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1
Uchida, Mai, and Joseph Biederman. Young Adult Outcome of Attention Deficit Hyperactivity Disorder. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190213589.003.0006.
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The Massachusetts General Hospital (MGH) Longitudinal Studies of Attention Deficit Hyperactivity Disorder (ADHD) evaluated and followed a large sample of both boys and girls with ADHD and controls without ADHD, along with their families, ascertained from psychiatric and pediatric sources. These studies documented that ADHD in both sexes is associated with high levels of persistence onto adulthood; high levels of familiality with ADHD and other psychiatric disorders; a wide range of comorbid psychiatric and cognitive disorders including mood, anxiety, and substance use disorders; learning disabilities with reading and math; executive function deficits; emotional dysregulation and autistic traits; as well as educational, social, and occupational dysfunctions. The MGH studies also suggested that stimulant treatment significantly decreased the risk of developing comorbid psychiatric disorders, substance use disorders, and impaired functional outcomes. The studies also documented the neural basis of the persistence of ADHD using resting-state functional magnetic resonance imaging (fMRI).
2
Cummings, Jeffrey, and Kate Zhong. Promise and Challenges in Drug Development and Assessment for Cognitive Enhancers. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190214401.003.0001.
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Cognitive disturbances are ubiquitous in neurologic and psychiatric disorders. Schizophrenia, depression, developmental disorders, acquired brain disorders (traumatic brain injury and stroke), and neurodegenerative disorders all have cognitive impairment as a manifestation. Cognitive enhancers can improve intellectual function and have been approved for Alzheimer’s dementia, dementia of Parkinson’s disease, and attention deficit hyperactivity disorder. Cognitive enhancers are being developed for other cognitive disorders. There are many advantages for development of symptomatic cognitive enhancers compared to disease-modifying agents. Cognitive enhancers typically modulate transmitter systems. Cross-disease phenotypes such as executive function impairment may represent a development strategy for cognitive enhancing agents. Life cycle management strategies for cognitive enhancers include expanding indications to disorders with related pathophysiology or to different stages of disease severity and development of alternate formulations. Cognitive enhancers can restore essential cognitive capability and are a critical element of optimal care of patients with neurologic and psychiatric disorders.
3
Alosco, Michael L., and Robert A. Stern, eds. The Oxford Handbook of Adult Cognitive Disorders. Oxford University Press, 2019. http://dx.doi.org/10.1093/oxfordhb/9780190664121.001.0001.
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The prevalence of cognitive impairment caused by neurodegenerative diseases and other neurologic disorders associated with aging is expected to rise dramatically between now and year 2050, when the population of Americans aged 65 or older will nearly double. Cognitive impairment also commonly occurs in other neurologic conditions, as well as in non-neurologic medical disorders (and their treatments), idiopathic psychiatric illnesses, and adult neurodevelopmental disorders. Cognitive impairment can thus infiltrate all aspects of healthcare, making it necessary for clinicians and clinical researchers to have an integrated knowledge of the spectrum of adult cognitive disorders. The Oxford Handbook of Adult Cognitive Disorders is meant to serve as an up-to-date, scholarly, and comprehensive volume covering most diseases, conditions, and injuries resulting in impairments in cognitive function in adults. Topics covered include normal cognitive and brain aging, the impact of medical disorders (e.g., cardiovascular, liver, pulmonary) and psychiatric illnesses (e.g., depression and bipolar disorder) on cognitive function, adult neurodevelopmental disorders (e.g., Down Syndrome, Attention Deficit/Hyperactivity Disorder), as well as the various neurological conditions (e.g., Alzheimer’s disease, chronic traumatic encephalopathy, concussion). A section of the Handbook is also dedicated to unique perspectives and special considerations for the clinicians and clinical researchers, covering topics such as cognitive reserve, genetics, diversity, and neuroethics. The target audience of this Handbook includes: (1) clinicians, particularly psychologists, neuropsychologists, neurologists (including behavioral and cognitive neurologists), geriatricians, and psychiatrists (including neuropsychiatrists), who provide clinical care and management for adults with a diverse range of cognitive disorders; (2) clinical researchers who investigate cognitive outcomes and functioning in adult populations; and (3) graduate level students and post-doctoral trainees studying psychology, clinical neuroscience, and various medical specialties.
4
Hodges, John R. Localized Cognitive Functions. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780192629760.003.0003.
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Chapter 3 discusses aspects of normal and abnormal language function, followed by a brief description of disorders of calculation (acalculia) and of higher-order motor control (apraxia). The second half of the chapter deals with disturbed right hemisphere functions: neglect phenomena, dressing and constructional apraxia, and complex visuo-perceptual deficits (agnosias).
5
Dud, Iulia, Louise Brennan, and Dene Robertson. Autism, Attention Deficit Hyperactivity Disorder, and Cognitive Enhancement. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190214401.003.0012.
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Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are common neurodevelopmental disorders. Impairments in attention and executive functions are core characteristics of ADHD. ASD is primarily characterized by severe deficits in social communication, but cognitive impairments are common, including in attention and executive functions. Currently, there is only limited evidence for efficacy of either pharmacological or behavioral interventions for the treatment of the cognitive deficits associated with the disorders. This chapter presents the current evidence base for cognitive enhancements for ADHD and ASD. It summarizes evidence from available and experimental pharmacological interventions, as well as behavioral, cognitive, and psychosocial interventions. The chapter also discusses the limitations of current tools and future directions.
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Hodges, John R. Testing Cognitive Function at the Bedside. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780192629760.003.0005.
