Contexte : Les répercussions de l’alcool au niveau des fonctions cognitives sont bien documentées. Certaines hypothèses suggèrent que l’alcool affecte des fonctions cognitives spécifiques alors que d’autres avancent l’hypothèse de déficits diffus. Cependant, une ambigüité persiste concernant quelles fonctions cognitives sont le plus touchées par l’alcool, et à quel point la durée d’abstinence affecte la récupération cognitive. Nous avons procédé à une des premières méta-analyses qui s’intéresse aux différentes fonctions cognitives touchées par la consommation problématique d’alcool et à la durée d’abstinence requise pour une récupération au niveau des cognitions. Méthodes : Une recherche de la littérature a permis d’identifier 62 études évaluant les cognitions chez les personnes présentant des troubles liés à l’utilisation d’alcool. Les estimations de la taille d’effet ont été calculées avec la Comprehensive Meta Analysis –V2 pour les 12 domaines cognitifs suivants : quotient intellectuel, fluidité verbale/langage, vitesse de traitement de l’information, mémoire de travail, attention, résolution de problème/fonctions exécutives, inhibition/impulsivité, apprentissage verbal, mémoire verbale, apprentissage visuel, mémoire visuelle, habiletés visuo-spatiales. Parmi ces 12 domaines cognitifs, 3 estimations de la taille d’effet ont été calculées selon les durées d’abstinences suivantes : court- (<1 mois), moyen- (2 à 12 mois) et long- (>1 an) termes. Résultats : Les résultats ont révélé la présence de dysfonctions modérées dans 11 domaines cognitifs durant l’abstinence à court terme, et dans 10 domaines cognitifs pour le moyen-terme. Des dysfonctions cognitives minimales furent notées durant l’abstinence à long-terme. Conclusions : Ces résultats révèlent des déficits cognitifs significatifs et diffus durant la première année d’abstinence. Déficits qui se normalisent après un an. Ces résultats soutiennent l’hypothèse de déficits cognitifs diffus reliés à l’alcoolisme et suggèrent que la cognition devrait faire partie intégrante du traitement d’alcoolisme. / Background: The cognitive repercussions of alcoholism are well documented. However, the literature remains somewhat ambiguous with which distinct cognitive functions are more susceptible to impairment in alcoholism and to how duration of abstinence affects cognitive recovery. Some theories claim alcohol negatively affects specific cognitive functions while others assert that deficits are more diffuse in nature. We performed the first meta-analysis to examine cognition in alcoholism and how duration of abstinence affects cognitive recovery. Methods: A literature search yielded 62 studies assessing cognitive dysfunction among alcoholics. Effect size estimates were calculated using the Comprehensive Meta-Analysis V2, for the following 12 cognitive domains: intelligence quotient, verbal fluency/language, speed of processing, working memory, attention, problem solving/executive functions, inhibition/impulsivity, verbal learning, verbal memory, visual learning, visual memory, and visuo-spatial abilities. Within these 12 domains, 3 effect size estimates were calculated based on abstinence duration and partitioned into short- (<1 month), intermediate- (2 to 12 months) and long- (>1 year) term abstinence. Results: Findings revealed moderate impairment across 11 cognitive domains during short term abstinence with moderate impairment across 10 domains during intermediate term abstinence, and overall small effect size estimates during long term abstinence. Conclusions: Results suggest significant cognitive dysfunction during the first year following abstinence from alcohol and that long term abstinence yields near normalisation of cognitive function. These findings support the diffuse brain deficits hypothesis. Clinical implications suggest that cognition may need to be considered an integral part of the treatment of alcoholism.

