Does carotid endarterectomy improve cognitive functioning?
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BACKGROUND: Carotid endarterectomy (CEA) might improve cognitive functioning, but studies thus far have produced mixed results. The aim of the present study was to examine the effect of CEA on cognitive functions in a methodologically more strict design, first by testing the presumption of preoperative cognitive impairment and second through a better control for the possible influence of the nonspecific effects of practice and surgery. METHODS: Preoperative performance on a neuropsychologic test battery of 56 patients with severe occlusive disease of the carotid artery but without history of major stroke was compared with the performance of 46 healthy control subjects and 23 patients before endarterectomy of the superficial femoral artery (remote endarterectomy). The degree of cognitive change in the 2 patient groups was compared at 3 and 12 months postoperatively. We assessed mood to control for possible momentary affective influences on cognition. RESULTS: Before CEA, patients showed reduced functioning compared with that seen in healthy control subjects in terms of attention, verbal and visual memory, planning of motor behavior, psychomotor skills, and executive function. Performance of patients before remote endarterectomy was reduced as well. Improvements in several cognitive functions were observed after both types of surgical interventions and were attributed to psychologic relief from uncomplicated surgery and to practice. CONCLUSIONS: No specific restorative effect of CEA on cognitive functioning was observed. The preoperative impairment in several cognitive domains might be caused by factors that patients with various types of vascular disease might have in common, such as small-vessel disease or other undetected abnormalities within the brain. (+info)
Immediate reward bias in humans: fronto-parietal networks and a role for the catechol-O-methyltransferase 158(Val/Val) genotype.
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The tendency to choose lesser immediate benefits over greater long-term benefits characterizes alcoholism and other addictive disorders. However, despite its medical and socioeconomic importance, little is known about its neurobiological mechanisms. Brain regions that are activated when deciding between immediate or delayed rewards have been identified (McClure et al., 2004, 2007), as have areas in which responses to reward stimuli predict a paper-and-pencil measure of temporal discounting (Hariri et al., 2006). These studies assume "hot" and "cool" response selection systems, with the hot system proposed to generate impulsive choices in the presence of a proximate reward. However, to date, brain regions in which the magnitude of activity during decision making reliably predicts intertemporal choice behavior have not been identified. Here we address this question in sober alcoholics and non-substance-abusing control subjects and show that immediate reward bias directly scales with the magnitude of functional magnetic resonance imaging bold oxygen level-dependent (BOLD) signal during decision making at sites within the posterior parietal cortex (PPC), dorsal prefrontal cortex (dPFC), and rostral parahippocampal gyrus regions. Conversely, the tendency of an individual to wait for a larger, delayed reward correlates directly with BOLD signal in the lateral orbitofrontal cortex. In addition, genotype at the Val158Met polymorphism of the catechol-O-methyltransferase gene predicts both impulsive choice behavior and activity levels in the dPFC and PPC during decision making. These genotype effects remained significant after controlling for alcohol abuse history. These results shed new light on the neurobiological underpinnings of temporal discounting behavior and identify novel behavioral and neural consequences of genetic variation in dopamine metabolism. (+info)
Sensory sensitivities and performance on sensory perceptual tasks in high-functioning individuals with autism.
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Recovery in schizophrenia: focus on neurocognitive functioning.
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Recovery encompasses symptom remission and functional elements such as cognition, social functioning and quality of life. Personal recovery is also important in illness management to help the person stay on track with treatment and focus on activities unrelated to taking medication that maintain mental health. In the present study we aimed to identify neurocognitive functioning in two clinically stable groups of patients with personal recovery and non-recovered patients. The results showered generalized cognitive deficits in both groups while the non-recovery group was more impaired in verbal and visual memory, acoustic and tactile gnosis and neurodynamics and executing functioning. Interestingly the recovery group demonstrated lack of programming of actions and sufficient error monitoring and self-correction whereas the non-recovery group was significantly more impaired in all executive domains. The obtained results could be beneficial in identifying a target for psychosocial treatments and specifically cognitive remediation for patients with schizophrenia to facilitate the process of recovery. (+info)
Neuropsychological aspects of 10-year-old children.
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