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Chapter 5 covers testing cognitive function at the bedside, and how the first part of the examination should assess distributed cognitive functions; deficits in these indicate damage to particular brain systems, but not to focal areas of one hemisphere. The second part of the assessment should deal with more localized functions, divided into those associated with the dominant (i.e. the left side, in right-handers) and non-dominant hemispheres.
7
(Editor), Sarah H. Broman, and Jordan Grafman (Editor), eds. Atypical Cognitive Deficits in Developmental Disorders: Implications for Brain Function. Lawrence Erlbaum, 1993.
8
Broman, Sarah H., and Jordan Grafman. Atypical Cognitive Deficits in Developmental Disorders: Implications for Brain Function. Taylor & Francis Group, 2016.
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H, Broman Sarah, and Grafman Jordan, eds. Atypical cognitive deficits in developmental disorders: Implications for brain function. L. Erlbaum Associates, 1994.
10
Hodges, John R. Testing Cognitive Function at the Bedside. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198749189.003.0005.
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This chapter explores the second component of assessment in patients with suspected cognitive dysfunction: testing cognitive function at the bedside. The first part of the examination should assess distributed cognitive functions, notably orientation and attention, episodic and semantic memory, and frontal executive function (initiation in the form of verbal fluency, abstraction, response inhibition, and set shifting); deficits in these indicate damage to particular brain systems, but not to focal areas of one hemisphere. The second part of the assessment deals with localized functions, divided into those associated with the dominant (i.e. the left side, in right-handers) and non-dominant hemispheres. The former relates largely to tests of spoken language with supplementary tests of reading, writing, calculation, and praxis when applicable. Testing right hemisphere function focuses on neglect (personal and extrapersonal), visuospatial and constructional abilities, and the agnosias including object and face agnosia.
11
Veech, Richard L., and M. Todd King. Alzheimer’s Disease. Edited by Detlev Boison. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190497996.003.0026.
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Deficits in cerebral glucose utilization in Alzheimer’s disease (AD) arise decades before cognitive impairment and accumulation of amyloid plaques and neurofibrillary tangles in brain. Addressing this metabolic deficit has greater potential in treating AD than targeting later disease processes – an approach that has failed consistently in the clinic. Cerebral glucose utilization requires numerous enzymes, many of which have been shown to decline in AD. Perhaps the most important is pyruvate dehydrogenase (PDH), which links glycolysis with the Krebs cycle and aerobic metabolism, and whose activity is greatly suppressed in AD. The unique metabolism of ketone bodies allows them to bypass the block at pyruvate dehydrogenase and restore brain metabolism. Recent studies in mouse genetic models of AD and in a human Alzheimer’s patient showed the potential of ketones in maintaining brain energetics and function. Oral ketone bodies might be a promising avenue for treatment of Alzheimer’s disease.
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Abramovitch, Amitai. Neuropsychological Function in OCD. Edited by Christopher Pittenger. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190228163.003.0015.
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This chapter reviews the neuropsychological literature in adult and pediatric OCD, and then reviews the limitations, current controversies, and caveats in this area. Characterization of neuropsychological deficits associated with psychological problems has the potential to integrate neurobiological and psychopathological research. The cognitive neuropsychology of Obsessive-Compulsive Disorder (OCD) has been extensively studied over the past three decades. This impressive body of literature indicates that individuals diagnosed with OCD tend to exhibit moderate underperformance on neuropsychological tests in most, although not all, cognitive domains. However, neuropsychological research in OCD has been notoriously inconsistent. Moreover, the presence of broad though modest deficits, rather than large discrete ones, raises serious challenges for attempts to integrate neuropsychological constructs into neurobiological and psychological models of OCD.
13
Chrzanowski, Daniel T., Elisabeth B. Guthrie, Matthew B. Perkins, and Moira A. Rynn. Child and Adolescent Psychiatry. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199326075.003.0015.
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Common disorders of children and adolescents include neurodevelopmental disorders (e.g., intellectual disability, autistic spectrum disorder, and learning disorders), internalizing disorders (e.g., mood and anxiety disorders), and externalizing disorders (e.g., oppositional defiant disorder and conduct disorder). The assessment of a child or adolescent patient always includes multiple informants, the context in which the child’s difficulties occur, and a functional behavioral assessment. Patients with autism spectrum disorder tend to have persistent deficits in social communication and social interaction, a restricted repertoire of behaviors and interests, and abnormal cognitive functioning. Children with disruptive mood dysregulation disorder experience chronic and severe irritability and frequent temper outbursts. Attention deficit hyperactivity disorder is characterized by hyperactivity, impulsivity, and inattention before 12 years of age. Behavior therapy has been effectively used to treat children and adolescents with neurodevelopmental disorders, attention deficit hyperactivity disorder, tic disorders, feeding and elimination disorders, and externalizing disorders. Fluoxetine is approved for treatment of depression in children and escitalopram, for adolescents. Methylphenidate and amphetamine preparations are first-line treatment for children with attention deficit hyperactivity disorder.
14
Carrión, Victor G., John A. Turner, and Carl F. Weems. Executive Function. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190201968.003.0001.
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In the first chapter, the relationship between traumatic stress and the broad domain of executive function (EF) and their neurofunctional correlates is discussed. The phenomenology of this relationship is reviewed in terms of the preclinical lesion and adult neuroimaging studies that have established a link between stress and deficits in executive functions. The myriad executive functions that have demonstrated vulnerability to traumatic stress are categorized as either updating, inhibiting, or shifting. Considerations from each domain establish clearly that the experience of trauma and the manifestation of posttraumatic stress symptoms can lead to or predispose individuals to deficits throughout the brain, resulting in slower processing speed, the formation of negative decision-making biases, and difficulties in emotional regulation, attention regulation, and response inhibition. The transition from psychometric cognitive tests to structural and functional neuroimaging and future directions for the study of executive function are also discussed.
