Differentiation of cognitive and motor slowing in the Digit Symbol Test (DST): differences between depression and schizophrenia

Hoof, Joris Jasper van; Jogems-Kosterman, B.J.M.; Sabbe, Bernard; Zitman, Frans G.; Hulstijn, Wouter

doi:10.1016/s0022-3956(98)00057-0

Cited by 56 publications

(23 citation statements)

References 11 publications

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“…Are all of these subprocesses slowed by some relatively constant amount, or are particular operations severely slowed, constraining the whole assembly of operations? A few studies have addressed these issues, 80,81 but a more concerted program of experimental research will be needed to improve our understanding. The current results and the broader meta-analytic literature may help to guide that work.…”

Section: Commentmentioning

confidence: 99%

Overlooking the Obvious

Dickinson

Ramsey²,

Gold

2007

Arch Gen Psychiatry

769

298

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Context:In focusing on potentially localizable cognitive impairments, the schizophrenia meta-analytic literature has overlooked the largest single impairment: on digit symbol coding tasks.Objective: To compare the magnitude of the schizophrenia impairment on coding tasks with impairments on other traditional neuropsychological instruments.Data Sources: MEDLINE and PsycINFO electronic databases and reference lists from identified articles.Study Selection: English-language studies from 1990 to present, comparing performance of patients with schizophrenia and healthy controls on coding tasks and cognitive measures representing at least 2 other cognitive domains. Of 182 studies identified, 40 met all criteria for inclusion in the meta-analysis.Data Extraction: Means, standard deviations, and sample sizes were extracted for digit symbol coding and 36 other cognitive variables. In addition, we recorded potential clinical moderator variables, including chronicity/ severity, medication status, age, and education, and potential study design moderators, including coding task variant, matching, and study publication date.Data Synthesis: Main analyses synthesized data from 37 studies comprising 1961 patients with schizophrenia and 1444 comparison subjects. Combination of mean effect sizes across studies by means of a random effects model yielded a weighted mean effect for digit symbol coding of g = −1.57 (95% confidence interval, −1.66 to −1.48). This effect compared with a grand mean effect of g=−0.98 and was significantly larger than effects for widely used measures of episodic memory, executive functioning, and working memory. Moderator variable analyses indicated that clinical and study design differences between studies had little effect on the coding task effect.Comparison with previous meta-analyses suggested that current results were representative of the broader literature. Subsidiary analysis of data from relatives of patients with schizophrenia also suggested prominent coding task impairments in this group. Conclusion:The 5-minute digit symbol coding task, reliable and easy to administer, taps an information processing inefficiency that is a central feature of the cognitive deficit in schizophrenia and deserves systematic investigation. Psychiatry. 2007;64:532-542 W ITH EVIDENCE FROM hundreds of studies, cognitive impairment is now widely recognized as a critical and reliable feature of schizophrenia. Meta-analytic methods have been useful in distilling this enormous literature. In the first major synthesis, Heinrichs and Zakzanis 1 found evidence of significant impairment across the full range of traditional neuropsychological tests, with some evidence of disproportionate impairment in the area of verbal memory. Other meta-analyses have focused more specifically on episodic memory, 2,3 executive functioning, 4 the Wisconsin Card Sorting Test,5,6 working memory, 7 and verbal fluency. 8 , 9 These meta-analyseshighlighting domains and measures associated with prefrontal and temporal brain regions-reflect the do...

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Section: Commentmentioning

confidence: 99%

Overlooking the Obvious

Dickinson

Ramsey²,

Gold

2007

Arch Gen Psychiatry

769

298

View full text Add to dashboard Cite

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“…For the motor component, the mean writing times were calculated and for the more cognitive component the mean matching times were derived. For more details of the method of analysis we refer to earlier publications (JogemsKosterman et al, 2001;Sabbe et al, 1999;van Hoof et al, 1998;Wezenberg et al, 2005).…”

Section: Assessment Of Information Processingmentioning

confidence: 99%

Acute Effects of the Ampakine Farampator on Memory and Information Processing in Healthy Elderly Volunteers

