磷脂酰丝氨酸复合胶囊辅助改善记忆功能的研究

目的：观察磷脂酰丝氨酸复合胶囊对改善小鼠及人体学习记忆功能的影响。方法：动物实验部分，昆明种雌性小鼠随机分为低、中、高 3 个剂量组（剂量分别为 333、667、1 000mg/kg·BW）和阴性对照组，每组共计12只，每48只1个大组进行行为学实验。连续灌胃给药 30d 后，分别进行水迷宫、跳台和避暗实验。1周后，小鼠按照相同的数量和方法重复上述实验；人体实验部分，选取49~65岁且知情同意的健康退休人员随机分为试食和对照组作为研究对象，试食组57人、对照组59人，服用30d，对照组服用相同外观的软胶囊安慰剂。实验开始及结束时采用中国科学院心理研究所编制的临床记忆量表测量评估，将各分测验量表得分和记忆商进行前后和平行比较。结果：磷脂丝氨酸复合胶囊可延长小鼠跳台实验的测验潜伏期、减少跳台训练错误次数；小鼠避暗消退实验的潜伏期延长，差异均具有显著性意义（P＜0.05）。重复实验也为阳性；试食组57人服用磷脂酰丝氨酸复合胶囊后，各分测量量表得分及记忆商与实验前比较均有明显的提高，差异具有显著性（P＜0.05），与对照组比较，试食组各分测验量表分（除指向记忆）均有所提高，差异具有统计意义（P＜0.05）。总量表分和记忆商试食组试食前后差异显著，试食后均显著提高（P＜0.05）。结论：磷脂酰丝氨酸复合胶囊具有辅助改善小鼠及人体学习记忆功能的作用。 磷脂酰丝氨酸；行为实验；学习记忆；临床记忆量表     

陆军青年军人心理素质与人格、心理健康的相关研究

目的：探讨陆军青年军人心理素质与人格、心理健康的关系。方法：整群抽取陆军青年官兵881名,采用军人心理素质量袁、艾森克人格问卷（EPQ）、症状自评量表（SCL-90）进行测评,进行方差分析和相关分析。结果：（1）陆军青年军人心理素质各因子分及总分与EPQ人格问卷中的E分呈显著正相关（p〈0．01）;与N分、P分呈显著负相关（p〈0．01）。高、中、低心理素质水平军人E、P、N得分比较有显著差异（p〈0．05）,表现为在E量表得分上高心理素质组〉中等心理素质组〉低心理素质组;而在P、N量表得分上则反之。（2）陆军青年军人心理素质各因子分及总分均与SCL-90各因子分和总均分呈显著负相关（p〈0．01）。高、中、低心理素质水平军人SCL-90各因子得分比较有显著差异（p〈0．05）,表现为低心理素质组〉中等心理素质组〉高心理素质组。结论：陆军青年军人心理素质与心理健康密切相关,心理素质越高,其心理健康水平也越高。     

侧脑室旁白质病变患者认知功能损害的特点研究

目的：脑白质病变与老年认知功能障碍关系密切,尤其是深部白质病变更是血管性认知功能损害的常见危险因素,但临床上对于侧脑室旁白质病变与认知功能损害的关系研究较少,本研究旨在探讨侧脑室旁白质病变患者认知功能损害的特点。方法：选取2011年2月．2012年10月住院健康查体者159例,根据有无侧脑室旁白质病变分为脑白质病变组及对照组,根据侧脑室白质病变严重程度分为轻度组及中重度组。所有患者分别进行蒙特利尔认知评估表（MontrealCognitiveAssessment,MoCA）中文版、简易精神状态检查表（MiniMentalStateExamination,MMSE）和画钟测验（clockdrawingtest,CDT）评估。结果：脑白质病变组MMSE量表总分、CDT、MoCA量表总分及视空间、计算力、延迟回忆及空间执行功能分低于对照组,差异有统计学意义（P〈0．05）;白质病变中重度组MMSE、MoCA量表总分及计算力得分低于轻度组,差异有统计学意义（P〈0．05）。结论：本研究显示侧脑室旁白质病变患者总体认知功能评分明显低于对照组,中重度患者的计算力下降尤为突出,提示我们侧脑室旁白质病变是导致患者总体认知功能下降及计算力损害的危险因素,临床上应该提高对于侧脑室旁白质病变的重视。     