Para descrever os achados da espectroscopia de prótons (1H-ERM) na doença de Alzheimer (DA) e no comprometimento cognitivo sem demência (CIND) em uma amostra da comunidade foram avaliados 13 pacientes com DA, 12 com CIND e 15 controles normais. A 1H-ERM foi realizada com voxel de 8 cm3 nas regiões temporal direita, parietal esquerda e occipital medial estudando os metabólitos: N-acetilaspartato (NAA), creatina (Cr), colina (Cho) e mio-inositol (mI). O NAA foi maior nos indivíduos controles do que nos DA e intermediário no CIND; o mI foi maior no grupo DA do que nos controles; a Cho mostrou tendência a estar aumentada na DA e CIND. Correlação entre os testes cognitivos e a 1H-ERM confirmou a hipótese de que alterações metabólicas estão presentes quando do aparecimento das primeiras alterações cognitivas. A espectroscopia pode, em função disso, contribuir para o diagnóstico e seguimento de indivíduos com queixa de memória em indivíduos da comunidade com a possibilidade de diagnósticos mais precoces. / For the description of the proton magnetic resonance spectroscopy (1H-ERM) data in Alzheimer´s disease (AD) and Cognitive Impairment Not Dementia (CIND) in a community set, subjects with AD (n=13), CIND (n=12) and normal control (n=15) were investigated. 1H-ERM was performance with single voxel (8 cm3) placed in temporal, parietal e occipital region and studied metabolites: N-acetylaspartate (NAA), creatine (Cr), choline (Cho) and myo-inositol (mI). NAA concentration was higher in control subjects than AD and intermediated level in CIND patients; mI was higher in patients with AD and CIND; Cho tended to be higher in AD and CIND. Metabolisms changes are present together the first cognitive deficits as showed by correlation between cognitive tests and 1H-ERM. Spectroscopy can be used in the diagnosis and follow-up of individuals with memory complain in the community set with the possibility of early diagnosis

There is a paucity of data on neurochemical abnormalities and associated effects on cognition and motor performance in rats ontogenetically treated with quinpirole, a rodent model of dopaminergic hyperfunction. The objective of the current study was to analyze the cognitive and motor effects produced by ontogenetic administration of quinpirole, a dopamine D2/D3 receptor agonist. Past research from this laboratory has shown that ontogenetic quinpirole treatment sensitizes D2 receptors and produces a variety of characteristic stereotypic behaviors in adult rats. In the current study, rats received quinpirole HCl (1 mg/kg/day) or saline from postnatal day (PD) 1 to PD 11 and went otherwise untreated until adulthood (PD 60). In Experiment 1, cognitive performance was assessed on the standard and matching-to-place versions of the Morris water task (MWT). In Experiment 2, skilled motor performance was assessed on the Whishaw reaching task and locomotor activity was also analyzed. We found that ontogenetically quinpirole-treated rats displayed a deficit on the probe trial given at the end of training of the standard version of the MWT but that there were no significant differences from control on the matching-to-place task. Additionally, rats treated in ontogeny with quinpirole showed significant enhancement in reaching accuracy on the Whishaw reaching task as well as increased locomotor activity relative to saline controls. These findings demonstrate that ontogenetic quinpirole treatments produce cognitive deficits, enhanced skilled reaching and hyperlocomotion. The behavioral changes produced by ontogenetic quinpirole treatment are consistent with dopaminergic hyperfunction, and possible mechanisms are discussed.

