Search results

1

ERPS AS AN INDEX OF IMPAIRED WORKING MEMORY IN AN ISCHEMIC BRAIN STROKE APHASIC PATIENT AWAKENED FROM A LONG-TERM COMA FOLLOWING AN AMPHETAMINE OVERDOSE

100%

Wilczek-Rużyczka E., Grzywniak C., Korab M., Cielebąk K.

Acta Neuropsychologica

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2021

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vol. 19(2)

137-145

EN

Nowadays, amphetamines constitute the prescription drugs most commonly abused by adolescents and young adults (Berman, O’Neill, Fears et al. 2008). The prevalence of problematic (mainly illegal) use of amphetamines as a stimulant by college students, and here especially before serious examinations, has also been rising. This fact represents a serious public health concern. The patient, aged 19, was awakened from from a long-term coma that had lasted 21 days following an amphetamine overdose and manifested tetraparesis, cortical blindness and deficits in cognitive and emotional processes. After a year of rehabilitation the majority of symptoms had disappeared, but cortical blindness andworking memory deficits remained. In addition, frontal lobe syndrome symptoms appeared. After two years of therapy as a result of immense tiredness caused by all an night wedding reception she started to manifest Charles-Bonnet syndrome. She experienced strange visual sensations such as visual hallucinations and saw various non-existing shapes (coloured blots, patterns and fireworks of vivid colours). She also saw objects (often terrifying) as well as animals (mainly African) and people with deformed faces and long teeth, and persons in African dress with feathers and coral beads in their hair. Her real identity was not remembered by the patient for longer than 2 hours and even then she insisted on being referred to as Shakira. She was given a qEEG examination (in open and closed eyes conditions) and ERPs with the use of auditory stimuli at the period when the hallucinations (to a small degree) still occurred. Studies conducted into the functional neuroimaging of the brain work in milliseconds in the examined patient can explain her symptoms. A comparison of the subject’s ERPs with the grand average of ERPs in healthy controls shows that the N170 and N 250 components are impaired in the subject: the occipital-temporal area of the subject brain shows a strong positivity instead of negativities. This positivity might reflect an enhanced reactivity of neurons in the corresponding area induced by the removal of lateral inhibition from the neurons as a result of local damage. ------------------------------------------------------------------------------------------------------------------------------------

2

EEG NEUROFEEDBACK IN THE TREATMENT OF COGNITIVE DYSFUNCTIONS AFTER THE INFECTION OF SARS-COV-2 AND LONG COVID-19

100%

Łuckoś M., Cielebąk K., Kamiński P.

Acta Neuropsychologica

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2021

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vol. 19(3)

361-372

EN

Coronavirus disease 2019 (COVID-19) is likely to have long-term mental health effects on individuals who have recovered from COVID-19. According to Centers for Disease Control and Prevention (CDC), individuals diagnosed with COVID-19 can see a range of long-term side effects. The aim of the study was to evaluate the effectiveness of neurotherapy (EEG neurofeedback and goal-oriented cognitive training) in the treatment of neurocognitive dysfunctions in a patient after the infection of SARS-CoV-2 and the long long-term side effects after the contraction of COVID-19. The 48-year-old woman ZR, an accountant by profession, an employee of the administration of the Municipal Board of Municipal Resources, fell ill on October 13, 2020. The disease began with very severe burning headache, eyeballs pain, muscle aches. Ten days later more symptoms joined: loss of smell (anosmia) and loss of taste (ageusia), hearing disorders, shortness of breath and chest pains. The symptoms were associated with SARS-CoV-2 coron- avirus infection confirmed by an rt-PCR genetic test. Brain MRI with intravenous paramagnetic contrast medium injection did not show either lesions of acute microischemic significance or areas of pathological enhancement after paramagnetic contrast medium ad- ministration. The patient was treated at home. In mid-November 2020, about a month after the infection of SARS-CoV-2 and con- tracting NeuroCOVID-19, neurocognitive impairment developed and after half a year she was deteriorating and not able to live in- dependently in society because of her condition. She called her problem "brain fog", and was referred for further diagnosis and therapy to the Reintegration and Training Center of the Polish Neuropsychological Society. We diagnosed a range of long-term side effects and introduced neurotherapy (EEG neurofeedback and goal-oriented cognitive training) in the treatment of neurocognitive dysfunctions. It was found that almost all the long-term side effects were reduced in magnitude. The patient improved and she was able to return to work. EEG neurofeedback and goal-oriented cognitive training might be helpful in the reduction of neurocognitive dysfunctions in patients following the infection of SARS-CoV-2 and long-term side effects after the contraction of COVID-19.