脑梗塞患者血清hs—CRP、TNF-α、血脂水平的变化及其临床意义

目的：观察脑梗塞患者血清超敏C反应蛋白（hs—CRP）、肿瘤坏死因子（TNF-α）及血脂水平的变化。并探讨其临床意义。方法：选择我院2010年6月-2012年6月收治的86例急性脑梗塞患者（轻型脑梗塞组27例、中型脑梗塞组34例、重型脑梗塞组25例）为实验组和同期40例健康体检者为对照组,检测和比较两组血清超敏C反应蛋白（hs-CRP）、肿瘤坏死因子（TNF—α）、甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白（LDL-C）和高密度脂蛋白（HDL-c）的水平,并进行相关性分析。结果：与健康对照组比较,实验纽血清hs—CRP、TNF-α及TC、TG、LDL—C水平显著升高,而血清HDL-C水平显著降低,差异均具有统计学意义（P〈0．05）。与轻型脑梗塞组比较,中、重型脑梗塞组血清hs-CRP、TNF-α及TC、TG、LDL-C等血脂水平均显著升高,而血清HDL-C水平显著降低,其异均具有统计学意义（P〈0．05）;与中型脑梗塞组比较,重型脑梗塞组血清TC、TG、LDL-C等血脂水平均显著升高,血清HDL—C水平显著降低,其差异亦均具有统计学意义（P〈0．05）。脑梗塞患者血清hs—CRP与TNF-α水平呈显著正相关（P〈0．05）,与TC、TG、LDL—C等血脂水平均亦呈显著正相关（P〈0．05）,与血清HDL—C水平呈显著负相关（P〈O．05）。脑梗塞患者血清hs．CRP、TNF-α水平与病情严重程度呈显著正相关（P〈0．05）。结论：检测血清hs-CRP、TNF-α及血脂指标水平对评估脑梗塞患者病情具有重要的临床意义。     

三七总皂苷对脊髓损伤大鼠运动功能恢复的作用

目的：探讨三七总皂苷对大鼠脊髓损伤（SCI）后运动功能恢复的作用。方法：正常SD大鼠随机分为5组（n=8）：正常对照组（Normal）、假手术组（Sham）、脊髓损伤（SCI）和脊髓损伤+三七总皂苷组（PNS）（n=8）。所有大鼠分别在造模前及造模后第1、3、7、14、21和28天接受运动功能评分（BBB）和运动诱发电位（MEP）检查,观察大鼠后肢运动功能的恢复情况。结果：造模后,Sham组、PNS组、SCI组BBB评分低于正常;MEP波幅低于正常;潜伏期较正常延长。PNS组与同期SCI组比较,第7、14、21、28天的BBB评分差异有统计学意义（P<0.05）;第7天、14天、21天、28天,MEP检查波幅（Amp）和潜伏期（Lat）组内有显著差异,并且与同期SCI组比较差异有统计学意义（P<0.05）。结论：三七总皂苷可促进大鼠SCI后运动功能的恢复。     

中青年2型糖尿病患者并发轻度认知功能障碍相关影响因素研究

摘要 目的：探究中青年2型糖尿病（T2DM）患者并发轻度认知功能障碍（MCI）的临床特点及相关影响因素。方法：选择2020年2月-2020年10月在上海交通大学医学院附属新华医院收治的中青年（18~60岁）T2DM患者,用蒙特利尔认知评估量表（MoCA）对患者进行认知功能测评,根据结果分为认知功能正常组（MoCA≥26分）和MCI组（MoCA＜26分）。收集两组患者的一般资料、生化指标以及认知功能量表得分进行两组比较,并采用Logistic回归分析中青年T2DM患者合并MCI的影响因素。结果：共收集161例中青年T2DM患者,其中认知功能正常者101例（62.73%）,MCI者60例（37.27%）。MCI组在视空间与执行能力、命名、注意、语言、抽象及延迟回忆各维度的异常率均高于认知功能正常组,差异有统计学意义（P＜0.05）,其中以延迟回忆受损（98.33%）最常见,其次为语言受损（90.00%）和抽象受损（81.67%）。两组年龄、受教育程度、糖尿病病程、糖化血红蛋白（HbA1c）比较,差异有统计学意义（P＜0.05）;以认知功能障碍作为因变量进行Logistic回归分析结果显示,糖尿病病程、HbA1c为中青年T2DM患者并发认知功能障碍的危险因素,受教育程度则是保护因素。结论：中青年T2DM患者认知功能障碍发生率较高,且以延迟回忆受损较为常见,糖尿病病程长、血糖控制不佳的中青年T2DM患者尤其需要注意认知功能的筛查。     

