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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In order to investigate relationships between cognition and regional brain function, we studied 20 non-demented patients with idiopathic Parkinson's disease (PD), 21 mildly demented patients with Alzheimer's disease (AD) and 24 control subjects using cognitive testing and single photon emission computerized tomographic (SPECT) measurements of relative regional cerebral blood flow (rCBF). Neuropsychological tests were grouped into clusters reflecting frontal lobe executive abilities, perseveration, memory and visuospatial ability, with a summary score summarizing performance in all four of these spheres. SPECT imaging utilized the tracer [123I]N-isopropyl-p-iodoamphetamine with a relative measure of regional tracer uptake normalized to occipital radiotracer uptake (rCBF ratios). Patients with PD performed more poorly than controls in all cognitive domains, and were intermediate to AD patients and controls in tests of memory and overall cognitive functioning. Those PD patients who performed most poorly on neuropsychological testing showed lowest rCBF ratios in left and right temporal lobes. Using a stepwise multiple regression procedure, we examined patterns of correlations between cognitive clusters and predictor variables, including rCBF ratios, in the PD patients. We found that while patient age was a strong determinant of performance on the memory cluster and the summary score, dorsolateral frontal lobe perfusion and scores on a depression inventory accounted for a greater proportion of the variance of the frontal lobe and perseveration clusters than did age. These results imply that different neural mechanisms are responsible for the different aspects of cognitive decline seen in PD patients, with overall cognitive function closely related to age and temporal perfusion, while frontal lobe abilities are more linked to frontal perfusion and the presence of depression.
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PMID:Cognitive function and regional cerebral blood flow in Parkinson's disease. 160 80

Sleep apnea is characterized by transient hypoxemias which are thought to affect mental functioning. Accordingly, speculation and research have focussed on relationships between sleep apnea and dementia. We studied 235 nursing home (ie institutionalized) patients (152 women with a median age of 83.5; 83 men with a median age of 79.7) with portable sleep recording equipment. The Mattis Dementia Rating Scale and the Geriatric Depression Scale were given to each. Seventy percent of the patients had five or more respiratory disturbances per hour of sleep and 96 percent showed some dementia. Sleep apnea was significantly correlated with all subscales on the dementia rating scale. There were trivial differences in dementia ratings between those with mild-moderate apnea and those with no apnea. There were significant differences, however, between the latter two groups and those with severe apnea. In particular, items reflecting attention, initiation and perseveration, conceptualization, and memory tasks on the DRS distinguished between those with and without severe sleep apnea. Among those patients with no depression, all patients with severe sleep apnea were also severely demented. Our data suggest that there is a strong relationship between dementia and sleep apnea when the sleep apnea and dementia are severe. Although causality cannot be inferred from associations, our hypothesis for study is that sleep apnea causes deficits in brain function, possibly due to global effects rather than any particular cortical or subcortical structure.
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PMID:Dementia in institutionalized elderly: relation to sleep apnea. 200 39

Manic-depressive illness may be explained as an alteration of the normally existing equilibrium to be found between two antagonist brain mechanisms located in the prefrontal isocortex area. Each mechanism, located in the middle frontal area, deriving from the hippocampal allocortex, is responsible for tendencies to change. Its predominance leads to clinical patterns of mania. The other mechanism--located in the lateral orbital area, deriving from the olfactory allocortex, is responsible for tendencies to perseveration. Its predominance leads to clinical patterns of depression. Any alteration in the frontal lobe morphogenesis is likely to cause a permanent unbalance between both mechanisms. Consequently, an oscillation between opposite tendencies--i.e. a tendency to change, and a tendency to perseveration, may be expected which, clinically speaking, appears as mania, and depression phases. In this connection, the following points are discussed, namely (a) prefrontal functions, (b) peri-allocortex frontal zones participating in affective behaviors, (c) the problem of differences between brain hemispheres, and the probability of an anatomic basis for temperament. Eventually, features of a psychiatric science based on brain anatomy are enhanced.
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PMID:[The frontal lobe and psychoses]. 207 21

Chronic pain patients and brain injured patients frequently exhibit anxiety, depression, perseveration, and fixed ideation about their injuries. Both populations also frequently suffer from decreased attention, impaired concentration, easy fatigability, personality changes, impaired relationships with family and friends, and difficulty maintaining a job. In cases where chronic pain coexists with traumatic brain injury, the brain injury is often obscured. Risk factors which should alert the medical team to possible coexisting brain injury include history of loss of consciousness at original injury, history of trauma to the head, whiplash injury to the neck, multisystem trauma, and admission of memory or attention deficits by the patient. When any of these risk factors are present, we have found that formal examination of cognitive function is required to explore the potential of coexisting brain injury; if pain is a prominent clinical feature, residual cognitive sequelae of mild brain injury is easily masked. Specific testing of attention, new learning ability, constructional ability, and higher cognitive functions are most helpful in this population, and they need to be included in the mental status examination when concomitant brain injury is suspected. In our study, seven patients were found to have undiagnosed brain injury in a series of 67 consecutive patient referrals to our pain rehabilitation program. Treatment failure is high in this subgroup of pain patients unless treatment is directed toward the sequelae of both brain injury and chronic pain.
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PMID:Brain injury obscured by chronic pain: a preliminary report. 237 79