Neonatal quinpirole (dopamine D(2)/D(3) agonist) treatment to rats has been shown to increase dopamine D(2) receptor sensitivity throughout the animal's lifetime. Male and female Sprague-Dawley rats were neonatalally treated with quinpirole (1 mg/kg) from postnatal days (P) 1-21 and raised to adulthood. Beginning on P62, rats were administered the atypical antipsychotic olanzapine (2.5 mg/kg) twice daily for 28 days. Starting 1 day after the end of olanzapine treatment, animals were behaviorally tested on the place and match-to-place version of the Morris water maze (MWM) over seven consecutive days, and a yawning behavioral test was also performed to test for sensitivity of the D(2) receptor 1 day following MWM testing. Similar to results from a past study, olanzapine alleviated cognitive impairment on the MWM place version and increases in yawning produced by neonatal quinpirole treatment. Brain tissue analyses showed that neonatal quinpirole treatment resulted in a significant decrease of hipppocampal ChAT and BDNF RNA expression that were unaffected by adulthood olanzapine treatment, although adulthood olanzapine treatment produced a significant increase in cerebellar ChAT RNA expression. There were no significant effects of drug treatment on NGF RNA expression in any brain area. These results show that neonatal quinpirole treatment produced significant decreases of protein RNA expression that is specific to the hippocampus. Although olanzapine alleviated cognitive deficits produced by neonatal quinpirole treatment, it did not affect expression of proteins known to be important in cognitive performance.

Introduction: Cognitive complaints are often reported by patients who also describe chronic pain. Reviews suggest chronic pain is likely to be associated with weaknesses, relative to control groups, in at least some cognitive functions including processing speed, attention, and possibly working memory, but differences between studies obscure the size of effects. Objective: This study provided a quantitative analysis of the magnitude of the association between chronic pain and neurocognitive test performances. Brief literature review is also done to focus on the functional brain changes associated with the chronic pain. Methods: Meta-analysis was performed using the Cochrane, PRISMA guidelines. The analysis included published experimental design and the tests were studied at least 3 times, by different researchers, and the outcomes were combined within the same cognitive test. Tests were excluded when heterogeneity of variance exceeded I2 = 0.60. Pain subgroups were combined. Results: 23 studies met criteria and involved heterogeneous pain populations, or subgroups including back pain, whiplash, and fibromyalgia. Seven tests had sufficient variance homogeneity. Effects sizes (- ve = chronic pain relative weakness) were: Tests measuring the attention such as PASAT and TEA, working memory (WAIS- digit span), executive functions such as Stroop test, TMT showed significant weaker performance on the tests performance, whereas performance on the test of visuospatial abilities such as ROCF and Corsi block test and WCST test, did not showed significant association. Conclusions: Chronic pain was associated with statistically significant performance reductions. The pattern suggests that chronic pain is associated with poorer performance in at least some tasks requiring processing speed, attention, working memory and learning. Differences between pain and control groups ranged from about 1/3 standard deviation to just under a full standard deviation. Too little research is available on non-verbal memory and executive functions in chronic pain. / Thesis / Master of Science (MSc)

Rationale Cognitive deficits are now recognised as a major symptom of schizophrenia with a number of studies reporting profound deficits in cognitive function in both chronic and first episode patients. Recent advances in cognitive remediation therapy have provided the opportunity for patients to improve their cognitive function and therefore improve their functional outcome. Aim The aim of the present study was to investigate cognitive deficits using the Cambridge Neuropsychological Test Automated Battery (CANTAB®) in first episode psychosis and chronic schizophrenia patients. In the first episode population the effect of ethnicity on cognition was also examined. In the chronic schizophrenia study comparisons between severity of deficits with first episode psychosis patients were also made. The effects of cognitive remediation therapy were also examined in a sample of first episode patients. Methods A total of 35 patients and 30 healthy controls were recruited into the first episode study, 17 patients and 17 controls into the chronic schizophrenia study and 11 patients into the cognitive remediation study. The first episode psychosis patients were recruited from the Bradford and Airedale Early Intervention Service and the chronic patients from the Leeds Partnership NHS Foundation Trust. The control subjects were matched as closely as possible in terms of intelligence and demographics to the patient groups. The Wechsler Test of Adult Reading (WTAR) was used to estimate subjects pre-morbid IQ. The severity of symptoms was assessed using the Positive and Negative Syndrome Scale (PANSS). All subjects who took part in the study completed a comprehensive battery of neuropsychological tests from the CANTAB®. Patients in the cognitive remediation study participated in group therapy sessions using X-cog®. Results There were no significant differences found between There were no significant differences found between patients and controls in relation to intelligence or demographics in all studies. The effect of ethnicity was shown to be not significant in the first episode study. Results show that patients performed significantly worse than controls across all iv cognitive domains tested in all studies. A correlation between negative symptoms and executive function was found in both first episode and chronic schizophrenia patients. Comparisons between first episode psychosis and chronic schizophrenia patients in cognition showed no significant differences, however significant differences were found in levels of negative symptoms and age between the two groups with chronic patients scoring higher on negative symptoms and being older. In the cognitive remediation study a significant improvement was observed in patients in the domain of executive function and a reduction in negative symptoms following completion of the intervention. Conclusion First episode and chronic schizophrenia patients display significant cognitive deficits across all domains when tested using the CANTAB®. Some of these deficits appear to be independent of the length of the illness but dependent on negative symptoms. This study demonstrates that cognitive deficits exist across all patient groups regardless of age, gender, pre-morbid IQ, years in education and ethnicity. Cognitive remediation therapy has also been shown to be effective in improving cognitive functioning in patients.