3

NEUROPSYCHOLOGICAL REHABILITATION OF AN ADOLESCENT PATIENT AFTER INTRACRANIAL EMBOLIZATION OF AVM – A CASE STUDY

88%

Golińska P., Bidzan M.

Acta Neuropsychologica

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2018

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vol. 16(4)

405-415

EN

This paper discussed a case study of a 15-year-old girl who had had a hemorrhagic stroke, caused by arteriovenous malformation. A brain arteriovenous malformation is a defect in the vascular system, a tangle of abnormal blood vessels connecting arteries and veins in the brain. The patient attended regularly neuropsychological rehabilitation and several various therapeutic methods were applied. A neuropsychological diagnosis was performed before and after therapy. The first assessment showed some cognitive disturbances: difficulties in the organization of memorized material, difficulties in maintaining attention and deficits in abstract thinking. Furthermore there were observed emotional problems: depression and high perfectionism. The patient participated in individual therapy lasting one year. Neuropsychological rehabilitation took into consideration the personal psychological resources and cognitive and emotional difficulties. As a result, there was observed an improvement in consequent cognitive functions: organization of memorized material, working memory, abstract thinking and verbal fluency. The emotional state was stable. It is important that the therapy should be holistic and includes all aspects of the patient’s functioning, which may have an influence on the final result of rehabilitation. One of the most important aims of the therapy psychologist was an acceptance of the disease. The cognitive tasks can also include psychological and therapeutic exercises.

4

NEUROPSYCHOLOGICAL EVALUATION OF NARRATIVE DISCOURSE PATTERNS IN INDIVIDUALS WITH EARLY STAGE VASCULAR DEMENTIA VS. PATIENTS WITH EARLY STAGE ALZHEIMER’S DISEASE

88%

Gawron N., Łojek E., Hintze B., Egbert A. R.

Acta Neuropsychologica

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2021

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vol. 19(2)

187-207

EN

Individuals in the early stages of dementia may demonstrate language difficulties. The aim of the study was an evaluation of the differences in narrative discourse abilities across two types of dementia, i.e., Vascular Dementia (VaD) and Alzheimer’s Disease (AD) in comparison to the young and old elderly. The AD and VaD groups displayed a lower performance than the age-matched YE on tasks involving reasoning. The VaD partici- pants outperformed patients with AD in verbal memory and narrative discourse. Discourse macrostructure analyses showed that the VaD reproduced more propositions than did the AD participants, but that these were comparable to YE and OE. There were more conjunctions in narratives reproduced by the VaD participants as compared to other groups, although this tendency was only present in the story but not in fairy tale reproductions themselves. Individ- uals in the AD group had more difficulties than YE and OE individuals in figuring out the moral of fairy tales. Clinical and control groups reproduced the microstructure and superstructure of texts comparatively well. Discourse recall correlated with performance on verbal memory, attention/working memory, and reasoning. Differences in narrative discourse abilities were found. Alzheimer’s Disease (AD) patients scored lower in verbal memory than did Vascular Dementia (VaD) patients. Both groups however obtained lower results than the young and old elderly.