The association of Pick's Disease (PD) and Amyotrophic Lateral Sclerosis (ALS) as a familial syndrome is reported for the first time. Four members in two generations of the investigated family suffered from this syndrome, allowing the hypothesis of a dominant mode of inheritance. PD is primary, with onset at 58 to 67 years: loss of interests, depression, aggressivity, perseveration , stereotypies, reduction of speech until total mutism; a few months later appear ALS signs: fasciculations and/or pyramidal symptoms. The total evolution is 3 to 5 years. The brain showed a fronto-temporal atrophy spreading to the precentral gyrus with cortical and white matter gliosis, neuronal loss, atrophic neurons and some ballooned cells, but without senile plaques (SP), neurofibrillary tangles (NFT) or cortical spongiosis; the spinal cord and the medulla oblongata showed typical ALS lesions; mild lesions in the basal nuclei, particularly in the substantia nigra and the pallidum. The differential diagnosis is discussed with: Alzheimer's Disease + ALS (SP + NFT); the Guam syndrome (NFT); Creutzfeldt-Jakob's Disease (cortical microspongiosis); ALS + dementia (primary ALS); Mitsuyama's syndrome (primary dementia and secondary ALS, but with cortical spongiosis and without familial incidence).
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PMID:[A familial syndrome: a combination of Pick's disease and amyotrophic lateral sclerosis]. 332 1

Two studies were conducted to assess the spontaneous self-focusing tendencies of depressed and nondepressed individuals after success and failure. Based on a self-regulatory perseveration theory of depression, it was expected that depressed individuals would be especially high in self-focus after failure and low in self-focus after success. The results of Experiment 1 suggested that immediately after an outcome, both depressed and nondepressed individuals are more self-focused after failure than after success. This finding led us to hypothesize that differences between depressed and nondepressed individuals in self-focus following success and failure emerge over time. Specifically, immediately following an outcome, both types of individuals self-focus more after failure because of self-regulatory concerns. However, over time, depressed individuals persist in higher levels of self-focus after failure than after success, whereas nondepressed individuals shift to the opposite, more hedonically beneficial pattern. The results of Experiment 2 provided clear support for these hypotheses. Theoretical implications of these results were discussed.
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PMID:Persistent high self-focus after failure and low self-focus after success: the depressive self-focusing style. 371 28

Long-term cognitive changes were observed in 8 depressed patients whose pretreatment cognitive impairment (depressive dementia or pseudodementia) resolved after treatment with ECT. Improved performance on the Mattis Dementia Rating Scale was maintained throughout a 4-year follow-up period. Improvements on Memory and Initiation and Perseveration subscales were most consistent over time. These aspects of cognitive functioning may be the most susceptible to the effects of depression, and this may be a factor to consider in clinically evaluating older patients with both depression and cognitive impairment. The findings indicate that elderly patients with cognitive dysfunction secondary to depression may experience improvement in cognitive functioning that is stable over time with remission of the affective disorder.
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PMID:Improvement in depression-related cognitive dysfunction following ECT. 771 88

The influence of depression on the cerebral hemispheric motor functioning of 40 right-handed women, half of whom had been classified as depressed, the other half as nondepressed, was examined. The depressed women were also characterized by elevated state and trait anxiety, suggestive of an anxious-depressive state with heightened arousal. A hand dynamometer was used as a standardized measure of hemispheric motor functioning such as hand-grip strength, perseveration, and fatigue. Primary findings indicated that depressed women displayed significantly less perseveration at the left hand than did nondepressed women, but a nonsignificant trend only was noted for less perseveration at the right hand. These results suggest possible differential arousal of the left and right cerebral hemispheres in this sample of anxious-depressed women and are discussed in terms of arousal theory.
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PMID:Functional asymmetry in the motor performances of women: neuropsychological effects of depression. 793 60

Vascular dementia (VAD) is common, and small vessel disease is one of the most frequent etiologies of the disorder. Lacunar state and Binswanger's disease are the two types of VAD associated with small vessel disease. Lacunar state and Binswanger's disease produce a dementia syndrome with characteristics of subcortical dementia including slowing of information processing, impaired memory, and poor sustained attention. Executive dysfunction includes poor word list generation and verbal fluency (design generation), impaired motor programming with perseveration and impersistence, and difficulty with set shifting. Memory loss in subcortical VAD is characterized by poor retrieval and intact recognition. Apathy is ubiquitous in VAD and depression and psychosis are common. Parkinsonism with prominent gait disturbances in conjunction with pyramidal tract signs, dysarthria, pseudobulbar affect, and incontinence are frequent motor manifestations of VAD with small vessel disease. The lesions of subcortical VAD affect the structures--caudate nucleus, globus pallidus, thalamus-and connecting fibers of frontal--subcortical circuits and produce a clinical syndrome similar to that seen in other subcortical diseases.
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PMID:Vascular subcortical dementias: clinical aspects. 808 75

The aim of the study was to investigate differences in some temperamental traits during depressive phase and in remission. The group of 30 patients with endogenous depression was compared with 30 healthy controls. All subjects completed Formal Characteristic of Behaviour-Temperamental Questionnaire (FCZ-KT by Zawadzki-Strelau) and were investigated by computer exposed task from Wiener-Testsystem (WT). Alertness subscale from FCZ-KT differentiates affective patients (in depression and remission) from healthy persons. Improvement of results during remission in scales from FCZ-KT: Alertness, Perseveration and Activity was observed. WT was more a sensitive method to show differences between patients with affective disorders and healthy persons. Results in WT during remission have demonstrated that deficits in Alertness, Perseveration, Reaction Time, Decision Making Time tasks even after depressive phase are still present.
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PMID:[Evaluation of selected temperamental traits in depression and in remission]. 897 62


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