• 【澳大利亚全科注册服务商的程序技能: 横断面分析。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Aghajafari F,Tapley A,Sylvester S,Davey AR,Morgan S,Henderson KM,van Driel ML,Spike NA,Kerr RH,Catzikiris NF,Mulquiney KJ,Magin PJ
    BACKGROUND & AIMS: BACKGROUND:Procedural skills are an essential component of general practice vocational training. The aim of this study was to investigate the type, frequency and rural or urban associations of procedures performed by general practice registrars, and to establish levels of concordance of procedures performed with a core list of recommended procedural skills in general practice training. METHODS:A cross-sectional analysis of a cohort study of registrars' consultations between 2010 and 2016 was undertaken. Registrars record 60 consecutive consultations during each six-month training term. The outcome was any procedure performed. RESULTS:In 182,782 consultations, 19,411 procedures were performed. Procedures (except Papanicolaou [Pap] tests) were performed more often in rural than urban areas. Registrars commonly sought help from supervisors for more complex procedures. The majority of procedures recommended as essential in registrar training were infrequently performed. DISCUSSION:Registrars have low exposure to many relevant clinical procedures. There may be a need for greater use of laboratory-based training and/or to review the expectations of the scope of procedural skills in general practice.
    背景与目标:
  • 【社会天真的自我评估调节了精神分裂症的认知洞察力与阳性症状之间的关系。】 复制标题 收藏 收藏
    DOI:10.1016/j.schres.2012.10.037 复制DOI
    作者列表:Guerrero AG,Lysaker PH
    BACKGROUND & AIMS: :Cognitive insight refers to awareness of one's own thinking. Research has found deficits in cognitive insight in schizophrenia but studies of its links with positive symptoms and delusions have been equivocal. One possibility is that the association of cognitive insight with positive symptoms and delusions is moderated by other factors. To explore this issue this study examined whether level of socially naive self-appraisal moderated the relationship of two forms of cognitive insight, self-reflectivity and self-certainty with delusions and positive symptoms. Participants were 92 adults, with diagnoses of schizophrenia or schizoaffective disorder, who were administered the Positive and Negative Syndrome Scale, self-deceptive subscale from the Marlowe-Crowne Social Desirability Scale and the Beck Cognitive Insight Scale. Stepwise multiple regressions with the interaction term of the predictive and moderator variables suggested that social naiveté moderates the relationship between self-reflectivity and self-certainty with positive symptoms in general. Moreover, association between self-certainty and delusions was also moderated by social naiveté self-appraisal. All models were significant after controlling for willful impression management as well as a measure of executive function. Results suggest that higher levels of self-certainty are a risk factor for having greater positive symptoms including more severe levels of delusions, when one has a view of oneself that is not tempered by the perceptions of others. Concerning lower levels of self-reflectivity it may be that this combined with a socially naïve view of oneself leaves persons less inhibited when they are tempted to accept unusual thoughts and perceptions as accurate. Implications for treatment are discussed.