5

PREDICTING VISUAL PERCEPTION AND WORKING MEMORY DEFICITS AMONG PATIENTS WITH TYPE 1 DIABETES: THE IMPLICATION OF EATING ATTITUDE AND MENTAL HEALTH STATUS

88%

Samir B., Hsaini A., Lababneh T., Louragli I., Benmhammed H., Touhami Ahami A. O., Aboussaleh Y.

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EN

Several recent studies designate that individuals with type-1-diabetes (T1D) are at higher risk for cognitive impairment than their peers without T1D. The aim of this study was to determine whether socio-demographic and clinical characteristics, eating attitude and psycho-emotional characteristics can predict visual perception (VP) and working memory (WM) impairment in the Moroccan population with T1D. A cross-sectional analysis was carried out in adult T1D patients (N=140). The Rey-Osterrieth Complex Figure test (electronical version) was used to evaluate the VP and WM. Moreover, patients also completed the 21-item Depression, Anxiety, and Stress Scale to assess their mental health state. In order to evaluate the risk of eating disorders the Eating attitudes Test-26 were used. Finally, anthropometric properties and clinical characteristics were evaluated. Predictors of cognitive dysfunction were determined using the hierarchical regression analysis. The major result was that age, long diabetes duration, glycemia, HbA1c, dieting and bulimia were the potential predictors of low scores in VP and WM. Other significant predictors were cholesterol, triglycerides for visual perception. Although psych-emotional symptoms including stress, anxiety, and depression were not a significant predictors of VP and WM impairment. Furthermore, our findings showed that the more the level of stress increases, the VP and WM scores significantly decrease. This study suggests that it can be helpful for medical practitioners to screen for disordered eating behaviors and emotional symptoms as a supplemental risk factor for cognitive impairment in T1D.

6

Does work stress affect neurocognitive functions? Case of Moroccan workers

88%

Arji S., Elhaddadi M., Ahami A. O. T., Ziri R.

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EN

Depending on its stage, stress influences cognitive functions. Indeed, several authors have ensured the degradation of cognitive functions by stress. Others did not find any association between the two. A third group of authors claimed that stress improves the performance of certain cognitive functions. Faced with this inconsistency of results, we conducted this study with the aim of finding out whether job stress alters or stimulates cognitive functions. Our study focused on 102 workers who were asked to freely and anonymously complete a questionnaire deemed relevant at the international scale. The age of the participants is between 22 and 60 years old with an average of 37 years and a standard deviation of 11 years. The population is made up of 77% of men and 23% of women. For the school level of the subjects: 50% of the subjects have a level bac to bac+2, 30% have a level higher than bac+2 and 20% have a level lower than bac. The professional status of workers is divided into three types: 48% are supervisors and technicians, 32% are executing workers and 20% are senior managers. The participants underwent two neurocognitive tests using the ELIAN software. Analysis of the results shows that there is no significant link between work stress and the cognitive functions studied. However, the analysis of the results of each socio-professional category separately shows that stress significantly reduces the visual working memory score of young people (< 40 years old), as well as the ability to concentrate of subjects with a school level higher than bac+2. While it improves visual perception in men and old people over the age of 40. There are significant links between some cognitive performances and the socio-professional characteristics of the stressed subjects. Therefore, work stress can affect neurocognitive health, which is more serious. In order to understand the relationship between work or chronic stress and cognition as well as their moderating factors, it is advisable to increase the size of the sample and to diversify the cognitive functions studied as well as their tasks.

7

Are there any links among psychopathological symptoms, musical preferences and verbal working memory in female adults?

88%

Giannouli V., Stoyanova S.

