multiple regression. The ADL score of the participants was 14.3, and 88.2% of the participants were severe cognitive disorder. ADL scores were positively related with MMSE-KC scores (r = 0.35, P < 0.001) and negatively with GDS scores (r = -0.20, P = 0.014). Factors that influenced ADL were faecal and urinary incontinence, regularity of exercise, MMSE-KC score and stroke history; these five variables explained 30.8% of the ADL score for the elderly with probable dementia. Multidisciplinary interventions are essential to improve the ADL and prevent deterioration of cognitive function in elderly patients with probable dementia.
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PMID:Factors that influence activities of daily living in the elderly with probable dementia. 2411 55

Alzheimer's disease (AD) is a neurodegenerative disease characterized by cognitive disorder and memory dysfunction. This kind of cognitive impairment is closely related to synaptic plasticity, in which N-methyl-D-aspartate receptor (NMDAR), which is one of the glutamate receptors, plays a critical role. Therefore the present study was designed to investigate whether the cognitive impairment of AD rat model has relation to the change of NMDAR. The adult male rats were randomly divided into three groups: control, AD and AD+APV (the competitive but not selective blocker of NMDAR) groups. The synaptic plasticity was measured by recording long-term potentiation (LTP) and depression (LTD) in the perforant path (PP) to dentate gyrus (DG) of hippocampus. The spatial memory and reversal learning were examined by Morris water maze (MWM) test. Results showed that the spatial learning performance of MWM was significantly impaired in AD group compared to that of control group. Rats of APV group showed a higher LTP and better performance in spatial memory, but worse performance in reversal learning test and lower LTD than those of AD group. In conclusion, the high concentration of APV influenced LTD and enhanced LTP in AD rats through changing the proportion of NMDAR, which suggested that the change of NMDAR may participate in the pathogenesis of AD at the synaptic level.
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PMID:The role of N-methyl-D-aspartate receptor in Alzheimer's disease. 2454 86

A 46-year-old man had a smoke inhalation injury. Within 1 month, he developed neuropsychiatric problems including toxic encephalopathy, cognitive disorder, depression symptoms and personality change. From 3 to 14 years after the toxic inhalation injury, the patient received treatment with sertraline and methylphenidate. The (18)F-fluorodeoxyglucose positron emission tomography scan at 3 years after injury showed deterioration of glucose metabolism in the hippocampus and orbital frontal region; at 14 years after injury, the hippocampus had no significant change but the orbital frontal region had deterioration of glucose metabolism. It was hypothesised that sertraline may have provided selective hippocampal neuroprotection. Further study is justified to evaluate sertraline as a possible neuroprotective agent after smoke inhalation injury.
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PMID:Limiting progressive hippocampal metabolic abnormalities after smoke inhalation injury. 2457 74

Up to now, in the treatment of stroke patients by acupuncture therapy, three main representative achievements involving scalp acupuncture intervention, "Xing Nao Kai Qiao" (restoring consciousness and inducing resuscitation) acupuncture technique and nape acupuncture therapy have been got. Regarding their neurobiological mechanisms, the scalp acupuncture therapy is based on the functional localization of the cerebral cortex, "Xing Nao Kai Qiao" acupuncture therapy is closely related to nerve stem stimulation, and the nape acupuncture therapy is based on the nerve innervation of the regional neck-nape area in obtaining therapeutic effects. In fact, effects of these three acupuncture interventions are all closely associated with the modern neuroanatomy. In the treatment of post-stroke spastic paralysis, cognitive disorder and depression with acupuncture therapy, modern neuroanatomical knowledge should be one of the key theoretical basis and new therapeutic techniques should be explored and developed continuously.
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PMID:[Achievements and enlightenment of modern acupuncture therapy for stroke based on the neuroanatomy]. 2481 3

A large number of studies have demonstrated that depression patients have cognitive dysfunction. With recently developed brain functional imaging, studies have focused on changes in brain function to investigate cognitive changes. However, there is still controversy regarding abnormalities in brain functions or correlation between cognitive impairment and brain function changes. Thus, it is important to design an emotion-related task for research into brain function changes. We selected positive, neutral, and negative pictures from the International Affective Picture System. Patients with major depressive disorder were asked to judge emotion pictures. In addition, functional MRI was performed to synchronously record behavior data and imaging data. Results showed that the total correct rate for recognizing pictures was lower in patients compared with normal controls. Moreover, the consistency for recognizing pictures for depressed patients was worse than normal controls, and they frequently recognized positive pictures as negative pictures. The consistency for recognizing pictures was negatively correlated with the Hamilton Depression Rating Scale. Functional MRI suggested that the activation of some areas in the frontal lobe, temporal lobe, parietal lobe, limbic lobe, and cerebellum was enhanced, but that the activation of some areas in the frontal lobe, parietal lobe and occipital lobe was weakened while the patients were watching positive and neutral pictures compared with normal controls. The activation of some areas in the frontal lobe, temporal lobe, parietal lobe, and limbic lobe was enhanced, but the activation of some areas in the occipital lobe were weakened while the patients were watching the negative pictures compared with normal controls. These findings indicate that patients with major depressive disorder have negative cognitive disorder and extensive brain dysfunction. Thus, reduced activation of the occipital lobe may be an initiating factor for cognitive disorder in depressed patients.
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PMID:Abnormal activation of the occipital lobes during emotion picture processing in major depressive disorder patients. 2520 66


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