    背景与目标: : 认知洞察力是指对自己思维的认识。研究发现精神分裂症的认知能力不足,但对其与阳性症状和妄想的联系的研究却模棱两可。一种可能性是,认知洞察力与积极症状和妄想的关联受到其他因素的调节。为了探讨这个问题,本研究检查了社交天真的自我评估水平是否调节了两种认知洞察力,自我反射和自我确定性与妄想和积极症状之间的关系。参与者为92名诊断为精神分裂症或分裂情感障碍的成年人,他们接受了阳性和阴性综合征量表,Marlowe-Crowne社会期望量表和Beck认知洞察力量表的自我欺骗性量表。具有预测变量和调节变量相互作用项的逐步多元回归表明,社会天真通常会缓和自我反射性和自我确定性与积极症状之间的关系。此外,社会天真的自我评估也减轻了自我确定性和妄想之间的联系。在控制了故意的印象管理以及执行功能的度量之后,所有模型都很重要。结果表明,当一个人对自己的看法不受他人的看法影响时,较高的自我确定性水平是出现更大积极症状 (包括更严重的妄想) 的危险因素。关于较低的自我反射率,这可能与对自己的社会天真的看法相结合,使人们在试图接受不寻常的想法和看法准确时受到的抑制较小。讨论了对治疗的影响。
  • 【儿科住院医师心脏听诊技巧的评价。】 复制标题 收藏 收藏
    DOI:10.1177/0009922812466584 复制DOI
    作者列表:Kumar K,Thompson WR
    BACKGROUND & AIMS: UNLABELLED:Auscultation skills are in decline, but few studies have shown which specific aspects are most difficult for trainees. We evaluated individual aspects of cardiac auscultation among pediatric residents using recorded heart sounds to determine which elements pose the most difficulty. METHODS:Auscultation proficiency was assessed among 34 trainees following a pediatric cardiology rotation using an open-set format evaluation module, similar to the actual clinical auscultation description process. RESULTS:Diagnostic accuracy for distinguishing normal from abnormal cases was 73%. Findings most commonly correctly identified included pathological systolic and diastolic murmurs and widely split second heart sounds. Those least likely to be identified included continuous murmurs and clicks. Accuracy was low for identifying specific diagnoses. CONCLUSIONS:Given time constraints for clinical skills teaching, this suggests that focusing on distinguishing normal from abnormal heart sounds and murmurs instead of making specific diagnoses may be a more realistic goal for pediatric resident auscultation training.
    背景与目标:
  • 【焦虑症成人认知行为治疗结果的荟萃分析综述。】 复制标题 收藏 收藏
    DOI:10.1097/01.nmd.0000253843.70149.9a 复制DOI
    作者列表:Norton PJ,Price EC
    BACKGROUND & AIMS: :The efficacy of cognitive behavioral treatments (CBT) for anxiety in adults has been supported by multiple meta-analyses. However, most have focused on only 1 diagnosis, thereby disallowing diagnostic comparisons. This study examined the efficacy of CBT across the anxiety disorders. One hundred eight trials of CBT for an anxiety disorder met study criteria. Cognitive therapy and exposure therapy alone, in combination, or combined with relaxation training, were efficacious across the anxiety disorders, with no differential efficacy for any treatment components for any specific diagnoses. However, when comparing across diagnoses, outcomes for generalized anxiety disorder and posttraumatic stress disorder were superior to those for social anxiety disorder, but no other differences emerged. CBT effects were superior to those for no-treatment and expectancy control treatments, although tentative evidence suggested equal effects of CBT when compared with relaxation-only treatments.
    背景与目标: : 认知行为治疗 (CBT) 对成年人焦虑的功效已得到多项荟萃分析的支持。然而,大多数只关注1个诊断,因此不允许进行诊断比较。这项研究检查了CBT在焦虑症中的功效。针对焦虑症的CBT试验达到了研究标准。单独使用认知疗法和暴露疗法,或与放松训练相结合,在焦虑症中是有效的,对于任何特定诊断的任何治疗成分都没有不同的功效。然而,当比较各种诊断时,广泛焦虑症和创伤后应激障碍的结果优于社交焦虑症,但没有其他差异。CBT效果优于无治疗和预期对照治疗,尽管初步证据表明CBT与仅松弛治疗相比具有相同的效果。
  • 【重度抑郁症治疗后复发与认知反应性的关系。】 复制标题 收藏 收藏
    DOI:10.1037/0022-006X.75.3.447 复制DOI
    作者列表:Fresco DM,Segal ZV,Buis T,Kennedy S
    BACKGROUND & AIMS: :Z. V. Segal et al. (2006) demonstrated that depressed patients treated to remission through either antidepressant medication (ADM) or cognitive-behavioral therapy (CBT), but who evidenced mood-linked increases in dysfunctional thinking, showed elevated rates of relapse over 18 months. The current study sought to evaluate whether treatment response was associated with gains in decentering-the ability to observe one's thoughts and feelings as temporary, objective events in the mind-and whether these gains moderated the relationship between mood-linked cognitive reactivity and relapse of major depression. Findings revealed that CBT responders exhibited significantly greater gains in decentering compared with ADM responders. In addition, high post acute treatment levels of decentering and low cognitive reactivity were associated with the lowest rates of relapse in the 18-month follow-up period.