N-乙酰半胱氨酸对犬心房快速起搏电重构的影响

目的：探讨N-乙酰半胱氨酸（NAC）对犬心房快速起搏电重构的影响。方法：取16只犬,随机分为对照组和NAC干预组。NAC组按照15mg／kg／d剂量给予NAC口服6周时间。在犬右房置入电极,快速起搏右心房,诱发房颤并维持2小时。在起搏前后分别测定有效不应期（AERP）。结果：房颤后对照组AERP显著缩短,AERP频率适应性下降（P〈0．05）;而NAC组房颤前后AERP和AERP频率适应性均无明显变化。结论：在心房快速起搏致房颤2h的模型中,NAC对心房电重构具有明显的保护作用。     

mito KATP和κ-阿片受体介导肢体缺血后处理对抗大鼠脑缺血／复灌损伤

目的：观察肢体缺血后处理（LIPC）在大鼠局灶性脑缺血／复灌损伤中的神经保护作用及其作用机制。方法：将大鼠随机分为6组：空白对照组,单侧LIPC组,双侧LIPC组（bLIPC）,bLIPC＋mito KATP阻断剂5-lydroxydecanoate（5-HD））预处理组,bLIPC＋κ-阿片受体拮抗剂nor-binaltorphimine（nor-BNI）预处理组,bLIPC＋双侧后肢体外循环组。采用线栓法建立大鼠大脑中动脉栓塞（MCAO）模型,术后进行神经系统症状评分,血浆强啡肽和脑啡肽水平测定,大脑梗死面积测定。结果：单侧L1PC能改善大鼠局灶性脑缺血／复灌损伤后的神经系统功能评分（P〈0．05）,并减少大脑梗死面积（P〈0．01）;而双侧12PC能显著提高大鼠局灶性脑缺血／复灌损伤后的神经系统功能评分,并显著减少大脑梗死面积（P〈0．01）,比单侧LIPC的作用更为明显（P〈0．05）。双侧L／PC后5、15、30min,1和2h这五个时间点,血浆强啡肽水平显著增高（P〈0．01）,12和24h这两个时间点恢复至正常水平;而血浆脑啡肽水平的改变与双侧LIPC前比较无显著差异（P〉0．05）。nor-BNI预处理（25nmol）和5-HD预处理（10mg／kg）均消除了双侧LIPC所致的神经系统功能评分增加和大脑梗死面积减少（P〈0．01）。结论：LIPC在大鼠局灶性脑缺血／复灌损伤中具有显著的神经保护作用,其作用可能与LIPC诱导内源性阿片激动剂释放和激活mito KATP有关。     

清热化瘀Ⅱ号方结合易筋经训练对脑卒中患者血流动力学及肢体功能恢复的影响

摘要 目的：探究清热化瘀Ⅱ号方结合易筋经训练对脑卒中患者血流动力学以及肢体功能恢复的影响。方法：选取我院2020年3月至2021年2月收治的92例脑卒中患者作为研究对象,依照随机数字表法将患者分为观察组和对照组,每组46例。对照组给予西医综合治疗方案和易筋经训练,观察组给予清热化瘀Ⅱ号方结合易筋经训练,对比两组患者在治疗前后神经功能、血流动力学、上肢功能、平衡能力和生活质量的变化情况。结果：经治疗后,两组患者的改良Rankin量表积分明显降低,且观察组的神经功能指标改良Rankin量表积分明显低于对照组,达到统计学差异（P<0.05）;两组患者的血流动力学指标纤维蛋白原、血浆黏度和血小板聚集率明显降低,且观察组血流动力学指标明显低于对照组,差异具有统计学意义（P<0.05）;两组患者的上肢功能指标Fugl-Meyer运动评定量表（Fugl-Meyer motor function assessment, FMA）和简易上肢功能检查方法（Simple test for evaluating hand function, STEF）评分明显升高,且观察组的FMA和STEF评分明显高于对照组,差异达到统计学意义（P<0.05）;两组患者的平衡能力指标Berg平衡量表（Berg balance scale, BBS）评分明显升高,且观察组的BBS评分明显高于对照组,差异具有统计学意义（P<0.05）;两组患者的生活质量指标生活质量（Quality of life, QQL）量表积分明显升高,且观察组的QQL量表积分显著高于对照组,差异具有统计学意义（P<0.05）。结论：清热化瘀Ⅱ号方结合易筋经训练可有效改善脑卒中患者的血流动力学,促进肢体功能恢复,对脑卒中患者的治疗和预后具有重要参考价值。     

