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Dementia and Lower Urinary Tract Dysfunction
Published in Jacques Corcos, Gilles Karsenty, Thomas Kessler, David Ginsberg, Essentials of the Adult Neurogenic Bladder, 2020
There may be a cerebral vascular component in the etiology of elderly OAB and incontinence.31 This is because MRI health surveys show that WMD occurs in around 10% of the general population, which is akin to that of OAB (10%–14%). In addition, WMD increases significantly with age and preferentially affects the prefrontal deep white matter.32 The frequency of nocturia in patients with Alzheimer's disease (44%) was less than that in WMD (84%), and it was intermediate (60%) in patients with both Alzheimer's disease and WMD.33 This suggests that WMD is a more significant burden of OAB in the geriatric population than Alzheimer's disease. In one study,34 detrusor overactivity (DO) was independent of general cognitive status (the mean MMSE score or any of its subdomains). In contrast, the presence of DO was significantly associated with the inhibitory control subdomain in the frontal assessment battery (FAB) test (p < 0.01). This finding agrees with the fact that brain perfusion was most severely reduced in the frontal lobe of subjects with WMD.32 The bladder is under general inhibitory control concerning decision-making and emotion by the prefrontal cortex. In patients with WMD, this neural network might be impaired, leading to both frontal cortex-related behavior changes and DO.34
Some psychobiological implications of cannabis use
Published in Philip N. Murphy, The Routledge International Handbook of Psychobiology, 2018
Cannabis users abstinent for approximately two weeks were reported to perform worse than non-using controls in the domains of abstract reasoning, motor programming, and cognitive flexibility measured by the Frontal Assessment Battery (FAB) of neuropsychological tests (Cunha et al., 2010). However, no differences were reported for environmental autonomy, sensitivity to interference, and inhibitory control. The number of joints smoked in the 30 days before testing was negatively correlated with inhibitory control performance but not any of the other domains. The tests comprising this battery have been shown to correlate with aspects of frontal lobe activity (Sarazin et al., 1998). Verdejo-Garcia and colleagues (2005) measured cognitive flexibility in a sample of detoxified cannabis users using a test requiring the manipulation of geometric figures. Composite scores representing lifetime cannabis use were inversely related to cognitive flexibility performance, but not to inhibitory control measured by the Stroop task. Montgomery and colleagues (2012) tried to address issues of ecological validity that can arise in the use of laboratory-based tests by using a non-immersive virtual-reality task which simulated an office-based daily work routine. Whilst cannabis users (who had been asked to abstain for five days prior to testing) performed worse than non-using controls on a measure of planning performance, there were no performance differences on measures of creative thinking and adaptive thinking, respectively.
Frontotemporal Dementia
Published in Marc E. Agronin, Alzheimer's Disease and Other Dementias, 2014
Two bedside neuropsychological tests that have been developed to assess executive function include the Frontal Assessment Battery or FAB (Dubois, Slachevsky, Litvan, & Pillon, 2000) and the Executive Interview or EXIT (Moorhouse, Gorman, & Rockwood, 2009; Royall, Mahurin, & Gray, 1992). The FAB is a 10-minute test composed of six subtests measuring various skills, such as conceptualization, mental flexibility, motor programming, sensitivity to interference, inhibitory control, and autonomy. The patient is asked to carry out a simple task to assess each skill. Research using the FAB for differential diagnosis among patients with FTD, AD, and VaD has shown limited discrimination and only on one or more subtests but not in terms of total scores (Boban, Malojcić, & Mimica, 2012; Lipton et al., 2005). The EXIT is a 25-item test that takes about 10 minutes and measures skills similar to those the measured on the FAB, but it also incorporates frontal release signs and shortened versions of several neuropsychological tasks. It can serve as an ideal supplement to the MMSE since it highlights dysfunction not well-captured on that instrument. However, it has not been shown to specifically identify FTD versus other forms of dementia. A quick assessment of frontal lobe function using items from a variety of cognitive screens including the FAB and EXIT can be found in Table 7.3.