    背景与目标: : Z。五.Segal等人 (2006) 证明,抑郁症患者通过抗抑郁药物 (ADM) 或认知行为疗法 (CBT) 治疗缓解,但证明了功能障碍思维的情绪相关增加,显示出超过18个月的复发率升高。当前的研究试图评估治疗反应是否与偏心的增加有关-观察一个人的思想和感觉作为暂时的,客观的心理事件的能力-以及这些增加是否缓解了与情绪相关的认知反应与重抑郁症复发之间的关系。调查结果显示,与ADM响应者相比,CBT响应者在偏心方面表现出更大的收益。此外,在18个月的随访期内,急性治疗后高水平的偏心和低认知反应性与最低的复发率相关。
  • 【评估多奈哌齐改善精神分裂症患者认知障碍的前景。】 复制标题 收藏 收藏
    DOI:10.1517/13543784.2013.750650 复制DOI
    作者列表:Thakurathi N,Vincenzi B,Henderson DC
    BACKGROUND & AIMS: INTRODUCTION:Even though cognitive impairment is manifested in almost all patients with schizophrenia, the Clinical Antipsychotic Trials for Intervention Effectiveness (CATIE) study showed no significant difference between first- and second-generation psychotropic drugs in improving cognitive abilities. Discovering new drugs that can improve impaired cognition, thus, is an attractive treatment target for patients with schizophrenia. AREAS COVERED:This article briefly reviews about donepezil, a highly selective (IC(50) = 6.7 nM) centrally acting reversible acetylcholinesterase inhibitor that has been approved by FDA for treating cognitive deficit states such as in Alzheimer's disease and its uses in clinical trials for the treatment of schizophrenia. The literature search included PubMed and Cochrane library with the following words: donepezil, schizophrenia and cognitive impairments. EXPERT OPINION:The results of several clinical trials utilizing donepezil as an adjunct to second-generation antipsychotic drugs targeting cognitive deficits in schizophrenia subjects have been disappointing and would not lead clinicians to consider this as a potential treatment option. While longer randomized controlled trials, increase dosage and selected groups of patients at different stage of cognitive impairment may provide a better understanding of the potential for this drug in addressing cognitive deficits, results to date have not been encouraging.
    背景与目标:
  • 【社交焦虑症的认知疗法: “自我关注的注意和安全行为实验” 对治疗过程的影响。】 复制标题 收藏 收藏
    DOI:10.1017/S1352465813000672 复制DOI
    作者列表:Schreiber F,Heimlich C,Schweitzer C,Stangier U
    BACKGROUND & AIMS: BACKGROUND AND AIMS:Several studies have shown that cognitive therapy is an effective treatment for social anxiety disorder (SAD). However, it remains unclear which of the complex interventions are associated with an anxiety reduction during the course of treatment. The aim of this study was to examine the impact of the intervention referred to as the "self-focused attention and safety behaviours experiment" on treatment outcome. METHOD:This study was part of a randomized controlled trial including 16 sessions of either individual cognitive therapy (CT) or interpersonal therapy (IPT) for SAD. Of particular importance, a concomitant time-series analysis was used to investigate the impact of the self-focused attention and safety behaviours experiment on subsequent social anxiety (1, 2, 3, and 4 weeks after the intervention) in 32 patients with SAD, who are receiving cognitive treatment. RESULTS:The results revealed a significant reduction of social anxiety after the self-focused attention and safety behaviours experiment during the subsequent month of treatment. CONCLUSION:The findings of the current study confirm current cognitive theories of SAD and demonstrate the importance of interventions that target self-focused attention and safety behaviour in cognitive therapy for SAD.
