neurocognition

Question 1

headings in deficits

Answer 1

1. attention/ vigilance
2. verbal memory and learning
3. visual learning and memory
4. reason and problem solving
5. speed of processing
6. verbal fluency
7. immediate/ working memory
8. social cognition

Question 2

what is vigilance, test name

Answer 2

Vigilance refers to the ability to maintain attention over time.
Continous performance tesy

Question 3

Identical Pairs” version of the
CPT

Answer 3

pt attends to a series of 2 to 4 digit numbers, presented sequentially on computer second at one per second. pt respond with a button press on the computer mourse or keyboard each time a number identical to the previous number is seen

Question 4

vigilance in schiz

Answer 4

1. moderately severe defects
2. can result in difficulty following social conversations and an inability to follow important instructions regarding treatment, therapy, or work functions
3. Simple activities such as reading or watching television can become labored or impossible.
4. social deficits, community functioning and skill acquisition defects

Question 5

what is verbal memory

Answer 5

abilities associated with learning new information, retaining newly learned information over time, and recognizing previously presented material.

Question 6

verbal learning and memory in schiz

Answer 6

patients with schizophrenia are not only impaired in their ability to immediately recall verbal material, they are also impaired compared to controls in their ability to learn over time. Patients are also impaired in recalling more engaging verbal material, such as stories.

Question 7

Visual Learning and Memory.

Answer 7

Visual memory has been found to correlate modestly with employment status, job tenure, psychosocial rehabilitation success, social functioning, quality-of-life ratings, and strongly with functional capacity.

Question 8

Wisconsin Card Sorting Test (WCST).

Answer 8

patients are given a deck of cards with various numbers of colored shapes on them and are asked to match their cards to four “key” cards that also have shapes on them that differ by color, form (i.e., shape), and number.

1st by color
then without warning, form
Repeated sorting attempts by the previously correct principle are referred to as perseverations

Question 9

Reasoning and Problem Solving. in schiz

Answer 9

by WCST
1. reduced activity of the dorsolateral prefrontal cortex during performance of this test led to widespread pursuit of the hypothesis of frontal hypoactivation in schizophrenia.
2. The rules of society and the workplace change regularly, and success in these arenas is often measured by one’s ability to adapt to changes

Question 10

Speed of Processing in schiz

Answer 10

tested by WAIS Digit symbol test : ach numeral (1 through 9) is associated with a different simple symbol. Subjects are required to copy as many of the symbols associated with the numerals as possible in 120 seconds.

deficits manifest in : daily life activities, job tenure, and independent living status. It is also sensitive to medication side effects such as somnolence and extrapyramidal symptoms

reduced processing speed on the ability of some patients with schizophrenia to keep in step with the task-oriented jobs that are frequently held by patients with schizophrenia. Psychomotor slowing

Question 11

2 types of verbal fluency

Answer 11

1. phonological or letter fluency: patient’s ability to produce as many words as possible beginning with a particular letter (e.g., “F”) within, for instance, 60 seconds.
2. semantic fluency : to produce words within a particular meaning-based category, such as “animals.”

Question 12

verbal fluency in schiz

Answer 12

roduce fewer words than normal controls but they are more likely than healthy people to produce words that are not outside the required category.

Impaired verbal fluency can damage functioning in social and vocational settings by making communication difficult and awkward.

Question 13

Immediate memory and workinf memory

Answer 13

1. mmediate memory refers to the ability to maintain a limited amount of information “online” for a brief period of time (usually a few seconds). Repeating a string of digits (digits forward)
2. working memory to be synonymous with immediate memory, whereas others describe that it should require some manipulation of the information being held online. ex: digits backward) requires maintenance of the initial string and an active manipulation because the information needs to be both held online and then subsequently reordered.

Question 14

Social Cognition.

Answer 14

theory-of-mind skills and social and emotional
perception are deficit

facial affect recognition and social cue perception are the two general areas into which studies of social perception in schizophrenia can be broken down.: stable deficits on tests of facial affect perception, perception of negative emotions and fear may be particularly impaired.

hey have more difficulty discerning other individuals’ goals and intentions than what they are wearing or saying.

Question 15

Prevalence of Neurocognitive Deficits in Schizophrenia

Answer 15

1. About 15 percent of patients with schizophrenia (and 85 percent of the general population) are rated as “unimpaired” by clinical neuropsychological assessment.
2. monozygotic twins discordant for a formal diagnosis of schizophrenia suggest that almost all affected twins perform worse than their unaffected twin on neurocognitive tests, although the unaffected twins are performing more poorly than expectations on the basis of previous educational attainment.
3. ognitive impairments in schizophrenia are similar across different countries, educational systems, and racial and ethnic groups, suggesting minimal influence of environmental and social variables.

