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Progressive multifocal leukoencephalopathy
Published in Avindra Nath, Joseph R. Berger, Clinical Neurovirology, 2020
Eric M. L. Williamson, Joseph R. Berger
Though we have learned the most from HIV-associated PML, subtle differences in the clinical presentation may be noted in PML that has arises as a consequence of different underlying disorders. We highlighted that headache was more common in the aforementioned Brooks and Walker cohort [4], where lymphoproliferative disorders constituted more than 60% of the patient pool. Natalizumab-associated progressive multifocal leukoencephalopathy also appears to differ in some ways. Natalizumab associated PML most frequently presents with cognitive disturbance (48%), but motor abnormalities (37%), language disorders (31%), and visual disturbances (26%) are also common. Typical cognitive complaints include memory loss and behavioral disturbances, noting cognitive dysfunction may be the presenting symptom in a third of cases.
Assessment of Cognitive Impairment, Alzheimer’s Disease, and Other Forms of Dementia
Published in Gwen Yeo, Linda A. Gerdner, Dolores Gallagher-Thompson, Ethnicity and the Dementias, 2018
J. Wesson Ashford, Frederick A. Schmitt, Carr J. Smith, Vinod Kumar, Nusha Askari
A review of the patient’s medical history should focus on illnesses that could have caused or contributed to the cognitive impairment. Of particular concern is the use of centrally active medications or toxins. Any medication with anticholinergic side effect could contribute to cognitive dysfunction, including anti-Parkinsonian agents (benztropine, trihexyphenidyl), tricyclic antidepressants (amitriptyline), older antipsychotics (thioridazine), antispasmodics (atropine, scopolamine, l-hyoscyamine, oxybutynin), or antihistamines (diphenhydramine, chlorpheniramine). Several medical conditions, such as head injury, post-traumatic stress disorder, and arthritis, and possibly hay fever or asthma and metal work, seem to influence the risk and age at the onset of dementia and AD.
Neoplasms
Published in Ad (Sandy) Macleod, Ian Maddocks, The Psychiatry of Palliative Medicine, 2018
Ad (Sandy) Macleod, Ian Maddocks
Language, visuospatial, memory, and executive dysfunctions may present, depending upon the site and size of the tumour. Radiotherapy, chemotherapy, medications (anticonvulsant, corticosteroid, opioids), post-ictal delirium and depression may all contribute to cognitive deficits. Some may be transient though the already impaired brain becomes increasingly sensitive to insult and less able to recover. Cognitive dysfunction is an important determinant of health-related quality of life and deserves rigorous assessment and, if possible, intervention. Formal psychometric evaluation is time-consuming and expensive, and is rarely justified in the terminal phase. Bedside assessment is usually adequate to determine the presence of cognitive impairment and monitor progression over time. The decline of cognitive functioning in brain tumour patients is usually insidious and subtle. The early cognitive deficits may be focal. Rapid change suggests an acute event such as haemorrhage into the tumour or medication toxicity. Competency issues may emerge as clinical concerns.
Executive functions mediate the association between alcohol use and declarative memory symptoms in daily life
Published in AIDS Care, 2023
David P. Sheppard, Anastasia Matchanova, Sylvie Naar, Angulique Y. Outlaw, Sharon L. Nichols, Erin E. Morgan, Steven Paul Woods
Despite these limitations, present findings highlight important mechanistic explanations for cognitive dysfunction that may inform potential interventions. Specifically, current findings indicate that by interventions aimed at improving memory and cognition may consider targeting executive function strategies. Examples of such interventions include emphasizing organizational or elaborative encoding strategies to address memory dysfunction (Taconnat et al., 2010). For example, a previous intervention study by Pennar et al. (2018) utilized an intervention that promoted targeted organization strategies and visualization techniques in young PLWH in order to specifically improve prospective memory for health behaviors, and this also resulted in improved viral load and participant resilience (Pennar et al., 2018). Together, the current study highlights that existing cognitive interventions for executive functions may be especially important for individuals who demonstrate memory difficulties in the context of alcohol use.
The effect of transcranial magnetic stimulation on the recovery of attention and memory impairment following stroke: a systematic review and meta-analysis
Published in Expert Review of Neurotherapeutics, 2022
Wen-Wen Xu, Qing-Hong Liao, Dan-Wei Zhu
The occurrence of cognitive dysfunction is closely related to the destruction of the frontal lobe, temporal lobe neural network, cerebral microcirculation, among which the frontal lobes are most commonly affected [2]. Therefore, the incidence of cognitive dysfunction following stroke is high. Significant heterogeneity exists with respect to the clinical manifestations which characterize cognitive dysfunction. However, the main clinical manifestations of stroke are attention impairment and memory impairment, which can significantly affect the social adaptation, self-care ability of daily life, and rehabilitation of stroke patients. The attention and memory impairment caused by post stroke cognitive impairment can reduce a person’s independence in performing basic activities of daily living (ADL), such as eating, dressing, and toileting, as well as instrumental ADL, such as housework and social interactions. Therefore, ongoing care and support is required, and a strain can be subsequently placed on families, caregivers, or society [34]. In order to improve the daily living ability of patients with stroke and reduce the burden on patients’ families and society, safe and effective treatment methods for attention and memory impairment are needed.
Cognition and Postural Tachycardia Syndrome (POTS): Participant-Identified Challenges and Strategies, and Implications for Intervention
Published in Occupational Therapy In Health Care, 2022
Carol Hollingsworth, Valerie Boyette, Emily M. Rich, Asha Vas
POTS is often considered an “invisible” illness due to the nature of these symptoms. Previous research has placed a heavy focus on understanding the physical changes that occur with POTS and has discovered a myriad of symptoms associated with this autonomic nervous system disorder that is estimated to affect between one to three million Americans and many more around the world (Dysautonomia International, n.d.). This number continues to increase as a percentage of individuals with long-COVID, a potential sequela of COVID-19, meet criteria for POTS, including symptoms of cognitive impairment (Raj et al., 2021). Few studies have sought to discover the impact of POTS on cognitive processes and the challenges it brings to daily functioning. The most frequently reported cognitive dysfunction includes memory issues, attention, concentration, complex information processing, and brain fog (Anderson et al., 2014; Raj et al., 2018; Ross et al., 2013). Of those, the one cited by many of those diagnosed with POTS as the most debilitating is a phenomenon referred to as “brain fog.” An actual definition of brain fog has not been agreed upon, nor is the physiological cause fully known. Many individuals report experiences of “cloudy” thinking, memory difficulties, and trouble focusing (Ross et al., 2013).