Memory deficits in Alzheimer’s disease (AD) and mild cognitive impairment (MCI) can be reflected in language-based tests, especially spontaneous speech tasks. Three spontaneous speech tests were developed in this study, including Thai Picture description (TPD), Thai Story Recall (TSR), and Semi-structured Interview for Thai (SIT) Ninety-eight Thai older adults underwent screening tests and three spontaneous speech tests. Then they were classified into three groups, including healthy control (HC), MCI, and AD. Their verbal responses were extracted into the content variables and acoustic features. Then the discriminant ability and accuracy in differentiating HC, MCI, and AD were examined with by Multivariate Discriminant Analysis (MDA) and analysis of the ROC curve and AUC. Two content variables showed significant differences among three groups of participants, i.e., correct information unit (CIU) of the TPD and delayed recall scores of the TSR. For acoustic features, ANOVAs revealed that three variables were significantly different among the three experimental groups, i.e., total utterance time in delayed recall, number of voice breaks in the TPD, and the SIT. The result of a stepwise estimation in MDA presented that the best combination of predictive model was CIU and backward digit span (BDS), in which provides 61.1% of correct classification. This discriminant function showed AUC of .81 in differentiating HC and MCI, AUC of .91 in distinguishing HC and AD, and AUC of .86 in detecting persons with cognitive impairments (MCI and AD) from HC. In conclusion, the combination of CIU of TPD and BDS is suitable for differentiating AD and persons with cognitive impairments from HC. However, there is no appropriate predictor in distinguishing MCI and AD.

The present study was designed to examine the etiology of suicidal behavior from cognitive and developmental perspectives. Given empirical evidence suggesting links between early negative life events and suicidal behavior, between early negative life events and cognitive factors, and between cognitive factors and suicidal behavior, it was hypothesized that early negative life events may impact individuals' suicidal behavior by affecting these individuals' cognitive functioning. That is, cognitive functioning may serve as a mediator in the relationship between early life events and suicidal behavior. The present study examined child maltreatment, family instability, and poor general family environment as early negative life events, and examined self-esteem, locus of control, hopelessness, and problem-solving deficits as cognitive factors. In addition, individuals' perceived social support before age 18 and current social support and life stress were also examined in relation to the above variables. The subject sample was comprised of 181 college students, including 51 suicidal, 60 depressed, and 70 normal-control individuals. Results from the study indicated that these three groups could be discriminated at highly satisfactory levels by using the above variables. A series of structural equation analyses also indicated that, even though early negative life events have mild direct impact on suicidal behavior, these events seem to have stronger direct impact on cognitive deficits which in turn seem to have stronger direct impact on suicidal behavior. / Ph. D.