Acta Neuropsychologica

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2018

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vol. 16(1)

9-15

EN

The question ‘Do psychopathology dimensions correlate with musical preferences in healthy individuals?’ still remains poorly investigated. Additionally, verbal working memory, psychopathology and music preferences have not been examined together. Participants consisted of ninety-three young women without a previous or current psychiatric diagnosis. All participants were examined with the Forward Digit Span Task, and completed a psychopathology symptom instrument along with a musical preferences question. Results revealed that the Global Score Index, Somatization, Hostility and Depression correlated in a statistically significant way with musical preferences in female adults. Hostility and Depression predicted classical music preferences. Depression, Obsessive/Compulsive, Somatization and Hostility predicted a pop preference, while Somatization and Psychoticism predicted a rock preference. No significant correlations were found between the above variables and verbal working memory, except for a significant correlation between age and the span of the working memory. Certain psychopathology dimensions do not influence cognition in the form of the verbal working memory in women, but can predict a specific choice of music genres. Findings suggest that music listening preferences may represent a field of inner experiences that could reveal easy-to-obtain information about the mental health of women who have not an official psychiatric diagnosis, but may be at risk of developing psychological problems due to high self-reported symptoms of psychopathology.

8

ERPS AS AN INDEX OF IMPAIRED COGNITIVE CONTROL IN AN ISCHEMIC BRAIN STROKE APHASIC PATIENT

88%

Cielebąk K., Grzywniak C.

Acta Neuropsychologica

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2021

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vol. 19(1)

11-22

EN

Stroke is a sudden-onset neurological deficit resulting from focal vascular lesions. This is either due to a clot-induced obstruction of a vessel (ischemic stroke) or a rupture of a vessel causing haemorrhage (hemorrhagic stroke). The appropriate diagnosis of brain stroke aphasic patients is a major public health problem one so important for effective rehabilitation. Here an important role is played by the diagnosis of impaired cognitive processes. The aim of the research was to find the index of impaired cognitive control with the use of ERPs in a patient following an ischemic stroke with aphasia. A male patient, aged 69, after an ischemic brain stroke experienced 4 months previously with resulting naming problem, was admitted to the Reintegrative and Teaching Center of the Polish Neuropsychological Society. In the neuropsychological evaluation three neuropsychological tests were employed: (a) the Boston Naming Test-Polish version, to evaluate the naming and word finding problem; (b) the nonverbal Bell test to ascertain a selective, visuospatial and strategic attentional evaluation; (c) the Digit Memory test to evaluate working memory capabilities; (d) ERPs as a neurophysiological index of impaired cognitive control. Significant changes were observed in testing. All cognitive functions including naming, nonverbal, visuospatial and strategic attention, along with the digit memory deviate substantially from the norm. The patient obtained a lo wer score, compared to the norm (p <0.05). Boston Naming Test (patient = 21< Mean-Norm = 57.29; SD= 0.52). Bell test (patient = 23 < Mean-Norm = 31.29; SD= 2.52). Digit Memory Test scores: Forward digit span (patient = 3 < Mean-Norm = 7.65, SD = 0.49). Backward digit span (patient = 2

9

MANAGEMENT OF ATTENTION DEFICIT AND FINE MOTOR INCOORDINATION OF PRIMARY SCHOOL GOING ADHD (INATTENTIVE TYPE) CHILDREN

88%

Khan N. A., Jahan M., Kanchan A., Singh A. R.

Acta Neuropsychologica

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2017

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vol. 15(3)

283-301

EN

Background: Children with Attention Deficit/Hyperactive Disorder (ADHD) have a wide range of neuropsychological deficits including attention, memory, and executive functioning. The study was targeted to use a neuropsychological approach in remediating attention and fine motor training or the incoordination of children with ADHD- Inattentive type (IA). Material/Methods: A total of 20 primary school children fulfilling the criteria of ADHD- IA type were selected from different schools in Mysuru, India. Neuropsychological deficits were assessed using appropriate tools. Children in the experimental group were given attention and fine motor training for 3 months. A post test was conducted after 3 months training. The maintenance effect of therapy was studied until the completion of 1 year. Results: Results revealed that attention fine motor training was effective in improving focused and selective attention, working memory, new learning ability, visual fluency and fine motor training incoordination. Conclusions: It can be concluded that a neuropsychological rehabilitation is effective in remediating the deficits faced by children with ADHD-IA.