15
Naninck, E. F. G., P. J. Lucassen, and Aniko Korosi. Consequences of Early-Life Experiences on Cognition and Emotion. Edited by Turhan Canli. Oxford University Press, 2013. http://dx.doi.org/10.1093/oxfordhb/9780199753888.013.003.
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Perinatal experiences during a critical developmental period program brain structure and function “for life,” thereby determining vulnerability to psychopathology and cognition in adulthood. Although these functional consequences are associated with alterations in HPA-axis activity and hippocampal structure and function, the underlying mechanisms remain unclear. The parent-offspring relationship (i.e., sensory and nutritional inputs by the mother) is key in mediating these lasting effects. This chapter discusses how early-life events, for example, the amount of maternal care, stress, and nutrition, can affect emotional and cognitive functions later in life. Interestingly, effects of perinatal malnutrition resemble the perinatal stress-induced long-term deficits. Because stress and nutrition are closely interrelated, it proposes that altered stress hormones and changes in specific key nutrients during critical developmental periods act synergistically to program brain structure and function, possibly via epigenetic mechanisms. Understanding how the adult brain is shaped by early experiences is essential to develop behavioural and nutritional preventive therapy.
16
Gilleen, James. Cognitive Enhancement in Schizophrenia. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190214401.003.0009.
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Schizophrenia is characterized by a constellation of heterogeneous symptoms including hallucinations and delusions, motivational and social deficits, and cognitive impairments. Although positive symptoms have historically been the target for drug development, in recent years, attention has turned to cognitive and negative symptoms. Cognitive deficits in schizophrenia are associated with significant impairments in functional, social, and employment outcomes, and although they are widely researched and relatively well understood, there are no currently approved compounds to treat them. This chapter provides a selective review of the current status of approaches developed to improve cognition in schizophrenia. It covers pharmacological approaches as well as cognitive training and cognitive remediation techniques. It also explores the various study design issues and challenges that contribute to the difficulties in discovering reliable ways to improve the cognitive deficits present in schizophrenia.
17
Taylor, Eric. Developmental Neuropsychiatry. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198827801.001.0001.
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Neurodevelopmental disorders are a group of conditions involving alterations of behaviour, thinking, and emotions. They have onsets in early childhood, persistence into adult life, and high rates of altered cognitive and neurological function. They are frequent reasons for referral to psychiatry, paediatrics, and clinical psychology and often require team approaches to meet a variety of needs for service. This book includes accounts of the typical development and possible pathology of key functions whose alterations can underlie problems of mental development: motor function, attention, memory, executive function, communication, social understanding and empathy, reality testing, and emotional regulation. It goes on to descriptions of frequent clinical conditions: the spectra of attention deficit hyperactivity disorder (ADHD), autism, tic disorders, coordination and learning difficulties, intellectual disability, and the psychotic disorders of young people. There are descriptions of recognition, diagnosis, prevalence, pathophysiology, and consequences for later development. These conditions very often coexist and present as dimensions rather than categorical illnesses. The effects of brain disorders on mental life are then considered, with special attention to epilepsy, cerebral palsy, hydrocephalus, acquired traumatic injury to the head, localized structural lesions, and endocrine and genetic disorders. Widely used treatments, both psychological and physical, are described in the context of their value for meeting multiple, often overlapping needs. Consequences of the conditions for individuals’ psychosocial development are described: stigma; physical illness and injury; economic disadvantage; and family, peer, and school stresses. This book is aimed at clinicians of all disciplines, clinical students, and educators encountering neuropsychiatric problems in young people.
18
Melikyan, Zara, Heather Romero, and Kathleen A. Welsh-Bohmer. Cognitive Enhancement at the Mild Cognitive Impairment Stage of Alzheimer’s Disease. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190214401.003.0008.
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Alzheimer’s disease (AD) is the most common cause of dementia in aging. Currently, therapeutic interventions are being initiated earlier in the disease course. The rationale of this strategy is to take advantage of the still healthy neuronal systems to optimize function, slow cognitive decline, and facilitate adaptive compensation in deficient brain networks. This chapter provides an overview and critique of the evidence supporting the enhancement of cognitive function at the early symptomatic stage of AD, so-called mild cognitive impairment due to AD (MCI-AD). It reviews the clinical diagnosis of MCI-AD, underscoring the differences between this condition and healthy brain aging and highlighting the importance of fluid and imaging biomarkers in ensuring reliable diagnosis and providing targets for therapeutic modification. Next, it discusses techniques to enhance cognition in MCI, with an emphasis on nonpharmacological interventional approaches. It concludes with a discussion of future challenges and opportunities in the treatment of MCI-AD.
19
Robertson, Ian H., and Redmond G. O'Connell. Rehabilitation of Attention Functions. Edited by Anna C. (Kia) Nobre and Sabine Kastner. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199675111.013.021.
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The evidence for the effectiveness of rehabilitation of three types of attention—selectivity, sustained attention, and attentional switching—is reviewed. Limited but significant effects in all three domains are observed, though evidence for generalization to wider everyday life functions remains relatively sparse. In the case of sustained attention and also in the case of spatial selectivity, the modulating effects of arousal are shown to be important, and higher level executive deficits may at times be exacerbated or even caused by lowered levels of arousal. Conversely, methods of modulating arousal may be used to improve sustained attention and executive functions in a range of clinical conditions. Attentional functions are key to other cognitive domains such as attention and perception, and so the promising evidence for attentional rehabilitation may contribute to the rehabilitation of other cognitive domains also.