    背景与目标:
  • 【多发性精神分裂症患者功能能力的认知筛查和行为观察: 一项探索性研究。】 复制标题 收藏 收藏
    DOI:10.1136/bmjopen-2016-014783 复制DOI
    作者列表:Norlin Bagge E,Esbjörnsson E,Sunnerhagen KS
    BACKGROUND & AIMS: OBJECTIVES:To evaluate the usability of a neuropsychological screening instrument and two observation scales of everyday behaviour to describe cognitive and functional capacity of patients with multiepisode schizophrenia and considerable care needs, who frequently refuse to participate in cognitive testing or performance-based functional measurement. SETTING:One psychiatric unit specialised in severe mental illness at the Sahlgrenska University Hospital, Gothenburg, Sweden. PARTICIPANTS:Patients were included consecutively from date of admission to the unit. INCLUSION CRITERIA:age 18-65 years, International Classification of Diseases 10 diagnoses F20.0-F20.9 (schizophrenia) or F25.0-F25.9 (schizoaffective disorder) since at least 5 years. EXCLUSION CRITERIA:acute serious psychotic episodes or physical illness, alcohol or drug abuse during the year before the study, diagnosed cerebral disorder at admission to the unit, and insufficient ability to speak Swedish. 64 patients filled the criteria and 19 accepted participation: 14 males, 5 females, median age 56 years. OUTCOME MEASURES:Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) scores, measured by a psychologist; Frontal Systems Behaviour Scale (FrSBe) Family Version and Functional Independence Measure (FIM) V.4.0 scores, measured by nursing staff. Non-parametric statistics were consistently applied to process the data. RESULTS:Failure analysis showed differences regarding gender and subdiagnoses between participants and non-participants. All participants had BNIS scores indicating cognitive dysfunction. FrSBe group medians showed apathy and executive problems, indicating possible frontal lobe disturbance. FIM showed dependency on others for linguistic and social communication, everyday problem solving, and remembering persons and daily routines. Correlations between FrSBe and FIM (p≤0.01) suggested executive dysfunction being crucial to explain difficulties in performing activities of daily functioning. CONCLUSIONS:Indications of considerable cognitive and functional difficulties found among the participants suggestedthat the instruments are clinically applicable for tentative assessment of cognitive and functional ability among patients with multiepisode schizophrenia and considerable care needs.
    背景与目标:
  • 【社区老年人的脑白质道完整性和认知能力: 洛锡安出生队列,1936。】 复制标题 收藏 收藏
    DOI:10.1037/a0033354 复制DOI
    作者列表:Booth T,Bastin ME,Penke L,Maniega SM,Murray C,Royle NA,Gow AJ,Corley J,Henderson RD,Hernández Mdel C,Starr JM,Wardlaw JM,Deary IJ
    BACKGROUND & AIMS: OBJECTIVE:The present study investigates associations between brain white matter tract integrity and cognitive abilities in community-dwelling older people (N = 655). We explored two potential confounds of white matter tract-cognition associations in later life: (a) whether the associations between tracts and specific cognitive abilities are accounted for by general cognitive ability (g); and (b) how the presence of atrophy and white matter lesions affect these associations. METHOD:Tract integrity was determined using quantitative diffusion magnetic resonance imaging tractography (tract-averaged fractional anisotropy [FA]). Using confirmatory factor analysis, we compared first-order and bifactor models to investigate whether specific tract-ability associations were accounted for by g. RESULTS:Significant associations were found between g and FA in bilateral anterior thalamic radiations (r range: .16-.18, p < .01), uncinate (r range: .19-.26, p < .001), arcuate fasciculi (r range: .11-.12, p < .05), and the splenium of corpus callosum (r = .14, p < .01). After controlling for g within the bifactor model, some significant specific cognitive domain associations remained. Results also suggest that the primary effects of controlling for whole brain integrity were on g associations, not specific abilities. CONCLUSION:Results suggest that g accounts for most of, but not all, the tract-cognition associations in the current data. When controlling for age-related overall brain structural changes, only minor attenuations of the tract-cognition associations were found, and these were primarily with g. In totality, the results highlight the importance of controlling for g when investigating associations between specific cognitive abilities and neuropsychology variables.