10

EXECUTIVE FUNCTION AND MEMORY FOR THE REY-OSTERREITH COMPLEX FIGURE TASK: RELATIONSHIP BETWEEN GENDER, HEART RATE AND NEUROPSYCHOLOGICAL PERFORMANCE IN MOROCCAN STUDENT SAMPLE

88%

Salim E. M., Touhami Ahami A. O., Oudda H., Ahmadou T. M.

Acta Neuropsychologica

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2022

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vol. 20(1)

35-51

EN

The present study has been conducted to investigate the visuospatial constructive cognition and memory among healthy students, as measured by the Rey Complex Figure Test (RCFT). We have compared the data used to draw the figures with the hypothesis that gender and physiological measurements have an impact on neuropsychological skills. One hundred twenty-five students (43 male, 82 female; age 18–32 years) participated in this study with a computerized numerical recording of the digital plot of the RCFT and a set of socio-demographic variables. Results revealed that visual perception and working memory were impacted by social and health determinants. Additionally, this study presents evidence supporting the implication of resting heart rate (RHR) and organizational strategy in working memory performance. Gender effect seems to be significant in physical and physiological differences. Regression analyses revealed a relevant contribution of study institution and sleep time on RCFT Copy score; RCFT Memory predicted by drawing from memory strategy, RHR, periodic medication use and marital status.

11

EVENT-RELATED POTENTIALS STUDIES OF PTSD AFTER INFECTION OF SARS-COV-2 AND NEUROCOVID-19

88%

Pąchalska M., Nowaczyk N.

Acta Neuropsychologica

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2021

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vol. 19(3)

347-360

EN

Coronavirus disease 19 (COVID-19) hospitalisation is a potentially traumatic experience, especially in severe cases. Furthermore, the unprecedented context of the SARS-CoV-2 pandemic, with the daily media bombardment about COVID-19 mortality, may have amplified its life-threatening perception also in patients with moderate infection. The purpose of our study was twofold: 1) to evaluate QEEG/ERPs shows of PTSD associated with severe infection SARS-CoV-2, and neuroCOVID-19, 2) to construct a neurofeedback protocol based on these indices to support the psychotherapy of the case study described herein. Patient N.C. 49, a frontline healthcare worker in the emergency services (an ambulance driver), became ill with Covid-19 on November 14, 2020. Initially, he lost his sense of smell (anosmia), of taste (ageusia), and had latent blinks (heterophila), headaches, and dizziness. After 10 days of illness, the patient had additionally a dry cough and a shortness of breath and he was hospitalized, sedated and mechanically ventilated for 24 days. After a few months he was diagnosed with PTSD (according to the DSM- 5 criteria) and referred to the Reintegration and Training Center of the Polish Neuropsychological Society for further diagnosis and treatment. It was found that the P3 GO and P3 NOGO waves were indeed less in his case (p < 0.01) when compared to the ERPs results of a health group of individuals of a similar age (n = 100), derived from the normative data bases of the Human Brain Index (HBI) in Switzerland. The ERPs wave pattern in our patient reflects the pattern appearing in patients with PTSD. The patient took part in 20 sessions of individually tailored anodal transcranial direct current stimulation (tDCS), with the excitatory stimulation of the left prefrontal cortex and inhibitory stimulation of the right prefrontal cortex which can reduce anxiety, as was proposed in the subject literature. Also, the neuromarker of PTSD obtained with the use of QEEG/ERPs was helpful in choosing the appropriate tDCS protocol. Neurostimulation with the use of tDCS was administered systematically, every day, 15-20 and 30-40 minutes for each session, for 20 days. He also received individual sessions of psychotherapy every day, 30-40 minutes for each session, for 20 day. After the treatment the patient improved and returned to his previous job as a frontline healthcare worker in the emergency services (an ambulance driver) in the fight against COVID-19. Detection of the PTSD neuromarker enabled the development of a proper tDCS protocol and the conduct of effective brain neurostimulation of a patient with PTSD. The proposed protocol of treatment, in combination with goal-oriented individual psychotherapy, offered to the patient, was effective in the reduction of PTSD. ERPs can be useful in the diagnosis of PTSD as well as in selecting an appropriate therapy protocol for these patients.