20
Lis, Stefanie, Nicole E. Derish, and M. Mercedes Perez-Rodriguez. Social Cognition in Personality Disorders. Edited by Christian Schmahl, K. Luan Phan, Robert O. Friedel, and Larry J. Siever. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199362318.003.0009.
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Changes in social cognition are increasingly recognized as core illness features in the personality disorders with a broad impact on social functioning. Despite the significant disability caused by social cognitive dysfunction, treatments for this symptom dimension tailored to the specific deficits of a disorder are still missing. This chapter characterizes the different domains of social cognitive processing and describes different approaches and instruments for measuring impairments. It provides a short overview of the evidence demonstrating changes in social cognition in schizotypal personality disorder, borderline personality disorder, and antisocial and avoidant personality disorder, as well as the neurobiology of social cognition. During the recent past the number of studies addressing this topic increased tremendously. Nevertheless, research in this area is still young and requires approaches that study these functions while emphasizing the social context and associate deficits observed in experimental paradigms with interpersonal dysfunction during every-day life.
21
Rajan, Shobana, and Vibha Mahendra. Awake Craniotomy. Edited by David E. Traul and Irene P. Osborn. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190850036.003.0003.
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Awake craniotomies are performed when the site of surgical instrumentation or resection directly involves or abuts eloquent areas of the brain and require a cooperative patient, a tailored neuroanesthetic technique, and good teamwork. Eloquent cortex refers to any cortical region in which injury produces a symptomatic cognitive or motor deficit and includes the primary sensorimotor cortex, essential speech areas, occipital visual areas, and mesial temporal regions crucial for episodic memory. An awake patient allows for intraoperative testing of motor, speech, or sensation function while removing or manipulating brain tissue. The two principal aims of resection of a brain tumor or an epileptic focus are to maximize excision of the offending lesion for better prognosis while minimizing or avoiding damage to surrounding brain tissue. Damage to adjacent brain tissue can be catastrophic, especially if the tumor or epileptogenic areas are located close to the eloquent regions of the brain.
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OʼShea, Jacinta, and Matthew F. S. Rushworth. Higher visual cognition: search, neglect, attention, and eye movements. Edited by Charles M. Epstein, Eric M. Wassermann, and Ulf Ziemann. Oxford University Press, 2012. http://dx.doi.org/10.1093/oxfordhb/9780198568926.013.0028.
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This article reviews the contribution of transcranial magnetic stimulation (TMS) research to the understanding of attention, eye movements, visual search, and neglect. It considers how TMS studies have confirmed, refined, or challenged prevailing ideas about the neural basis of higher visual cognition. It shows that TMS has enhanced the understanding of the location, timing, and functional roles of visual cognitive processes in the human brain. The main focus is on studies of posterior parietal cortex (PPC), with reference to recent work on the frontal eye fields (FEFs). TMS offers many advantages to complement neuropsychological patient studies to enhance the understanding of how the fronto-parietal cortical nerves function. The visuo-spatial neglect- and extinction-like deficits incurred by parietal damage have been modelled successfully using TMS. Future work might be directed at teasing apart the distinct functional roles of nodes within this frontoparietal network in different sensorimotor contexts.
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Soloff, Paul, and Christian Schmahl. Suicide and Nonsuicidal Self-Injury. Edited by Christian Schmahl, K. Luan Phan, Robert O. Friedel, and Larry J. Siever. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199362318.003.0011.
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This chapter reviews current data on the prevalence of suicidal behavior and non-suicidal self-injury (NSSI) in patients with PDs; the characteristics of attempters versus completers; and the epidemiology of NSSI in borderline personality disorder (BPD). In addition, it presents explanatory models for suicide and NSSI. Also, there are comprehensive discussions of the neurobiological mechanisms involved in both suicidality and NSSI focusing on the structural and functional neuroimaging of emotion dysregulation, impulsivity, executive cognitive deficits, affective interference and cognitive function, and the Endogenous Opioid System. The chapter concludes with a detailed description of pain processing as it interacts with NSSI.
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Hopkins, Ramona O., and James C Jackson. Cognitive Impairment Following Critical Illness. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199653461.003.0019.
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Millions of individuals each year survive critical illness, many of whom will develop post-intensive care syndrome which includes new or worsening impairments in physical, psychiatric, or cognitive functioning. Cognitive impairments are common in survivors of critical illness, are often severe, and persist years after hospital discharge. Cognitive impairments improve in some patients and, in others, appear stable over time, rather display a pattern of progressive decline. Cognitive impairment contributes to clinically significant functional decrements as well as decreased quality of life. The biological mechanisms of cognitive impairment are not well defined, although numerous risk factors have been identified. As the number of ICU survivors increases, there is a growing population of patients with cognitive impairments following critical illness, underscoring the need to address cognitive impairments through prevention, treatment, and rehabilitation. Interventions to prevent or reduce the severity of cognitive impairments (i.e. sedation, delirium, and early mobility protocols) need to be investigated. Although there are very limited examples in which rehabilitation is used in ICU populations, it may hold the potential to facilitate improvements in cognition, particularly among individuals with deficits in memory, attention, and executive functioning. Despite over a decade of focused investigation, fundamental questions pertaining to cognitive impairments after critical illness exist. Research is needed on methods to proactively identify those at risk for cognitive impairment and to develop methods which will robustly prevent and improve deficits in ICU survivors.
