The Corsi Block-Tapping Task measures visuospatial short-term and working memory, but a standardized backward condition is lacking. The authors present a standardized backward procedure that was examined in 246 healthy older adults (ages 50 to 92), comparing the results with the Digit Span subtest of the Wechsler Adult Intelligence Scale--Third Edition. Principal component analysis resulted in a two-factor model, dissociating a verbal and a spatial working-memory factor. Also the Corsi backward is not more difficult than the Corsi forward, in contrast to the Digit Span backward that is more difficult than the Digit Span forward. This may suggest that the Corsi Block-Tapping Task backward task relies on processing within working-memory's slave systems, whereas the Digit Span backward also relies on the central executive component of working memory. Finally, regression-based normative data and cutoff scores for older adults are presented for use in clinical practice.
People with diabetes mellitus are at increased risk of cognitive dysfunction and dementia. This review explores the nature and severity of cognitive changes in patients with type 2 diabetes. Possible risk factors such as hypo- and hyperglycemia, vascular risk factors, micro- and macrovascular complications, depression and genetic factors will be examined, as well as findings from brain imaging and autopsy studies. We will show that type 2 diabetes is associated with modest cognitive decrements in non-demented patients that evolve only slowly over time, but also with an increased risk of more severe cognitive deficits and dementia. There is a dissociation between these two 'types' of cognitive dysfunction with regard to affected age groups and course of development. Therefore, we hypothesize that the mild and severe cognitive deficits observed in patients with type 2 diabetes reflect separate processes, possibly with different risk factors and aetiologies.
OBJECTIVEType 2 diabetes is known to be associated with decrements in memory and executive functions and information-processing speed. It is less clear, however, at which stage of diabetes these cognitive decrements develop and how they progress over time. In this study, we investigated cognitive functioning of patients with recent screen-detected type 2 diabetes, thus providing insight into the nature and severity of cognitive decrements in the early stage of the disease. Possible risk factors were also addressed.RESEARCH DESIGN AND METHODSIncluded in this study were 183 diabetic patients from a previously established study cohort and 69 control subjects. A full neuropsychological assessment, addressing six cognitive domains, was made for each participant. Raw test scores were standardized into z scores per domain and compared between the groups. Possible risk factors for cognitive decrements were examined with multivariate linear regression.RESULTSRelative to scores for the control group, mean z scores were between 0.01 and 0.2 lower in the diabetic group across all domains, but after adjustment for differences in IQ between patients and control subjects, only memory performance was significantly reduced (mean difference −0.15 [95% CI −0.28 to −0.03]). A history of macrovascular disease and current smoking were significant determinants of slower information-processing speed in patients with diabetes.CONCLUSIONSThis study shows that modest cognitive decrements are already present at the early stage of type 2 diabetes. A history of macrovascular disease and smoking are significant risk factors for some early decrements.
Introduction: Historically, most studies about awake brain surgery have focused on language or motor functions. More recently, other cognitive functions have also been assessed. However, a clear overview of the neuropsychological tests or test paradigms that are used during such procedures is missing. The primary research question of this review is: What neuropsychological tests or paradigms are used during awake brain surgery? This review aims to give an extensive overview about the assessment of cognition during awake brain surgery. Method: A systematic search was performed in PubMed and Embase. Studies about awake surgery that mentioned a specific test or test paradigm for assessing cognition were included in this review. Results: The search yielded 4,052 articles. A manual selection for cognition in title and abstract resulted in 360 studies. Those were evaluated in full text; 212 articles described a cognitive task or paradigm. Further reference-list search yielded 20 more studies. In 207 of 232 studies, a test for assessment of language is reported. Tests for the visuospatial domain and motor and sensory functions are described in, respectively, only 23 and 20 studies. Tests for memory, calculation, emotions, or other cognitive functions are reported only in a minority of the included studies. Conclusions: Tests for assessment of language functions during awake brain surgery are widely reported. Other cognitive functions are underexposed. There is a need for development of tests or paradigms for assessment of other cognitive functions so that the broad spectrum of cognition can be monitored during awake brain surgery.
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