12

How the mind is ageing?

63%

Nosal C. S., Nosal C. S.

Nauka

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2019

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issue 2

13

Ocena zależności między objawami pozytywnymi/negatywnymi a funkcjonowaniem pamięci operacyjnej u pacjentów z pierwszym epizodem schizofrenii

63%

Libera U., Pawełczyk T., Rabe-Jabłońska J.

Psychiatria i Psychologia Kliniczna

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2009

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vol. 9

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issue 3

146-158

EN

Objectives: Evaluation of the correlation between efficiency of working memory and positive and negative symptoms in patients with the first episode of schizophrenia, those who have not been treated so far and those after six weeks’ treatment with antipsychotics. Methods: The study covered 32 patients (20 men and 12 women) aged 18-46 years (22 years on average) with diagnosed first episode of schizophrenia (ICD-10), admitted to hospital, not treated so far. Prior to treatment and after six weeks of antipsychotic treatment (14 – TN and 18 – NAP in typical doses) clinical state (PANSS) and working memory were evaluated (WCST, TMT B, Digit Span backward from Wechsler Intelligence Scale WAIS-R – PL). Conclusions: 1) In previously untreated patients, during severe symptoms of schizophrenia the working memory dysfunction was mostly correlated with the presence of negative symptoms, to a less extent – with the presence of general symptoms. 2) After six weeks of antipsychotic treatment of patients with the first episode of schizophrenia an advantageous change in the working memory functioning and significant change of mental state were observed, expressed by abatement – to a significant extent – of both positive and negative symptoms. 3) The advantageous change in the working memory functioning after six weeks’ treatment of patients with the first episode of schizophrenia was associated with abatement of all groups of pathological symptoms, but it mostly correlated with an improvement within negative symptoms. 4) Finding a strong correlation between the working memory disorders and the presence and severity of negative symptoms before and after pharmacotherapy, whatever its type (TN or NAP), perhaps indicates a similar aetiology of these symptoms (common neuroanatomic basis) and existence of a special subtype of schizophrenia.

PL

Cele: Ocena związku między sprawnością pamięci operacyjnej a objawami pozytywnymi i negatywnymi u pacjentów z pierwszym epizodem schizofrenii, dotychczas nieleczonych oraz po sześciu tygodniach kuracji lekami przeciwpsychotycznymi. Metody: Do badania włączono 32 chorych (20 mężczyzn i 12 kobiet) w wieku 18-46 lat (średnio 22 lata), z rozpoznaniem pierwszego epizodu schizofrenii (ICD-10), przyjętych do szpitala, dotychczas nieleczonych. Przed leczeniem i po sześciu tygodniach leczenia przeciwpsychotycznego (14 – LPIG i 18 – LPIIG w typowych dawkach) oceniono stan kliniczny (PANSS) oraz pamięć operacyjną (WCST, TMT B, Powtarzanie Cyfr wspak z WAIS-R – PL). Wnioski: 1) U chorych wcześniej nieleczonych w okresie ostrych objawów schizofrenii dysfunkcja pamięci operacyjnej miała związek przede wszystkim z obecnością objawów negatywnych, w mniejszym stopniu z obecnością objawów ogólnych. 2) Po sześciu tygodniach leczenia przeciwpsychotycznego pacjentów z pierwszym epizodem schizofrenii stwierdzono korzystną zmianę funkcjonowania pamięci operacyjnej oraz znamienną zmianę stanu psychicznego, wyrażoną ustępowaniem w istotnym stopniu zarówno objawów pozytywnych, jak i negatywnych. 3) Pozytywna zmiana funkcjonowania pamięci operacyjnej po sześciu tygodniach leczenia chorych z pierwszym epizodem schizofrenii wiązała się z wycofywaniem się wszystkich grup objawów choroby, lecz w największym stopniu korelowała z poprawą w zakresie objawów negatywnych. 4) Stwierdzenie silnego związku między zaburzeniami pamięci operacyjnej a obecnością i nasileniem objawów negatywnych przed farmakoterapią i po niej, niezależnie od jej rodzaju (KN lub LPIIG), wskazuje być może na podobną etiologię tych objawów (wspólne podłoże neuroanatomiczne) oraz istnienie szczególnego podtypu schizofrenii.