    背景与目标:
  • 【认知能力与非痴呆的帕金森氏症患者纹状体相关部分的多巴胺能变性程度相关。】 复制标题 收藏 收藏
    DOI:10.1007/s00702-017-1747-2 复制DOI
    作者列表:Kübler D,Schroll H,Buchert R,Kühn AA
    BACKGROUND & AIMS: :Parkinson's disease (PD) patients show cognitive deficits that are relevant in terms of prognosis and quality of life. Degeneration of striatal dopaminergic afferents proceeds from dorsal/caudal to anterior/ventral and is discussed to account for some of these symptoms. Treatment with dopamine (DA) has differential effects on cognitive dysfunctions, improving some and worsening others. We hypothesized that cognitive performance during the dopaminergic OFF state correlates with DAT availability in the associative striatum. 16 PD patients underwent motor and cognitive examination ON and OFF DA. Global cognition was measured using the Montréal Cognitive Assessment (MoCA) test and executive functioning using a Stroop test. Nigrostriatal dopaminergic innervation was characterized with [123I]FP-CIT SPECT. A connectivity atlas of the striatum was used to assess DAT availability in functionally defined striatal subregions. Correlations between imaging data and behavioral data OFF medication were calculated. Correlations between DAT availability and MoCA performance in the dopaminergic OFF state was strongest in the associative part of the striatum (r = 0.674, p = 0.004). MoCA test performance did not differ between the ON and the OFF state. There was no correlation of DAT availability with Stroop performance in the OFF state but performance was significantly better during the ON state. Not only motor but also cognitive dysfunctions in PD are associated with striatal dopaminergic depletion. Cognitive decline in non-demented PD patients goes along with nigrostriatal degeneration, most pronounced in the associative subdivision of the striatum. In addition, the present findings suggest that executive dysfunctions are ameliorated by DA whereas global cognition is not improved by dopaminergic medication.
    背景与目标: : 帕金森氏病 (PD) 患者表现出与预后和生活质量相关的认知缺陷。纹状体多巴胺能传入的变性从背侧/尾部到前/腹侧进行,并讨论了其中一些症状。多巴胺 (DA) 治疗对认知功能障碍有不同的影响,改善了一些,恶化了另一些。我们假设多巴胺能关闭状态下的认知表现与联想纹状体中的DAT可用性相关。16例PD患者在DA和DA上进行了运动和认知检查。使用蒙特利尔认知评估 (MoCA) 测试测量全球认知,并使用Stroop测试测量执行功能。黑质纹状体多巴胺能神经支配的特征是用 [123I]FP-CIT SPECT。纹状体的连通性图谱用于评估功能定义的纹状体子区域中的DAT可用性。计算药物外的成像数据和行为数据之间的相关性。多巴胺能关闭状态下DAT可用性和MoCA性能之间的相关性最强纹状体的关联部分 (r = 0.674,p = 0.004)。MoCA测试性能在开启和关闭状态之间没有差异。在关闭状态下,DAT可用性与Stroop性能没有相关性,但在开启状态下,性能明显更好。PD不仅运动功能障碍,而且认知功能障碍与纹状体多巴胺能耗竭有关。非痴呆性PD患者的下降伴随着黑质纹状体变性,在纹状体的关联细分中最明显。此外,目前的发现表明,DA可以改善执行功能障碍,而多巴胺能药物不能改善整体认知。
  • 【脑血管病和淀粉样 β 负荷对皮质下血管性认知障碍受试者认知的影响。】 复制标题 收藏 收藏
    DOI:10.1016/j.neurobiolaging.2013.06.026 复制DOI
    作者列表:Park JH,Seo SW,Kim C,Kim SH,Kim GH,Kim ST,Jeon S,Lee JM,Oh SJ,Kim JS,Choe YS,Lee KH,Shin JS,Kim CH,Noh Y,Cho H,Yoon CW,Kim HJ,Ye BS,Ewers M,Weiner MW,Lee JH,Werring DJ,Na DL