La Réalité Virtuelle (RV) semble ouvrir des voies de recherche prometteuses, pour évaluer l’impact des troubles cognitifs chez des personnes cérébrolésées dans des situations de vie quotidienne simulées. Cette application réactualise des questions relatives à la validité écologique des évaluations neuropsychologiques et aux liens entre performance fonctionnelle et processus cognitifs. Objectif : La présente thèse se propose d’étudier la validité écologique d’environnements virtuels et les relations entre performance fonctionnelle et processus cognitifs à l’aide de deux tâches de vie quotidienne simulées sous RV, chez des patients cérébrolésés. Matériels et Méthodes Expérimentation 1 : 27 patients traumatisés crâniens ont été consécutivement inclus et répartis en 2 groupes. Le premier groupe de 13 sujets a appris un trajet dans un quartier proche de l’hôpital de Bordeaux. 14 sujets ont suivi la même procédure dans un quartier virtuel recréant le même environnement réel. Différents tests sur les représentations spatiales ont été ensuite effectués. Expérimentation 2 : 95 patients cérébrolésés après traumatisme crânien ou AVC ont réalisé une tâche de courses dans le supermarché virtuel VAP-S (Marié et al 2003, Klinger et al 2004). En outre, 50 de ces sujets ont passé une batterie neuropsychologique testant les grands processus cognitifs. Résultats Expérimentation 1 : Il n’y a pas de différence significative des caractéristiques générales ou pathologiques entre les deux groupes. Parmi les tests de représentation spatiale, seule une épreuve d’arrangement d’images montre des résultats supérieurs en environnement réel [U = 32.5; p = 0.01]. Expérimentation 2 : Il n’y a pas de différence significative entre les 50 sujets qui ont passé la batterie complète et les 45 autres sujets pour ce qui concerne les données démographiques, les scores neuropsychologiques, la thymie et l’insertion sociale. Une analyse en composantes principales (ACP) portant sur les résultats des 50 sujets testés avec la batterie neuropsychologique complète propose un modèle à 4 facteurs qui explique 69.4% de la variance. Dans ces facteurs, les capacités en mémoire épisodique, en mémoire prospective et en organisation perceptive montrent autant de liaisons avec les indicateurs VAPS que l’attention et les composantes exécutives (inhibition et mise à jour). L’un de ces facteurs (F3) est en outre relié à l’insertion sociale, ce qui est un argument en faveur de la validité écologique du VAP-S. Discussion. Dans la première expérimentation, bien que les représentations spatiales générées par un environnement réel et un environnement virtuel paraissent différentes, la RV donne des résultats comparables à l’environnement réel, et se montre ainsi une technique fiable et sans danger pour l’évaluation fonctionnelle de la performance topographique. La deuxième expérimentation suggère qu’une tâche de vie quotidienne simulée sous RV telle que faire des courses dans un supermarché virtuel mobilise l’ensemble des ressources cognitives dans des interactions probablement proches de la vie quotidienne réelle. Elle permet de dépasser les limites d’une neuropsychologie fractionnée du fonctionnement cognitif, dans de bonnes conditions de mesure écologique. Beaucoup de prudence s’impose néanmoins dans l’interprétation et la généralisation des résultats du fait d’importantes variations individuelles. Conclusion La présente thèse confirme la validité écologique d’évaluations d’activités de la vie quotidienne en environnement virtuel (validité écologique) et approche la complexité des relations entre la performance observée en vie quotidienne et les processus cognitifs qui les sous-tendent. / Virtual Reality (VR) seems to open promising ways to research, particularly regarding the impact of cognitive deseases among people with acquired brain injury (ABI) immersed in simulated daily life situations. The use of VR raises or brings up to date concerns about the ecological validity of neuropsychological tests and the links between functional performance and cognitive processes. Aim: This thesis aims to study the ecological validity of virtual environments and relationships between functional performance and cognitive processes using two simulated tasks of daily life among people with ABI. Apparatus and method: Experimentation 1 Study population: 27 patients with Traumatic Brain Injury had been consecutively included and divided into two groups.Method: the first group including 13 subjects learned a route in an urban district near from the hospital of Bordeaux. In the second group 14 subjects had to do the same procedure in a virtual district that replicated the real environment. All