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Sprich, Susan, and Steven A. Safren. Overcoming ADHD in Adolescence. Oxford University Press, 2020. http://dx.doi.org/10.1093/med-psych/9780190854485.001.0001.
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This Client Workbook is an accompaniment to the Therapist Guide, Overcoming ADHD in Adolescence: A Cognitive Behavioral Approach. The treatment and manuals are designed for clients to complete with the help of a therapist who is familiar with cognitive behavioral therapy (CBT) and/or other structured therapeutic approaches. The program is designed to help adolescent clients with attention-deficit/hyperactivity disorder (ADHD) learn skills to help them cope with their ADHD symptoms. Core modules on organizing and planning, reducing distractibility, and adaptive thinking are included, as is an optional module on reducing procrastination. The emphasis is primarily on teaching the adolescent how to learn skills to combat ADHD and function independently. Information is provided regarding how to include parents in the treatment: inviting a parent or parents in at the end of sessions, including parents in goal setting in joint sessions with the adolescent, and optional coaching sessions without the adolescent present. The guide concludes with a discussion of how to help clients maintain the gains that they have made in treatment. The client workbook and therapist guide include a discussion of how to incorporate technology into the treatment and a “signposts of change” section in each chapter. The manuals include many worksheets and forms, as well as a link to an assessment measure that can be used repeatedly to gauge progress in treatment.
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Sprich, Susan, and Steven A. Safren. Overcoming ADHD in Adolescence. Oxford University Press, 2020. http://dx.doi.org/10.1093/med-psych/9780190854522.001.0001.
Full textAbstract:
This Therapist Guide is accompanied by a Client Workbook entitled, Overcoming ADHD in Adolescence: A Cognitive Behavioral Approach. The treatment and manuals are designed for clients to complete with the help of a therapist who is familiar with cognitive behavioral therapy (CBT) and/or structured therapeutic approaches. The program is designed to help adolescent clients with attention-deficit/hyperactivity disorder (ADHD) learn skills to help them cope with their ADHD symptoms. Core modules on organizing and planning, reducing distractibility, and adaptive thinking are included, as is an optional module on reducing procrastination. The emphasis is primarily on teaching the adolescent how to learn skills to combat ADHD and function independently. Information is provided regarding how to include parents in the treatment: inviting a parent or parents in at the end of sessions, including parents in goal setting in joint sessions with the adolescent, and optional coaching sessions without the adolescent present. The guide concludes with a discussion of how to help the client maintain the gains that they have made in treatment. The Client Workbook and Therapist Guide include a discussion of how to incorporate technology into the treatment and “signposts of change” sections in each chapter. The manuals include many worksheets and forms as well as a link to an assessment measure that can be used repeatedly to gauge progress in treatment.
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Young, Jared W., Alan Anticevic, and Deanna M. Barch. Cognitive and Motivational Neuroscience of Psychotic Disorders. Edited by Dennis S. Charney, Eric J. Nestler, Pamela Sklar, and Joseph D. Buxbaum. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190681425.003.0016.
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Schizophrenia is a complex neuropsychiatric syndrome presenting with a constellation of symptoms. Clinicians have long recognized that abnormalities in cognitive function and motivated behavior are a key component of psychosis, and of schizophrenia in particular. Here we postulate that these deficits may reflect, at least in part, impairments in the ability to actively maintain and utilize internal representations of emotional experiences, previous rewards, and motivational goals in order to drive current and future behavior in a way that would normally allow individuals to obtain desired outcomes. We discuss the evidence for such impairment in schizophrenia, how it manifests in domains typically referred to as executive control, working memory, and episodic memory, how it may help us understand impairments in reward processing and motivation in schizophrenia, and the animal research consistent with these hypotheses.
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Manohar, Sanjay, Valerie Bonnelle, and Masud Husain. Neurological Disorders of Attention. Edited by Anna C. (Kia) Nobre and Sabine Kastner. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199675111.013.027.
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Attention deficits are a frequent and particularly disabling consequence of many neurological disorders, from patients with focal brain lesions through to individuals with traumatic brain injury or neurodegenerative conditions, such as Parkinson’s disease. They are often associated with apparent confusion, fatigue, irritability, and increased time and effort to perform even simple everyday tasks, and constitute a real challenge for rehabilitation. In many cases, attention deficits may be crucial factors underlying failures of memory and higher cognitive functions, contributing to difficulties in resuming previous activities and independent daily living. Here the authors first consider four aspects of attention—selective, sustained, executive, and divided—together with brain regions and networks considered to underpin normal attention and disorders of attention. The authors focus on focal brain lesions, traumatic brain injury and Parkinson’s disease as important examples illustrating the effects of different brain pathologies on attention function.
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Gaetz, Michael B., and Kelly J. Jantzen. Electroencephalography. Edited by Ruben Echemendia and Grant L. Iverson. Oxford University Press, 2016. http://dx.doi.org/10.1093/oxfordhb/9780199896585.013.006.
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Axonal injury is currently considered to be the structural substrate behind most concussion-related neurological dysfunction. Because the principal generators of EEG fields are graded excitatory and inhibitory synaptic potentials of pyramidal neurons, the EEG is well suited for characterizing large-scale functional disruptions associated with concussion induced metabolic and neurochemical changes, and for connecting those disruptions to deficits in behavior and cognition. This essay provides an overview of the use of EEG and newly developed analytical procedures for the measurement of functional impairment related to sport concussion. Elevations in delta and theta activity can be expected in a percentage of athletes and change in asymmetry and coherence may also be present. Newer techniques are likely to be of critical importance for understanding the anatomical and physiological basis of cognitive deficits and may provide additional insight into susceptibility to future injury. Computational modeling may advance our understanding of concussion.
