SUMMARY In IS normotensive subjects, 17 newly diagnosed, untreated hypertensive patients, and 22 effectively treated hypertensive patients, a battery of neuropsychological tests was given. All subjects were neurologically asymptomatic. The neuropsychological battery included tests evaluating global cognitive functions (Card Sorting Test, Wechsler Memory Scale, Progressive Matrices 1938), as well as specific cognitive functions (Benton Test, subtests of the Wechsler-Bellevue Scale). Normotensive controls obtained better scores in all the tests. Statistical analysis of the scores suggests that hypertension is highly correlated with impairment of memory, logical reasoning, visuospatial organization, and attention. Therapy seems to impair attention, while the duration of disease seems to influence visuospatial performances. (Hypertension 4: 226-229, 1982) KEY WORDS • hypertension • cognitive functions • neuropsychological tests R ECENT years have brought to light increasing evidence of the fundamental role played by arterial hypertension in the pathogenesis of stroke.1 "* In a high percentage of hypertensive patiets deceased without neurological complications, mild but diffuse cerebrovascular abnormalities have been found.*"* In spite of such frequent cerebral damage, neurological symptoms and signs seem to be rare and mild in hypertensive patients.* In our experience, hypertensive patients often report slightly impaired powers of concentration, lightheadedness, and easy fatigue, causing impaired intellectual performance.10 These symptoms might correlate with diffuse and mild cerebrovascular abnormalities, but might also be explained by neurophysiological cortical depression, clearly shown in experimental models, 11 or by emotional reactions to the illness.Personality and psychological factors predisposing to, sustaining, and determined by hypertension have been extensively investigated." These investigations, although interesting for a global approach to hypertensive patients, are beyond the aim of our study, which is to investigate the possible neuropsychological deficits induced by neurologically asymptomatic hypertension.For this purpose we compared the results obtained by normotensive and hypertensive subjects in a battery of widely used neuropsychological tests.
The effects of various oral doses (1, 2, 4 mg) of flunitrazepam on vigilance, attention, immediate memory, short-term memory, learning, non-consolidated and consolidated long-term memory were determined. Twelve healthy young male volunteers were given placebo or flunitrazepam in a double-blind, random latin-square sequence, crossing over every 2 weeks. Volunteers completed a battery of tests at night, 3.5 h after drug administration, and in the morning, 10 h after drug administration. Flunitrazepam 1 mg did not significantly impair any of the functions tested at night, while 4 mg impaired vigilance, attention, immediate memory, short-term verbal memory and learning. The impairments of immediate and short-term memory seem to be related and proportional to reductions in vigilance and attention. Doses of 2 mg and 4 mg impaired the speed of learning but did not decrease the amount of material learned. Flunitrazepam caused dose-related impairment of long-term memory, both consolidated and not. This reduction of long-term memory does not seem to be related to the impairments of vigilance, attention or learning. The lowest dose did not modify vigilance and learning in any subject, improved attention in half of the subjects but reduced long-term memory in a similar number of subjects. Therefore, our results indicate selective impairment of long-term memory. Since there were no differences between the effects on consolidated and non-consolidated memory, the amnesic effect of flunitrazepam seems to be due to a decrease in the storage of memory traces. There were no clear generalized residual effects in the morning after administration.
We planned a double-blind cross-over study of memory processes in patients with common types of amnesia after administration of vasopressin, physostigmine and placebo in order to validate the possible role of these drugs in the treatment of organic amnesia. Memory, learning, vigilance, attention and concentration were tested in 24 organic amnesic patients after the three treatments. No statistically significant differences among the treatments were found.
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