Question 16

NATURAL HISTORY OF NEUROCOGNITIVE IMPAIRMENT

Answer 16

1. In most patients, detectable deficits may be present in childhood, followed by a decline in neurocognitive function that occurs sometime prior to the first episode.
2. In most patients, the severity of neurocognitive impairments becomes greater around the time that psychosis develops.
3. It is also clear that progress of deficits over the illness is generally absent, even in very poor outcome cases, until later life and then is limited to a subset of cases

Question 17

Deficits in Children at Risk for Schizophrenia

Answer 17

1. children with one or two biological parents with schizophrenia have suggested that attention deficits can predict which children will develop schizophrenia in the future.
2. neurocognitive functions are significantly impaired in adolescents who are later hospitalized for schizophrenia.
3. Along with social isolation and organizational ability, neurocognitive deficits are significant predictors of which young people will eventually develop a psychotic disorder.

Question 18

Prodrome

Answer 18

1. olfactory identification and verbal memory deficits may help predict which individuals at ultrahigh risk will develop schizophrenia.
2. neurogenesis continues later into adulthood in the brain regions that contribute to these functions.

Question 19

First Episode of Psychosis Studies

Answer 19

Once psychosis develops, neurocognitive deficits are severe. Patients with a first episode of schizophrenia who have never taken antipsychotic medication already exhibit neurocognitive impairment of a magnitude similar to cases with an established illness.

Question 20

Neurocognitive Changes in Patients Recovering from Acute Exacerbation

Answer 20

do not appear to demonstrate improvements in the severity of their neurocognitive impairment, despite clear improvements in symptoms with treatment.

Question 21

Longitudinal Change in Neurocognitive Function

Answer 21

1. aging-related changes may affect those functions that are already severely impaired in adults with schizophrenia.
2. schizophrenia is a neurodegenerative process, and some have concluded that schizophrenia is progressive.
3. a complex relationship between relapse, retreatment with antipsychotic medications, changes in cortical structure, and changes in cognition.
4. loss of white and gray matter and ventricular enlargement seen following relapses due to medication discontinuation after initial successful treatment.

Question 22

Relationships of NC symptoms with negative symptoms of schizophrenia

Answer 22

1. tests of verbal fluency and the negative symptom of “poverty of speech” both measure the level at which a patient generates speech. A patient who generates speech at a slow rate will do so during a test of verbal fluency as well as in an interview during which he or she is being rated for poverty of speech.
2. Deficient motor skills are represented in both the negative symptom and the neurocognitive
   dysfunction domain,
3. they put forth a normal amount of effort when being given neurocognitive tests of modest difficulty, yet their decreased processing capacity leads them to be unable to engage in difficult tasks.

Question 23

relation b/w neurocognition and FTDs

Answer 23

1. Deficits in semantic memory

diff b/w semantic and phonologic fluency indicates the severity of impairment of “semantic network” in schizophrenic patients, predicted the severity of their formal thought disorder.

2. Thus, a patient’s inability to have verbal information available (referred to as semantic priming) may be the most important neurocognitive factor in formal thought disorder.
3. deficits in working memory
4. deficits in attention

Question 24

cost of neurocognitive impairment

Answer 24

loss of ability for self-care, level of inpatient and outpatient care needed, and loss of productivity (for both patient and caretaker)

early admission to nursing homes or long-term care facilities in the case of elderly patients and other patients who are consistently unable to live in the community.

symptoms have remitted continue to experience profound neurocognitive deficits that interrupt their ability to function independently, benefit from rehabilitation programs, find and maintain employment, and experience healthy levels of quality of life.

Question 25

Impact of Antipsychotic Treatment on Neurocognition

Answer 25

Larger doses of conventional antipsychotics cause lethargy, somnolence, and extrapyramidal symptoms, all of which impair neurocognition. In addition, the anticholinergic medications that are used to control side effects cause additional neurocognitive impairment. Furthermore, lowering dosages of conventional antipsychotic medications has some modest neurocognitive benefit,

“atypical” antipsychotic treatments provide greater neurocognitive benefit to patients with schizophrenia than first-generation antipsychotics

Question 26

Neurocognitive batteries

Answer 26

1. WAIS
2. Weschler memory scale
3. Measurement and Treatment Research to Improve Cognition in Schizophrenia)
   4.Scale for Cognition in Schizophrenia (SCoRS)
4. UPSA, University of California Performance-Based Skills Assessment;

Question 27

non pharma trt

Answer 27

cognitive remediation