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Abrahams, Sharon, and Christopher Crockford. Cognitive and behavioural dysfunction in ALS and its assessment. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198757726.003.0008.
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Cognitive and behavioural dysfunction in amyotrophic lateral sclerosis (ALS) occurs in up to half of patients with a spectrum from ALS with no cognitive or behavioural impairment to ALS with frontotemporal dementia (FTD). ~ 15% have a full blown ALS-FTD syndrome, while ~ 35% show milder and specific deficits on verbal fluency, executive and language functions and social cognition. Patients may show a behavioural syndrome that ranges from mild specific difficulties to changes that fulfil diagnostic criteria for behavioural variant-FTD. Apathy is the most prevalent symptom, but disinhibition, perseveration, loss of sympathy/empathy, and change in eating behaviour are also described. The importance of assessment is increasingly recognized. A distinction is made between brief assessment tools useful within ALS clinics and more extensive neuropsychological assessment by a qualified clinical neuropsychologist. Newly developed assessments specifically designed for ALS are available and will make valuable contribution to clinical care.
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Oscar-Berman, Marlene, Trinity A. Urban, and Avram J. Holmes. Effects of Alcoholism on Neurological Function and Disease in Adulthood. Edited by Kenneth J. Sher. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199381708.013.22.
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Alcoholism is associated with disparate and widespread negative consequences for brain anatomy and function. Consistent with a diffuse neurobiological profile, alcoholism is marked by a heterogeneous mix of cognitive and emotional abnormalities. Alcohol use disorders arise through diverse origins and follow an uncertain clinical course, with severity and consequences depending on many factors. The identification of specific alcoholism-related deficits is constrained both by methodological techniques employed and the distinct populations studied. To understand alcoholism-related alterations in brain structure and function, it is critical to consider the influence of contextual factors on clinical course. The optimal approach for understanding alcohol use disorders leverages a variety of scientific methodologies and clinical settings. The resulting confluence of data can provide evidence linking alterations in neurobiology with behavioral and neuropsychological effects of alcoholism. Critically, these data may help determine the degree to which abstinence and treatment facilitate the reversal of brain atrophy and dysfunction.
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Scerif, Gaia, and Rachel Wu. Developmental Disorders. Edited by Anna C. (Kia) Nobre and Sabine Kastner. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199675111.013.030.
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Tracing the development of attentional deficits and their cascading effects in genetically and functionally defined disorders allows an understanding of intertwined developing systems on three levels. At the cognitive level, attention influences perception, learning, and memory. Attention and other cognitive processes interact to produce cascading effects across developmental time. At a systems neuroscience level, developmental disorders can reveal the systems and mechanisms necessary to attain adults’ efficient attentional processes. At the level of cellular neuroscience and functional genomics, disorders of known genetic aetiology provide inroads into cellular pathways and protein networks leading to attentional deficits across development. This chapter draws from both genetically defined and functionally defined disorders to delineate the complexities and necessity of studying attentional deficits and their neural correlates. Studying developmental disorders highlights the need to study attentional processes and other cognitive processes (e.g. memory and learning) in tandem, given their inseparable nature.
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Drane, Daniel L., and Dona E. C. Locke. Mechanisms of Possible Neurocognitive Dysfunction. Edited by Barbara A. Dworetzky and Gaston C. Baslet. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190265045.003.0005.
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This chapter covers what is known about the possible mechanisms of neurocognitive dysfunction in patients with psychogenic nonepileptic seizures (PNES). It begins with a review of all research examining possible cognitive deficits in this population. Cognitive research in PNES is often obscured by noise created by a host of comorbid conditions (e.g., depression, post-traumatic stress disorder, chronic pain) and associated issues (e.g., effects of medications and psychological processes that can compromise attention or broader cognition). More recent studies employing performance validity tests raise the possibility that studies finding broad cognitive problems in PNES may be highlighting a more transient phenomenon secondary to these comorbid or secondary factors. Such dysfunction would likely improve with successful management of PNES symptomatology, yet the effects of even transient variability likely compromises daily function until these issues are resolved. Future research must combine the use of neuropsychological testing, performance validity measures, psychological theory, neuroimaging analysis, and a thorough understanding of brain–behavior relationships to address whether there is a focal neuropathological syndrome associated with PNES.
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Marano, Christopher M. Driving Considerations in Cognitive Impairment and Depression in Older Patients. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199959549.003.0008.
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Cognitive impairment can impair driving skills and safety, and given the fact that persons with MCI can develop cognitive deficits in several cognitive domains it is important to address driving safety. The goal of the clinician is to identify potentially unsafe drivers without unnecessarily restricting safe drivers, and this chapter focuses on evaluating patients in this gray area. The office exam can be be broadened to address cognitive and functional assessments that may reflect on driving safety, and the clinician may advise the patient and family to have a comprehensive driving assessment by a driving rehabilitation specialist. Clinicians need to be well informed about state law regarding the evaluation of driving safety in order to maintain privacy while adhering to highest standards of public safety.
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Goodkind, Madeleine S., and Amit Etkin. Functional Neurocircuitry and Neuroimaging Studies of Anxiety Disorders. Edited by Dennis S. Charney, Eric J. Nestler, Pamela Sklar, and Joseph D. Buxbaum. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190681425.003.0034.