    BACKGROUND & AIMS: :Cerebrovascular disease (CVD) and amyloid burden are the most frequent pathologies in subjects with cognitive impairment. However, the relationship between CVD, amyloid burden, and cognition are largely unknown. We aimed to evaluate whether CVD (lacunes, white matter hyperintensities, and microbleeds) and amyloid burden (Pittsburgh compound B [PiB] retention ratio) contribute to cognitive impairment independently or interactively. We recruited 136 patients with subcortical vascular cognitive impairment who underwent magnetic resonance imaging, PiB-positron emission tomography, and neuropsychological testing. The number of lacunes was associated with memory, frontal dysfunctions, and disease severity. The volume of white matter hyperintensities and the PiB retention ratio were associated only with memory dysfunction. There was no direct correlation between CVD markers and PiB retention ratio except that the number of lacunes was negatively correlated with the PiB retention ratio. In addition, there were no interactive effects of CVD and PiB retention ratio on cognition. Our findings suggest that CVD and amyloid burden contribute independently and not interactively to specific patterns of cognitive dysfunction in patients with subcortical vascular cognitive impairment.
    背景与目标: : 脑血管疾病 (CVD) 和淀粉样蛋白负担是认知障碍患者最常见的病理。然而,CVD,淀粉样蛋白负担和认知之间的关系在很大程度上尚不清楚。我们旨在评估CVD (腔隙,白质高信号和微出血) 和淀粉样蛋白负荷 (匹兹堡化合物B [PiB] 保留比) 是否独立或交互地导致认知障碍。我们招募了136名皮质下血管性认知障碍患者,他们接受了磁共振成像,PiB-正电子发射断层扫描和神经心理学测试。腔隙的数量与记忆,额叶功能障碍和疾病严重程度有关。白质高信号的体积和PiB保留率仅与记忆功能障碍有关。CVD标记与PiB保留率之间没有直接相关性,只是腔隙数与PiB保留率呈负相关。此外,CVD和PiB保留率对认知没有交互作用。我们的发现表明,在皮质下血管性认知障碍患者中,CVD和淀粉样蛋白负担独立且非交互作用地促进了认知功能障碍的特定模式。
  • 【认知功能的快照: 在现实世界的住院环境中,为精神分裂症和其他慢性精神疾病提供有效评估认知的工具。】 复制标题 收藏 收藏
    DOI:10.1016/j.psychres.2013.07.006 复制DOI
    作者列表:Wong QJ,Miller M,Fiorito A,Ireland J
    BACKGROUND & AIMS: :Previous research has led to the development of short batteries of tests that efficiently measure the cognitive functioning of individuals with schizophrenia. To attempt to replicate previous findings, we applied an empirical test selection strategy to archival cognitive test data of two non-overlapping inpatient samples of individuals with schizophrenia or schizoaffective disorder (total N=110). We then extended previous findings by applying the empirical test selection strategy to the archival data of two non-overlapping inpatient samples of individuals with various psychiatric disorders (total N=149). For each sample, tests were selected by examining the relationships between individual test scores and averaged test scores representing global cognitive functioning while taking into account test administration times. Across patient samples, digit symbol coding tasks, verbal fluency tasks, and tests with a processing speed component (Trail Making Test Part A and Stroop) emerged as efficient and effective indicators of overall cognitive functioning. A brief cognitive assessment tool incorporating coding, fluency, and processing speed tasks would provide a valid and clinically useful snapshot of a patient's level of cognitive functioning if more comprehensive testing cannot be completed.
