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5 results

  • Clinical validation of the WMS-IV-NL brief cognitive status exam (BCSE) in older adults with MCI or dementia

  • Zita Bouman, Marc P. H. Hendriks, Albert P. Aldenkamp, Roy P. C. Kessels
  • Journal:
    International Psychogeriatrics / Volume 27 / Issue 2 / February 2015
    Published online by Cambridge University Press:
    31 July 2014, pp. 221-229
  • Background:

    The Brief Cognitive Status Exam (BCSE) is a new, optional subtest of the Wechsler Memory Scale-IV (WMS-IV) developed for rapid detection of cognitive deficits. We examined the clinical validation of the Dutch version of the BCSE in older adults with mild cognitive impairment (MCI) or dementia, comparing it to the Mini-Mental State Examination (MMSE).

    Method:

    BCSE and MMSE were administered in 39 older adults with MCI, 51 with dementia and 96 matched healthy controls.

    Results:

    Our results show that the BCSE is a valid screening instrument, with psychometric properties similar to the widely used MMSE. High correlations were found between the BCSE and MMSE (r = 0.79, n = 183, p < 0.001). Furthermore, a BCSE cut-off score ≤ 42 revealed a sensitivity of 96% a specificity of 92%, a positive predictive value of 86% and a negative predictive value of 97%, whereas the MMSE cut-off score of ≤ 24 showed values of 84%, 96%, 91%, and 92%, respectively. Sensitivity, specificity, positive and negative predictive values to detect MCI compared to controls was 81%, 80%, 61%, and 92%, respectively, on the BCSE, with a cut-off score of ≤ 46, and 84%, 76%, 57%, and 92%, respectively, on the MMSE, with a cut-off score of ≤ 27.

    Conclusions:

    The Dutch version of the BCSE is a clinically valid screening instrument for the detection of cognitive impairment in patients with dementia. Nevertheless, for distinguishing older adults with MCI from healthy controls both the BCSE and MMSE have limitations.

  • Chapter 15 - Antiepileptic drugs and cognitive disorders

  • Edited by Michael R. Trimble, Institute of Neurology, London, Bettina Schmitz
  • Book:
    The Neuropsychiatry of Epilepsy
    Published online:
    07 October 2011
    Print publication:
    09 June 2011, pp 153-164

  • Summary

    Depression in epilepsy represents a frequently encountered psychiatric comorbidity that is likely to be related to a number of variables that are both biological and psychosocial. Current literature on the neurobiology of depression in epilepsy has focused on frontal lobe dysfunction. Modern studies of interictal psychiatric disorders of epilepsy have usually attempted to identify their similarities to the psychiatric disorders that meet current classificatory systems. In the interictal dysphoric disorder, eight key symptoms, grouped in three major categories, are identified: labile depressive symptoms, labile affective symptoms, and supposedly specific symptoms (paroxysmal irritability and euphoric moods). A specific instrument, named Interictal Dysphoric Disorder Inventory (IDDI), has been developed in the context of a collaborative German-Italian study. One of the most frequent methodological errors in studies of depression in epilepsy is the sole reliance on screening instruments for the diagnosis of depressive disorders.

  • 22 - Cognitive side-effects due to antiepileptic drug combinations and interactions

  • from Part IV - Drug interactions in specific patient populations and special conditions
    • By Albert P. Aldenkamp, Department of Neurology, University Hospital of Maastricht, The Netherlands; Department of Behavioral Science, Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands; University of Amsterdam, SCI Kohnstamm Research Institute, Amsterdam, The Netherlands, Mark de Krom, Department of Neurology, University Hospital of Maastricht, The Netherlands, Irene Kotsopoulos, Department of Neurology, University Hospital of Maastricht, The Netherlands, Jan Vermeulen, Epilepsy centre SEIN, Heemstede, The Netherlands
  • Edited by Jerzy Majkowski, Blaise F. D. Bourgeois, Harvard University, Massachusetts, Philip N. Patsalos, Institute of Neurology, London, Richard H. Mattson, Yale University, Connecticut
  • Book:
    Antiepileptic Drugs
    Published online:
    07 September 2009
    Print publication:
    26 May 2005, pp 403-418

  • Summary

    This chapter reviews some of our knowledge about a specific subgroup of central nervous system (CNS)-related chronic side-effects of antiepileptic drug (AED) treatment, that is, cognitive side-effects: the adverse effects of drug treatment on information-processing systems. Cognitive AED effects may be examined through an analysis of the relationship between test scores of subjects and their individual serum drug levels, and this approach seems to offer a way out of the problem. Although the psychometric studies generally show a tendency of cognitive impairments in polytherapy compared to monotherapy, this merely suggests a drug interaction effect. Systematic analysis of subjective patients complaints about side-effects of AEDs show that the impact of side-effects may be larger than hitherto suspected both in number of patients involved and the frequency of the complaints. Formal psychometric studies are much more difficult to interpret, especially when formal scientific standards in line with evidence-based medicine are applied.

  • 17 - Antiepileptic drug treatment and epileptic seizures – effects on cognitive function

  • Edited by Michael Trimble, Institute of Neurology, London, Bettina Schmitz, Humboldt-Universität zu Berlin
  • Book:
    The Neuropsychiatry of Epilepsy
    Published online:
    05 October 2010
    Print publication:
    29 August 2002, pp 256-265

  • Summary

    Introduction

    One of the consequences of epilepsy is impairment of cognitive function and memory impairments, mental slowing and attentional deficits are the most frequent disorders (Aldenkamp et al., 1995a; Dodson and Trimble, 1994). Sometimes such cognitive consequences are more debilitating for the individual patients than the seizures.

    The exact causes of cognitive impairment in epilepsy have not been explored fully, but clearly three factors are involved: aetiology, the seizures and the ‘central’ side effects of treatment (Dodson and Pellock, 1993). Aetiology-related factors are often clear, are separate from epilepsy or concern a small group; especially in the age-dependent encephalopathies, such as the West syndrome (Berg and Shinnar, 1997).

    We concentrate here on the cognitive effects of seizures and antiepileptic drug treatment. When evaluating these factors it is imperative to realize that in practice most cognitive problems have a multifactorial origin and the three aforementioned factors combined are responsible for most of the ‘make-up’ of a cognitive problem in an individual patient. Moreover the factors are related, which causes therapeutic dilemmas when seizure control can only be achieved with treatments that are associated with cognitive side effects. Nonetheless, these factors are discussed here separately and sequentially. In the last paragraph the overall impact of the factors combined is discussed.

    Cognitive side effects of antiepileptic drugs

    Treatment of seizures requires antiepileptic drug (AED) treatment for the large majority of patients and may be accompanied by unwanted effects on cognitive function.