14

Stop walking when talking, czyli związek funkcji poznawczych z kontrolą chodu

63%

Rajtar-Zembaty A., Rajtar-Zembaty J., Starowicz-Filip A., Skalska-Dulińska B., Czechowicz I. K., Skalska A.

Aktualności Neurologiczne

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2015

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vol. 15

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issue 1

22-27

EN

Nowadays, more and more scientific reports highlight the importance of cognitive skills in motor control. It is believed that movement also engages higher mental processes such as executive functions, attention and working memory. Executive functions include cognitive processes, such as the ability to initiate, plan, modify and control behaviour. They play an integrative role in the processing of information, including both cognitive and behavioural elements, necessary for goal-directed and effective action. Executive functions play a key role in the regulation of gait in the case of taking new steps or modifying previously learned motor programmes. Neuroimaging studies show that there is a common pattern of neural activity for walking, executive functions and attention, involving the frontal cortex and cortico-subcortical neuronal network. Many studies have shown that the impairment of executive functions may contribute to gait disturbances and increased risk of falls. Executive functions allow movement patterns to be modified, and enable the introduction of adaptive compensatory strategies in response to changing internal and external environmental stimuli. Studies with dual-task paradigm also stress the importance of attention in maintaining the control over gait. The addition of a cognitive task slows gait in the elderly. The incidence of falls is higher in subjects with dementia. The identification of cognitive risk factors of falls may allow more effective diagnostic and therapeutic methods to be developed. The aim of this study was to elucidate the relationship between cognitive function, i.e. executive functions and attention, and the risk of falls.

PL

Współcześnie powstaje coraz więcej doniesień naukowych podkreślających znaczenie sprawności funkcji poznawczych w kontroli motorycznej. Uważa się, że chód angażuje także wyższe procesy psychiczne: funkcje wykonawcze, uwagę i pamięć operacyjną. Funkcje wykonawcze obejmują takie procesy poznawcze, jak zdolność do inicjowania, planowania, modyfikowania i kontroli zachowania. Pełnią integracyjną funkcję w przetwarzaniu informacji – obejmują elementy poznawcze i behawioralne niezbędne do skutecznego działania, zorientowanego na cel. Funkcje wykonawcze odgrywają kluczową rolę w regulacji chodu w przypadku podejmowania nowych czynności bądź modyfikowania uprzednio wyuczonych programów ruchowych. Jak dowodzą badania neuroobrazowe, dla chodu, funkcji wykonawczych i uwagi istnieje wspólny wzorzec aktywności neuronalnej, obejmujący korę czołową i jej korowo-podkorową sieć neuronalną. W wielu badaniach wykazano, że osłabienie funkcji wykonawczych może przyczyniać się do powstawania zaburzeń chodu i zwiększać ryzyko upadków. Funkcje wykonawcze umożliwiają modyfikowanie wzorców ruchowych, jak również wprowadzanie adaptacyjnych strategii kompensacyjnych w odpowiedzi na zmieniające się bodźce – pochodzące ze środowiska zarówno wewnętrznego, jak i zewnętrznego. Badania w paradygmacie podwójnego zadania podkreślają też znaczenie uwagi w utrzymaniu kontroli chodu. Dodanie zadania angażującego funkcje poznawcze przekłada się w grupie ludzi starszych na spowolnienie chodu. Częstość upadków jest wyższa u osób z otępieniem. Identyfikacja poznawczych czynników ryzyka upadków może pozwolić na opracowanie skuteczniejszych metod diagnostycznych i terapeutycznych. Celem niniejszej pracy jest próba wyjaśnienia mechanizmów relacji między funkcjami poznawczymi – funkcjami wykonawczymi i uwagą – a ryzykiem upadków.