subjects had to complete spatial representation tests at the end of the delayed recall route. Experiment 2 Study population: 95 patients with ABI (essentially including people with TBI or Cerebral Vascular Desease) were included. Method: Subjects had to do errands in the virtual supermarket VAP-S (Marié et al 2003, Klinger et al 2004). Among the initial group 50 subjects had a neuropsychological battery.Results Experiment 1 No significant difference has been found between the two groups according to demographic data and TBI severity. There was no effect of the real or virtual environement on the recall of route and the number of error was the same wathever was the environmental condition [(1, 25) = 0.679; p = 0.4176)]. Among the spatial representation tests, only the scene arrangement test were higher in the real environment [U = 32.5; p = 0.01]. Expériment 2 No significant difference between the two groups has been found according to demographic data, neuropsychological tests, mood, and social integration. A Principal Componant Analysis (PCA) on the results of the 50 subjects who had completed the whole neuropsychological battery raised a four factor solution that accounts for 69.4% of the variance. Among these factors, episodic memory, prospective memory and perceptual organization showed as many relationships with VAP-S indicators as attention and executive componants (inhibition and updating). The factor 3 is linked to social integration. It is an argument in favor of the ecological validity of the VAP-S Discussion In the first experiment, despite the fact that spatial representations seemed different between the real and virtual environments, learning results were the same. RV is a reliable and safe to assess the topographical performance which is important in the daily life and notably in social and vocational rehabilitation. The second experiment suggested that VR simulated activity of daily living as shopping in a virtual supermarket bring together cognitive resources within interactions probably close than daily life. This result overcomes the limits of the splitting cognitive functioning in neuropsychology with a good ecological validity. However these results must be examined with caution due to large individual variation. Conclusion This thesis confirms the ecological validity of RV simulated activities of daily living close to the complexity of the relationships between the performance observed in the daily life and cognitive processes that are underlying it. It opens interesting perspectives to assessment and cognitive rehabilitation using RV of people with ABI and cognitive deseases with the purpose to improve autonomy in daily life.

Thesis (M.A. (Clinical Psychology) --University of Limpopo, 2007 / Disruptive Behaviour Disorders are often associated with high rates of school drop outs, academic skills deficits and low achievement, drug abuse, low self esteem, depression, delinquency and incarceration. The main aim of the study was to establish whether children with DBDs are cognitively and/or neurologically impaired. The study investigated (1) whether children with DBDs show deficiencies in cognitive and motor functions and (2) whether gender and subtype influence cognitive and motor functions. Method: The sample of 137 children with DBDs (ADHD, ODD and CD) and those without a diagnosis of DBDs was drawn from children aged between 8 and 15 years. They were assessed using instruments that were selected to be measures of Executive Functions, cognitive functioning, and motor functions. The scores obtained from the administration of these measures were compared for significant differences between the DBD subtypes and a non-DBD control group as a possible function of gender. Results: The findings indicate that children with symptoms of DBDs performed poorer than the control group on all tests with the exception of the Digits backward. EF and motor impairments are associated with ADHD-C and ADHD-PI, and not with ADHD-HI, ODD and CD. Although among the DBDs, neuropsychological and cognitive impairments have been found to be severe in children with ADHD-PI and ADHD-C, the ADHD-C subtype showed qualitatively larger differences with the normal control group on most measures. There were no differences found between the genders in the performance on all tests that were administered. Conclusion Children of the ADHD-C and ADHD-PI subtypes are significantly more impaired on measures of Executive, cognitive and motor functions than those with ADHD-HI, ODD and CD and those without externalising disorders. However, the ADHD-C subtype found to be more severely impaired when compared with the ADHD-PI subtype.