    背景与目标: : 先前的研究导致了短电池测试的发展,可以有效地测量精神分裂症患者的认知功能。为了尝试复制先前的发现,我们将经验测试选择策略应用于精神分裂症或分裂情感障碍患者的两个非重叠住院患者样本的存档认知测试数据 (总计N = 110)。然后,我们通过将经验测试选择策略应用于两个非重叠的住院患者样本的档案数据来扩展先前的发现。患有各种精神疾病的个体 (总计N = 149)。对于每个样本,通过检查单个测试分数与代表整体认知功能的平均测试分数之间的关系来选择测试,同时考虑测试给药时间。在患者样本中,数字符号编码任务,言语流利度任务以及具有处理速度分量的测试 (跟踪测试a部分和Stroop) 成为整体认知功能的有效指标。如果无法完成更全面的测试,则包含编码,流利度和处理速度任务的简短认知评估工具将为患者的认知功能水平提供有效且临床有用的快照。
  • 【认知储备和脑脊液生物标志物与临床前阿尔茨海默病临床症状出现的关系。】 复制标题 收藏 收藏
    DOI:10.1016/j.neurobiolaging.2013.06.017 复制DOI
    作者列表:Soldan A,Pettigrew C,Li S,Wang MC,Moghekar A,Selnes OA,Albert M,O'Brien R,BIOCARD Research Team.
    BACKGROUND & AIMS: :The levels of β-amyloid (Aβ) and phosphorylated tau (p-tau), as measured in cerebrospinal fluid, have been associated with the risk of progressing from normal cognition to onset of clinical symptoms during preclinical Alzheimer's disease. We examined whether cognitive reserve (CR) modifies this association. Cerebrospinal fluid was obtained at baseline from 239 participants (mean age, 57.2 years) who had been followed for up to 17 years with clinical and cognitive assessments (mean follow-up, 8 years). A composite score based on the National Adult Reading Test, vocabulary, and years of education at baseline was used as an index of CR. Cox regression models showed that the increased risk of progressing from normal cognition to symptom onset was associated with lower CR, lower baseline Aβ, and higher baseline p-tau. There was no interaction between CR and Aβ, suggesting that the protective effects of higher CR are equivalent across the observed range of amyloid levels. In contrast, both tau and p-tau interacted with CR, indicating that CR was more protective at lower levels of tau and p-tau.
    背景与目标: : 在脑脊液中测得的 β-淀粉样蛋白 (a β) 和磷酸化tau (p-tau) 的水平与临床前阿尔茨海默氏病从正常认知发展为临床症状发作的风险有关。我们检查了认知储备 (CR) 是否改变了这种关联。在基线时从239名参与者 (平均年龄,57.2岁) 获得脑脊液,这些参与者接受了长达17年的临床和认知评估 (平均随访,8年)。使用基于全国成人阅读测试,词汇和基线受教育年限的综合分数作为CR的指标。Cox回归模型显示,从正常认知到症状发作的风险增加与较低的CR,较低的基线a β 和较高的基线p-tau相关。CR和a β 之间没有相互作用,这表明在观察到的淀粉样蛋白水平范围内,较高的CR的保护作用是等效的。相反,tau和p-tau均与CR相互作用,表明CR在较低的tau和p-tau含量下具有更大的保护性。
  • 【D-环丝氨酸是一种公认的认知增强剂,可促进阿尔茨海默病脑中N-甲基-D-天冬氨酸受体-离子载体复合物的激活。】 复制标题 收藏 收藏
    DOI:10.1016/0006-8993(91)91668-q 复制DOI
    作者列表:Chessell IP,Procter AW,Francis PT,Bowen DM
    BACKGROUND & AIMS: :The action of D-Cycloserine (DCS) at the strychnine-insensitive glycine recognition site of the NMDA receptor-ionophore complex has been studied with membranes from inferior parietal cortex of patients with Alzheimer's disease. The maximal response of the site, measured using [3H]MK-801 binding, was 64% of that observed with glycine. Stimulation of binding induced by DCS in the presence of fixed concentrations of glycine resulted in a family of dose-response curves, consistent with the antibiotic having the property of a partial agonist at this glycine site. It is proposed that because of circumscribed glutamatergic pyramidal cell pathology DCS will have benefit for Alzheimer's patients over and above all other types of cognitive impairment.