不同部位脑卒中患者认知功能损害的特点分析

目的：探讨不同部位缺血性脑卒中急性期患者认知功能损害的特点。方法：收集230例脑梗死急性期（1-14天）患者,包括额叶31例,颞叶27例,顶叶26例,枕叶21例,基底节47例,丘脑35例,小脑23例,脑干20例;采用中文版蒙特利尔认知评估量表（montreal cognitive assessment,MoCA）对受试者进行认知功能测评。结果：（1）各病变部位认知障碍的发生率存在显著性差异（P〈0.05）,额叶组及丘脑组认知障碍发生率最高,达90%以上,其次为颞叶组,达到80%以上,小脑组及脑干组最低,约30%左右。（2）额叶组在视空间与执行功能、注意认知域分值低于其他各组（P〈0.05）;颞叶组在命名、延迟回忆认知域分值低于其他各组;顶叶组及枕叶组MoCA总分分值低于基底节、小脑、脑干组（P〈0.05）;丘脑组不仅在视空间与执行功能、注意认知域得分低于顶叶、枕叶、基底节、小脑和脑干组,且其语言及定向认知域分值低于其他各组（P〈0.05）。结论：不同部位脑梗死患者认知障碍的发生率及认知功能损害的特点不同。     

Endoscopic surgery versus conservative treatment for the moderate-volume hematoma in spontaneous basal ganglia hemorrhage (ECMOH): study protocol for a randomized controlled trial

ABSTRACT: BACKGROUND: Spontaneous intracerebral hemorrhage is a disease with high morbidity, high disability rate, high mortality, and high economic burden. Whether patients can benefit from surgical evacuation of hematomas is still controversial, especially for those with moderate-volume hematomas in the basal ganglia. This study is designed to compare the efficacy of endoscopic surgery and conservative treatment for the moderate-volume hematoma in spontaneous basal ganglia hemorrhage. METHODS: Patients meet the criteria will be randomized into the endoscopic surgery group (endoscopic surgery for hematoma evacuation and the best medical treatment) or the conservative treatment group (the best medical treatment). Patients will be followed up at 1, 3, and 6 months after initial treatment. The primary outcomes include the Extended Glasgow Outcome Scale and the Modified Rankin Scale. The secondary outcomes consist of the National Institutes of Health Stroke Scale and the mortality. The Barthel Index(BI) will also be evaluated. The sample size is 100 patients. DISCUSSION: The ECMOH trial is a randomized controlled trial designed to evaluate if endoscopic surgery is better than conservative treatment for patients with moderate-volume hematomas in the basal ganglia.     

降纤酶治疗急性脑梗死Ⅱ期临床研究

目的探讨降纤酶治疗急性脑梗死的有效性和安全性,并进行客观评价.方法按照全国脑防办<降纤酶治疗急性脑梗死第二阶段临床再评价研究>实施方案,采用前瞻性、随机、双盲、安慰剂对照的临床研究方法,将49例符合标准的急性脑梗死患者随机分为降纤酶组和对照组.评定指标包括脑卒中的临床神经功能缺损程度评分、Barthel指数、血浆纤维蛋白原水平、副作用.结果治疗组23例,终止治疗5例,其中1例自动退出试验、2例消化道出血、1例出现皮肤大片淤斑、1例突然死亡;对照组26例,终止1例,为自动退出试验.(1)治疗组应用降纤酶后血浆纤维蛋白原水平降低与对照组比较,差异非常显著(P＜0.001).尤其用药第6天最显著;(2)治疗后14天临床神经功能缺损评分减少优于对照组,有显著性差异(P＜0.05),但第14天、3个月时Barthel指数评分并无显著差异;(3)治疗组应用降纤酶后有1例病情加重,而对照组中有4例病情加重;(4)治疗组中有2例出现上消化道出血,1例皮肤大片淤斑,而对照组无上述情况.结论降纤酶降低血浆纤维蛋白原的作用确切,对减少神经功能缺损评分疗效显著,具有抑制急性脑梗死病情进展的作用,本组无1例并发颅内出血,但有消化道出血及皮下出血,有增加出血危险性的可能.     