Wezenberg

Verkes

Ruigt³

et al. 2006

Neuropsychopharmacol

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Ampakines act as positive allosteric modulators of AMPA-type glutamate receptors and facilitate hippocampal long-term potentiation (LTP), a mechanism associated with memory storage and consolidation. The present study investigated the acute effects of farampator, 1-(benzofurazan-5-ylcarbonyl) piperidine, on memory and information processes in healthy elderly volunteers. A double-blind, placebocontrolled, randomized, cross-over study was performed in 16 healthy, elderly volunteers (eight male, eight female; mean age 66.1, SD 4.5 years). All subjects received farampator (500 mg) and placebo. Testing took place 1 h after drug intake, which was around T max for farampator. Subjects performed tasks assessing episodic memory (wordlist learning and picture memory), working and short-term memory (N-back, symbol recall) and motor learning (maze task, pursuit rotor). Information processing was assessed with a tangled lines task, the symbol digit substitution test (SDST) and the continuous trail making test (CTMT). Farampator (500 mg) unequivocally improved short-term memory but appeared to impair episodic memory. Furthermore, it tended to decrease the number of switching errors in the CTMT. Drug-induced side effects (SEs) included headache, somnolence and nausea. Subjects with SEs had significantly higher plasma levels of farampator than subjects without SEs. Additional analyses revealed that in the farampator condition the group without SEs showed a significantly superior memory performance relative to the group with SEs. The positive results on short-term memory and the favorable trends in the trail making test (CTMT) are interesting in view of the development of ampakines in the treatment of Alzheimer's disease and schizophrenia.

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“…Depressive symptoms are quite frequent in AN and high BDI scores are often found and may reflect the severity of the pathology [35]. On the other hand, depression is known to have a slowing influence on both cognitive and motor aspects of the (Dutch version of the) DST [22], which makes the finding of a shorter matching time in the AN group at T1 even more intriguing. While the improvement of AN patients from T1 to T2 in this study was not different from that found in controls, it can therefore be attributed to a practice effect due to repeated testing.…”

Section: Discussionmentioning

confidence: 99%

“…perception, working memory, sustained attention and planning, a relatively new recording and analysing technique was used in this study. It has been used before in a study comparing psychomotor performance on the DST in depressed and schizophrenic patients [22]. The DST was administered on a digitizing tablet allowing the precise recording of the pen movements made during the test.…”

Section: Introductionmentioning

confidence: 99%

Differentiation of Cognitive and Motor Aspects in a Digit Symbol Substitution Test in Anorexia nervosa Patients, before and after Weight Restoration

Pieters¹,

Maas

Hulstijn

et al. 2004

Psychopathology

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Background: In a previous study, using computerized analysis of fine motor behaviour, seriously underweight anorexia nervosa patients in the early phase of treatment were found to have shorter reaction times, but not movement times, in experimental drawing and copying tasks. These differences persisted with weight restoration. Sampling and Methods: Using computerized analysis of writing and drawing behaviour during the performance of a Digit Symbol Substitution Test, 15 anorexia nervosa patients were compared with 15 normal controls, matched for age, sex and educational level. Patients were retested after weight restoration, as were controls after a similar interval. Results: Patients turned out to be superior in the cognitive, but not in the motor aspects of the Digit Symbol Substitution Test. These differences persisted after weight restoration. A practice effect, due to repeated testing, was found in both groups, which turned out to be cognitive in nature. Conclusions: The findings show that this new technique can add to the interpretation of classic neuropsychological tests. The results are compatible with previous findings of intact or even superior functioning in anorexia nervosa patients on neuropsychological tasks requiring considerable cognitive effort.

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Differentiation of cognitive and motor slowing in the Digit Symbol Test (DST): differences between depression and schizophrenia

Cited by 56 publications

References 11 publications

Overlooking the Obvious

Overlooking the Obvious

Acute Effects of the Ampakine Farampator on Memory and Information Processing in Healthy Elderly Volunteers

Differentiation of Cognitive and Motor Aspects in a Digit Symbol Substitution Test in Anorexia nervosa Patients, before and after Weight Restoration

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