Full textAbstract:
Anxiety and fear serve adaptive functions and include wide-ranging subjective, physiological, behavioral, and cognitive responses. When these reactions are present chronically, and to a heightened degree that generalizes to signals beyond those that are objectively dangerous, one sees emergence of clinical anxiety disorders. Historically, anxiety disorders have been conceptualized as disruptions in fear processing, though more recent accounts also highlight changes in emotional reactivity beyond fear and deficits in emotion regulation. In this chapter, we review the neural circuitry relevant for fear processing and for emotional reactivity and regulation more broadly. We then review neuroimaging studies of social anxiety disorder, specific phobia, generalized anxiety disorder, panic disorder, and posttraumatic stress disorder. We highlight areas of overlap between disorders as well as disorder-specific perturbations.
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Nie, Pei Huey, and David L. Sultzer. Treatments for Neurocognitive Disorders. Oxford University Press, 2015. http://dx.doi.org/10.1093/med:psych/9780199342211.003.0026.
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Dementia, or neurocognitive disorders, refers to a number of clinical syndromes originating in brain pathology and characterized by cognitive deficits and functional impairment. This chapter provides an update on treatment options in addition to a brief summary of dementia types and an overview of the diagnostic criteria for cognitive disorders. The diagnosis of dementia is ultimately a clinical one and includes a multidimensional perspective; as such, treatment requires a comprehensive approach. This chapter addresses two aspects of the treatment of neurocognitive disorders: pharmacological interventions that can temporarily slow the decline of cognitive deficits and the management of behavioral and psychological symptoms (neuropsychiatric symptoms) associated with dementia syndromes. The chapter also reviews disease-modifying treatments in development that may beneficially alter the course of disease, or reduce or prevent symptom expression in those at risk.
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Hodges, John R. Delirium and Dementia. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198749189.003.0002.
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Delirium and dementia affect one or more cognitive domains with a distributed neural basis—attention, memory, and executive function—in some instances accompanied by more focal cognitive deficits. Patients with one, or both, of these conditions constitute the commonest presentation in behavioural neurology and in geriatric psychiatry. This chapter first describes the core characteristics and causes of delirium. This is followed by a description of the major causes of dementia notably, Alzheimer’s disease, frontotemporal dementia, Huntington’s disease, dementia with Lewy bodies, and progressive supranuclear palsy. These are contrasted with pseudodementia, with mention of the causes of rapidly progressive dementia, and differential diagnosis of delirium and dementia.
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Elliott, Doug, and Linda Denehy. Post-ICU Rehabilitation. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199653461.003.0051.
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More than three-quarters of patients who experience a critical illness and intensive care unit admission survive their initial physiological insult and are subsequently discharged from hospital. Some of these survivors have physical, psychological, or cognitive deficits that persist and delay optimal recovery in the following months and, in some instances, years. A range of generic screening and functional assessment strategies has been used with post-ICU cohorts, but methodological limitations were evident. Further research is therefore required, possibly using a battery of instruments to cover a broad range of function across the recovery period, to explore optimal screening times. Commencing or continuing rehabilitation strategies for patients after ICU discharge in both hospital and post-hospital environments have their own set of challenges. A key step is to improve awareness and understanding of the sequelae of critical illness among rehabilitation specialists, primary care practitioners, and the broader health community. Coordination and optimal use of scarce resources in hospital and community settings is required. Evidence supporting post-ICU rehabilitation interventions is mixed. Studies are needed to discern which patients likely to respond and the optimal amount, type, and timing of interventions. Innovative use of wearable technologies and smartphone or tablet applications may offer some solutions for monitoring, motivation, compliance, and optimal recovery for survivors of a critical illness who have identified functional deficits.
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Frakey, Laura L., and Donald A. Davidoff. Neuropsychological Assessment in Geriatric Forensic Psychiatry. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199374656.003.0004.
Full textAbstract:
While memory complaints are ubiquitous among elders, and memory impairment is one of the most significant aspects of cognitive dysfunction in elderly persons, deficits in other cognitive domains can also negatively impact the ability of elderly individuals to function independently and can have marked consequences in the forensic arena. Neuropsychological assessment is a critical element in identifying cognitive changes that can have a negative impact on legal capacity. Information about cognitive vulnerabilities, combined with data concerning day-to-day functioning, provides critical information to identify what specific areas of capacity may be impaired, and wherever possible, identify the least restrictive accommodations to preserve the individual’s dignity and autonomy. This chapter outlines the components and procedures associated with forensic neuropsychological assessments to help the practitioner understand the potential utility of these types of assessments and how to critically evaluate and interpret the neuropsychological findings regarding the geriatric client within the forensic setting.
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Quain, Angela, and Anne M. Comi. Sturge-Weber Syndrome and Related Cerebrovascular Malformation Syndromes. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199937837.003.0112.
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Sturge-Weber syndrome is a rare disorder presenting with a capillary malformation, better known as a port-wine birthmark, on the upper face, glaucoma, and a leptomeningeal angioma. Most children develop seizures and strokes, with variable degrees of neurodevelopmental impairments including hemiparesis, visual field deficits, cognitive deficits, epilepsy, and migraines. In 2013, a somatic activating mutation in GNAQ was identified in the capillary malformations and leptomeningeal angiomas of Sturge-Weber patients. In the diagnosis of Sturge-Weber syndrome, contrast-enhanced imaging is essential to the diagnosis of brain involvement. Functional imaging has demonstrated impaired venous drainage and a role for seizures in exacerbating perfusion deficits. Aggressive seizure management is fundamental to treatment. Some data supports the use of low-dose aspirin to reduce the occurrence of strokelike episodes and seizures.