Clinicodemographic and Psychosocial Factors Related to Presentation or Severity of Delusions of Theft among Females with Amnestic Mild Cognitive Impairment and Alzheimer’s Disease
Published in Clinical Gerontologist, 2022
Keisuke Inamura, Shunichiro Shinagawa, Yuri Tsuneizumi, Tomoyuki Nagata, Kenji Tagai, Kazutaka Nukariya, Masahiro Shigeta
ADL was assessed with the use of the Physical Self-Maintenance Scale (PSMS) (Lawton & Brody, 1969a), and IADL with the Lawton IADL scale (Lawton & Brody, 1969b). Both ADL and IADL were completed by the primary caregiver because a-MCI patients tend to overestimate or underestimate their abilities and often lack full insight into the impairments caused by their disease (Jekel et al., 2015). The severity of the caregiver’s burden was assessed with the use of the Japanese version of the Zarit Caregiver Burden Interview (ZBI-J) (Arai, Hosokawa, Washio, Miura, & Hisamichi, 1997), which was completed by the primary caregiver. PSMS, the Lawton IADL scale, and ZBI-J were assessed independently once in one session and completed by the primary caregiver. General cognition was assessed with the use of the MMSE score, and executive functions were assessed with the use of the Frontal Assessment Battery (FAB) score (Dubois, Slachevsky, Litvan, & Pillon, 2000). MMSE and FAB scores were independently determined by an expert geriatric psychiatrist once in one session.
Expanding the clinical and genetic spectrum of SQSTM1-related disorders in family with personality disorder and frontotemporal dementia
Published in Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 2021
Sara Llamas-Velasco, Ana Arteche-López, Antonio Méndez-Guerrero, Verónica Puertas Martín, Juan Francisco Quesada Espinosa, Jose Miguel Lezana Rosales, Marta González-Sánchez, Victor Antonio Blanco-Palmero, Carmen Palma Milla, Alejandro Herrero-San Martín, Daniel Borrego-Hernández, Alberto García-Redondo, David Andrés Pérez-Martínez, Alberto Villarejo-Galende
In the neurocognitive assessment (Table 1), the patient was attentive and collaborated throughout the testing. He verbally expressed himself fluently and coherently without dysphasic or dysarthric elements and could identify objects, repeat sentences, and understand sequential orders. He recalled recent events, such as the food eaten the previous day and the score of soccer matches, although declarative memory performance was low in the neuropsychological study. His Mini-Mental State Examination (Folstein) score was 27/30 (Pe [standard punctuation] 11; pathological <5), and he scored 13 in semantic verbal fluency test (Pe: 7; pathological <5), 10/18 in the Frontal Assessment Battery (Pe: 2; pathological <5), 13 in Hamilton Depression Rating Scale (HDRS-17), and 40 in Neuropsychiatric Inventory (NPI). The neurological examination revealed a hypomimic face and mild symmetric bilateral akinetic-rigid syndrome.
Does executive functioning contribute to locomotion in amyotrophic lateral sclerosis patients?
Published in Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 2019
EglĖ SukockienĖ, Gilles Allali, Jean-Paul Janssens, Ruxandra Iancu Ferfoglia
We used two validated bedside tools to measure executive function and locomotion. With the Frontal Assessment Battery (FAB) (6), we explored the following executive domains: conceptualization, mental flexibility, motor programing, sensitivity to interference, inhibitory control, and environmental autonomy, using six items. Locomotion was evaluated with the Timed Up and Go (TUG) (7), a largely used test in neurological and geriatric settings to assess mobility. We also included the imagined version of the TUG (iTUG) which has been validated to assess higher level of gait control (8). The TUG and iTUG have been previously correlated with functional disability measures and muscle strength in ALS (9). For the TUG, patients were asked to rise from a chair, walk 3 meters, turn around and return to a seated position; their performance was quantified with a precision of 0.01s. For the iTUG, subjects (while sitting) were instructed to imagine performing the iTUG at the same speed that they would actually perform the TUG, and to say ‘stop’ loudly when they had completed the task. The ALSFRS-R total score, demographic and clinical data including the time from first symptoms and diagnosis was recorded.