    背景与目标: : D-环丝氨酸 (DCS) 在NMDA受体-离子载体复合物的士的宁不敏感甘氨酸识别位点的作用已通过阿尔茨海默氏病患者下顶叶皮层的膜进行了研究。用 [3H]MK-801结合测得的最大反应是用甘氨酸观察到的64%。在固定浓度的甘氨酸存在下,由dc诱导的结合刺激导致了一系列剂量反应曲线,与在该甘氨酸位点具有部分激动剂性质的抗生素一致。有人提出,由于谷氨酸能锥体细胞病理学的限制,DCS将比所有其他类型的认知障碍更有益于阿尔茨海默氏症患者。
  • 【精神分裂症患者创伤后应激障碍、认知功能和生活质量。】 复制标题 收藏 收藏
    DOI:10.1016/j.psychres.2007.10.012 复制DOI
    作者列表:Fan X,Henderson DC,Nguyen DD,Cather C,Freudenreich O,Evins AE,Borba CP,Goff DC
    BACKGROUND & AIMS: :The purpose of the present study was to assess posttraumatic stress disorder (PTSD), cognitive function, and quality of life in patients with schizophrenia who had a self-reported history of trauma exposure. Outpatients diagnosed with schizophrenia or schizoaffective disorder were referred to the study. Each patient was assessed with the Positive and Negative Syndrome Scale (PANSS), the Harvard Trauma Questionnaire (HTQ), a cognitive assessment battery, Heinrich's Quality of Life Scale (QLS), and the Behavior and Symptom Identification Scale (BASIS). Eighty-seven subjects who reported experiencing at least one traumatic event were included in the study. Fifteen of 87 (17%) met the DSM-IV criteria for PTSD. The PTSD group had significantly worse overall cognitive performance than the non-PTSD group, especially in the domains of attention, working memory and executive function. In addition, the PTSD group showed significantly worse self-rated quality of life as measured by the BASIS total score. The development of PTSD is associated with poor cognitive function and subjectively, but not objectively, rated low quality of life in patients with schizophrenia. Evaluating PTSD in patients with schizophrenia could have important implications from both clinical and research perspectives.
    背景与目标: : 本研究的目的是评估有自我报告的创伤暴露史的精神分裂症患者的创伤后应激障碍 (PTSD),认知功能和生活质量。诊断为精神分裂症或分裂情感障碍的门诊患者被转介到该研究。用阳性和阴性综合征量表 (PANSS),哈佛创伤问卷 (HTQ),认知评估电池,海因里希生活质量量表 (QLS) 以及行为和症状识别量表 (BASIS) 对每位患者进行评估。该研究包括了87名报告经历至少一次创伤事件的受试者。87个 (17%) 中有15个符合PTSD的dsm-iv标准。PTSD组的整体认知能力明显低于非PTSD组,尤其是在注意力,工作记忆和执行功能方面。此外,根据基础总分,PTSD组的自我评估生活质量明显较差。创伤后应激障碍的发展与认知功能差有关,主观上但不是客观上认为精神分裂症患者的生活质量低。从临床和研究角度评估精神分裂症患者的PTSD可能具有重要意义。

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