15

Zaburzenia pamięci operacyjnej i wybranych funkcji poznawczych u chorych leczonych na schizofrenię paranoidalną

63%

Giętkowski D.

Psychiatria i Psychologia Kliniczna

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2012

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vol. 12

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issue 1

26-33

EN

Already since the times of Baddeley and Hitch the dorsolateral part of the frontal lobe was regarded as the functional centre of the working memory. Working memory disorders are, on the other hand, one of the basic and consolidated disorders in the course of paranoid schizophrenia. The concept of neurodevelopmental schizophrenia combines these elements and associates the illness with the changes occurring in the brain in the prenatal period. The efficiency of the working memory system, which acts as a buffer manipulating with the possessed and inflowing information, influences the quality of other cognitive processes, such as long‑term memory, short‑term memory, concentration and thinking. A study was performed on two groups: one experimental consisting of 31 people suffering from paranoid schizophrenia and one control group of 31 healthy people. In both groups a replica of Wisconsin Card Sorting Task was used in order to measure the efficiency of the working memory and selected tests from WAIS‑R (PL): the Polish adaptation of Wechsler Adult Intelligence Scale to assess the functioning of concentration, memory and thinking. The results of the study showed that in the experimental group the efficiency of the working memory is very low and that the illness affects the performance of concentration, memory and thinking. Moreover the tests proved that the working memory disorder increases with time.

PL

Grzbietowo‑boczna część płata czołowego już od czasów Baddeleya i Hitcha uważana była za funkcjonalny ośrodek pamięci operacyjnej (roboczej). Z kolei zaburzenia pamięci operacyjnej są jednym z podstawowych i utrwalonych zaburzeń w przebiegu schizofrenii paranoidalnej. Koncepcja neurorozwojowa schizofrenii łączy te elementy, tłumacząc zachorowania zmianami powstałymi w mózgu w okresie prenatalnym. Poziom funkcjonowania pamięci operacyjnej, która spełnia funkcję bufora manipulującego napływającymi oraz posiadanymi informacjami, rzutuje bezpośrednio na jakość innych procesów poznawczych, takich jak pamięć długotrwała, krótkotrwała, uwaga, koncentracja czy myślenie. W celu wykazania różnic w poziomie funkcjonowania pamięci operacyjnej przebadano dwie grupy: eksperymentalną (31 osób chorujących na schizofrenię paranoidalną, leczonych na oddziale psychiatrycznym) oraz kontrolną (31 osób zdrowych). W dwóch grupach do oceny poziomu funkcjonowania pamięci operacyjnej posłużyła replikacja testu Sortowania Kart z Wisconsin – Test KFL (Kolor Figura Liczba) oraz do oceny jakości funkcjonowania uwagi, myślenia oraz pamięci – wybrane testy z WAIS‑R (PL) (Polska Adaptacja Skali Inteligencji Wechslera): arytmetyka, powtarzanie cyfr, symbole cyfr, klocki, braki w obrazkach oraz podobieństwa. Wyniki badań wskazywały na znaczne obniżenie poziomu funkcjonowania pamięci operacyjnej w grupie eksperymentalnej oraz wpływ tego zaburzenia na inne procesy poznawcze, w tym myślenie, uwagę oraz pamięć. Wykazano ponadto, iż poziom zaburzenia pracy pamięci roboczej wzrasta wraz z czasem trwania choroby.

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