Action selection and refinement in subcortical loops through basal ganglia and cerebellum

Subcortical loops through the basal ganglia and the cerebellum form computationally powerful distributed processing modules (DPMs). This paper relates the computational features of a DPM's loop through the basal ganglia to experimental results for two kinds of natural action selection. First, functional imaging during a serial order recall task was used to study human brain activity during the selection of sequential actions from working memory. Second, microelectrode recordings from monkeys trained in a step-tracking task were used to study the natural selection of corrective submovements. Our DPM-based model assisted in the interpretation of puzzling data from both of these experiments. We come to posit that the many loops through the basal ganglia each regulate the embodiment of pattern formation in a given area of cerebral cortex. This operation serves to instantiate different kinds of action (or thought) mediated by different areas of cerebral cortex. We then use our findings to formulate a model of the aetiology of schizophrenia.     

Effects of venlafaxine on the expression level and methylation status of genes involved in oxidative stress in rats exposed to a chronic mild stress

Recent human and animal studies indicate that oxidative and nitrosative stress may play a role in the aetiology and pathogenesis of depression. This study investigates the effect of chronic administration of the serotonin-norepinephrine reuptake inhibitor, venlafaxine, on the expression and methylation status of SOD1, SOD2, GPx1, GPx4, CAT, NOS1 and NOS2 in the brain and blood of rats exposed to a chronic mild stress (CMS) model of depression. Separate groups of animals were exposed to CMS for 2 or 7 weeks; the second group received saline or venlafaxine (10 mg/kg/d, IP) for 5 weeks. After completion of both stress conditions and drug administration, the mRNA and protein expression of selected genes and the methylation status of their promoters were measured in peripheral mononuclear blood cells (PBMCs) and in brain structures (hippocampus, amygdala, hypothalamus, midbrain, cortex, basal ganglia) with the use of TaqMan Gene Expression Assay, Western blot and methylation-sensitive high-resolution melting techniques. CMS caused a decrease in sucrose consumption, and this effect was normalized by fluoxetine. In PBMCs, SOD1, SOD2 and NOS2 mRNA expression changed only after venlafaxine administration. In brain, CAT, Gpx1, Gpx4 and NOS1 gene expression changed following CMS or venlafaxine exposure, most prominently in the hippocampus, midbrain and basal ganglia. CMS increased the methylation of the Gpx1 promoter in PBMCs, the second Gpx4 promoter in midbrain and basal ganglia, and SOD1 and SOD2 in hippocampus. The CMS animals treated with venlafaxine displayed a significantly higher CAT level in midbrain and cerebral cortex. CMS caused an elevation of Gpx4 in the hippocampus, which was lowered in cerebral cortex by venlafaxine. The results indicate that CMS and venlafaxine administration affect the methylation of promoters of genes involved in oxidative and nitrosative stress. They also indicate that peripheral and central tissue differ in their response to stress or antidepressant treatments. It is possible that that apart from DNA methylation, a crucial role of expression level of genes may be played by other forms of epigenetic regulation, such as histone modification or microRNA interference. These findings provide strong evidence for thesis that analysis of the level of mRNA and protein expression as well as the status of promoter methylation can help in understanding the pathomechanisms of mental diseases, including depression, and the mechanisms of action of drugs effective in their therapy.     

Dopamine modulation in the basal ganglia locks the gate to working memory

The prefrontal cortex and basal ganglia are deeply implicated in working memory. Both structures are subject to dopaminergic neuromodulation in a way that exerts a critical influence on the proper operation of working memory. We present a novel network model to elucidate the role of phasic dopamine in the interaction of these two structures in initiating and maintaining mnemonic activity. We argue that neuromodulation plays a critical role in protecting memories against both internal and external sources of noise. Increases in cortical gain engendered by prefrontal dopamine release help make memories robust against external distraction, but do not offer protection against internal noise accompanying recurrent cortical activity. Rather, the output of the basal ganglia provides the gating function of stabilization against noise and distraction by enhancing select memories through targeted disinhibition of cortex. Dopamine in the basal ganglia effectively locks this gate by influencing the stability of up and down states in the striatum. Dopamine's involvement in affective processing endows this gating with specificity to motivational salience. We model a spatial working memory task and show that these combined effects of dopamine lead to superior performance. Action editor: Misha V. Tsodyks     

HIV-infected macrophages mediate neuronal apoptosis through mitochondrial glutaminase