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Butterworth, Brian, Sashank Varma, and Diana Laurillard. Dyscalculia. Edited by Roi Cohen Kadosh and Ann Dowker. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199642342.013.001.
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Recent research in cognitive and developmental neuroscience is providing a new approach to the understanding of dyscalculia that emphasizes a core deficit in understanding sets and their numerosities, which is fundamental to all aspects of elementary school mathematics. The neural bases of numerosity processing have been investigated in structural and functional neuroimaging studies of adults and children, and neural markers of its impairment in dyscalculia have been identified. New interventions to strengthen numerosity processing, including adaptive software, promise effective evidence-based education for dyscalculic learners.
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Crum, Brian A., Eduardo E. Benarroch, and Robert D. Brown. Neurologic Disorders Categorized by Anatomical Involvement. Oxford University Press, 2012. http://dx.doi.org/10.1093/med/9780199755691.003.0523.
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Neurological disorders of the brain, spine, and peripheral nervous system are examined. Symptoms and signs related to disorders of the cerebral cortex may lead to alterations in cognition and consciousness. Unilateral neurologic symptoms involving a single neurologic symptom commonly localize to the cerebral cortex. Abnormalities of speech and language are localized to the dominant cerebral hemisphere, whereas abnormalities of the nondominant hemisphere may lead to visuospatial deficits, confusion, or neglect of the contralateral side of the body. The hypothalamus is important in many functions that affect everyday steady-state conditions, including temperature regulation, hunger, water regulation, sleep, endocrine functions, cardiovascular functions, and regulation of the autonomic nervous system. Cortical and subcortical abnormalities may also lead to visual system deficits, usually homonymous visual defects of the contralateral visual field. Sensory levels, signs of anterior horn cell involvement, and long-tract signs in the posterior columns or corticospinal tract suggest a spinal cord lesion.
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Alvis, Bret, and Amy Robertson. Hepatic Encephalopathy. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0075.
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Hepatic encephalopathy is a complication of both acute and chronic liver failure. The disease can range from mild cognitive deficits to deep coma. Ammonia accumulation and inflammation are the two most accepted causes of hepatic encephalopathy. It is important to confirm an elevated serum ammonia level and rule out alternative causes of neurological derangements. Nonabsorbable disaccharides are the mainstay of treatment; however, the only definitive treatment is liver transplantation. Pertinent anesthetic considerations include avoiding benzodiazepines, understanding the implications of diminished hepatic function, and recognizing factors that may contribute to increased intracranial cerebral pressure. Proper assessment and management of the patient presenting with hepatic encephalopathy will be discussed.
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Pillai, Jagan A., and Jeffrey L. Cummings. Conclusions on Neurodegenerative Disorders. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190233563.003.0019.
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Neurodegenerative diseases strip an individual of his or her cognitive powers, functional capacity, and autonomy while increasing dependence on others. They are an existential threat to an aging society in its ability to provide a meaningful and high quality of life to all its citizens. The classical view of neurodegenerative disorders (NDDs) emphasized the distinctness of each NDD ,with a definable clinical syndrome of neurological deficits, behavioral changes, and progressive functional decline, underpinned by inexorable neuronal loss that is pathological for the age of the subject. Neurodegenerative Disorders: Unifying Principles has covered each of these themes from multiple expert domains to basic science to clinical therapeutics. This detailed overview emphasizes the work recently accomplished to uncover shared themes across NDDs and further posits questions for the future.
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Moss, Aleeze, and Diane Reibel. Mindfulness-Based Interventions for Psychiatric Disorders. Edited by Anthony J. Bazzan and Daniel A. Monti. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190690557.003.0012.
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Mindfulness-Based Interventions (MBIs) are nonpharmacological interventions that show promise for the treatment of a number of mental health conditions. This chapter describes several MBIs, specifically Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT), Dialectical Behavior Therapy (DBT) and Acceptance and Commitment Therapy (ACT) and the research that supports the efficacy of these interventions in the treatment of psychiatric disorders. MBSR and MBCT have been shown to be effective in the treatment of anxiety and depression. DBT has been shown to be effective in the treatment of borderline personality disorder and ACT effective in the treatment of obsessive-compulsive disorder. New MBIs are being developed to work specifically with populations suffering with posttraumatic stress disorder, eating disorders, addictions, and attention deficit hyperactivity disorder. Current research on neural mechanisms associated with mindfulness training and its benefits are demonstrating structural and functional changes in the brain.
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Cummings, Jeffrey L., and Jagan A. Pillai. Neurodegenerative Diseases. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190233563.003.0001.
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Neurodegenerative diseases (NDDs) are growing in frequency and represent a major threat to public health. Advances in scientific progress have made it clear that NDDs share many underlying processes, including shared intracellular mechanisms such as protein misfolding and aggregation, cell-to-cell prion-like spread, growth factor signaling abnormalities, RNA and DNA disturbances, glial cell changes, and neuronal loss. Transmitter deficits are shared across many types of disorders. Means of studying NDDs with human iPS cells and transgenic models are similar. The progression of NDDs through asymptomatic, prodromal, and manifest stages is shared across disorders. Clinical features of NDDs, including cognitive impairment, disease progression, age-related effects, terminal stages, neuropsychiatric manifestations, and functional disorders and disability, have many common elements. Clinical trials, biomarkers, brain imaging, and regulatory aspects of NDD can share information across NDDs. Disease-modifying and transmitter-based therapeutic interventions, clinical trials, and regulatory approaches to treatments for NDDs are also similar.