A significant number of patients infected with human immunodeficiency virus-1 (HIV-1) suffer cognitive impairment ranging from mild to severe HIV-associated dementia (HAD), a result of neuronal degeneration in the basal ganglia, cerebral cortex and hippocampus. Mononuclear phagocyte dysfunction is thought to play an important role in the pathogenesis of HAD. Glutamate neurotoxicity is triggered primarily by massive Ca²⁺ influx arising from over-stimulation of the NMDA subtype of glutamate receptors. The underlying mechanisms, however, remain elusive. We have tested the hypothesis that mitochondrial glutaminase in HIV-infected macrophages is involved in converting glutamine to glutamate. Our results demonstrate that the concentration of glutamate in HIV-1 infected conditioned media was dependent on glutamine dose, and HIV-1 infected conditioned medium mediated glutamine-dependent neurotoxicity. These results indicate HIV-infection mediates neurotoxicity through glutamate production. In addition, glutamate-mediated neurotoxicity correlated with caspase activation and neuronal cell cycle re-activation. Inhibition of mitochondrial glutaminase diminished the HIV-induced glutamate production, and attenuated NMDA over-stimulation and subsequent neuronal apoptosis. These data implicate mitochondrial glutaminase in the induction of glutamate-mediated neuronal apoptosis during HIV-associated dementia, and provides a possible therapeutic strategy for HAD treatment.     

Microstructural Changes in the Striatum and Their Impact on Motor and Neuropsychological Performance in Patients with Multiple Sclerosis

Grey matter (GM) damage is a clinically relevant feature of multiple sclerosis (MS) that has been previously assessed with diffusion tensor imaging (DTI). Fractional anisotropy (FA) of the basal ganglia and thalamus might be increased in MS patients, and correlates with disability scores. Despite the established role of the striatum and thalamus in motor control, mood and cognition, the impact of DTI changes within these structures on motor and neuropsychological performance has not yet been specifically addressed in MS. We investigated DTI metrics of deep GM nuclei and their potential association with mobility and neuropsychological function. DTI metrics from 3T MRI were assessed in the caudate, putamen, and thalamus of 30 MS patients and 10 controls. Sixteen of the patients underwent neuropsychological testing. FA of the caudate and putamen was higher in MS patients compared to controls. Caudate FA correlated with Expanded Disability Status Scale score, Ambulation Index, and severity of depressive symptomatology. Putamen and thalamus FA correlated with deficits in memory tests. In contrast, cerebral white matter (WM) lesion burden showed no significant correlation with any of the disability, mobility and psychometric parameters. Our findings support evidence of FA changes in the basal ganglia in MS patients, as well as deep GM involvement in disabling features of MS, including mobility and cognitive impairment. Deep GM FA appears to be a more sensitive correlate of disability than WM lesion burden.     

The Importance of Intentionality in Accurate and Complete Text Recall; (Comparative Study of Mentally Retarded and Normal Schoolchildren)

Viewed from the perspective of their standpoint on the significance of intention for memory and recall, theories of memory in bourgeois psychology may be divided into two groups. One group completely disregards the role of intention in memory and recall. For example, it follows necessarily from Ebbinghaus's associationist theory that memory and recall take place independently of the intention of the subject and depend exclusively on the multiple repetition of what is contained in consciousness.     

Task-Specific and General Cognitive Effects in Chiari Malformation Type I

Objective

Our objective was to use episodic memory and executive function tests to determine whether or not Chiari Malformation Type I (CM) patients experience cognitive dysfunction.

Background

CM is a neurological syndrome in which the cerebellum descends into the cervical spine causing neural compression, severe headaches, neck pain, and number of other physical symptoms. While primarily a disorder of the cervico-medullary junction, both clinicians and researchers have suspected deficits in higher-level cognitive function.

Design and Methods

We tested 24 CM patients who had undergone decompression neurosurgery and 24 age- and education-matched controls on measures of immediate and delayed episodic memory, as well as three measures of executive function.

Results

The CM group showed performance decrements relative to the controls in response inhibition (Stroop interference), working memory computational speed (Ospan), and processing speed (automated digit symbol substitution task), but group differences in recall did not reach statistical significance. After statistical control for depression and anxiety scores, the group effects for working memory and processing speed were eliminated, but not for response inhibition. This response inhibition difference was not due to overall general slowing for the CM group, either, because when controls'' data were transformed using the linear function fit to all of the reaction time tasks, the interaction with group remained statistically significant. Furthermore, there was a multivariate group effect for all of the response time measures and immediate and delayed recall after statistical control of depression and anxiety scores.

Conclusion

These results suggest that CM patients with decompression surgery exhibit cognitive dysfunction compared to age- and education-matched controls. While some of these results may be related to anxiety and depression (likely proxies for chronic pain), response inhibition effects, in particular, as well as a general cognitive deficit persisted even after control for anxiety and decompression.