problems in addition to the signs of the Wernicke-Korsakoff syndrome. Many of the patients were closely examined over long periods and the authors make the point that repeated examinations for as long as ten years in some instances allowed them to describe the natural history of the syndrome. and this they do in their third chapter. Again the description of the pathological findings is precise and comprehensive and the authors stress the periventricular distribution of the lesions and their bilateral symmetry. The authors consider specifically the neuropathological substrate on which are based the defective memory, ocular motor signs, the ataxia, the global confusional state and the occasional disturbance of olfactory and gustatory function. They argue a unity between Wernicke's disease and Korsakoff's psychosis and discuss the relationship between these two and alcoholic cerebellar degeneration, central pontine myelinolysis and other myelinolytic syndromes and interestingly discuss the problem of \"alcoholic dementia\" concluding that the nosological status ofalcoholic dementia is by

https://jnnp.bmj.com/content/jnnp/52/10/1218.2.full.pdf

Neuropsychology Mental Structure

Executive function and PTSD: disengaging from trauma.

Cognitive deficits are now widely recognized to be an important component of anxiety. In particular, anxiety is thought to restrict the capacity of working memory by competing with task-relevant processes. The evidence for this claim, however, has been mixed. Although some studies have found restricted working memory in anxiety, others have not. Within studies that have found impairments, there is little agreement regarding the boundary conditions of the anxiety/WMC association. The aim of this review is to critically evaluate the evidence for anxiety-related deficits in working memory capacity. First, a meta-analysis of 177 samples (N = 22,061 individuals) demonstrated that self-reported measures of anxiety are reliably related to poorer performance on measures of working memory capacity (g = -.334, p < 10-29). This finding was consistent across complex span (e.g., OSPAN; g = -.342, k = 30, N = 3,196, p = .000001), simple span (e.g., digit span; g = -.318, k = 127, N = 17,547, p < 10-17), and dynamic span tasks (e.g., N-Back; g = -.437, k = 20, N = 1,318, p = .000003). Second, a narrative review of the literature revealed that anxiety, whether self-reported or experimentally induced, is related to poorer performance across a wide variety of tasks. Finally, the review identified a number of methodological limitations common in the literature as well as avenues for future research. (PsycINFO Database Record

Anxiety and working memory capacity: A meta-analysis and narrative review.

Posttraumatic stress disorder (PTSD) is associated with regional alterations in brain structure and function that are hypothesized to contribute to symptoms and cognitive deficits associated with the disorder. We present here the first systematic meta-analysis of neurocognitive outcomes associated with PTSD to examine a broad range of cognitive domains and describe the profile of cognitive deficits, as well as modifying clinical factors and study characteristics. This report is based on data from 60 studies totaling 4,108 participants, including 1,779 with PTSD, 1,446 trauma-exposed comparison participants, and 895 healthy comparison participants without trauma exposure. Effect-size estimates were calculated using a mixed-effects meta-analysis for 9 cognitive domains: attention/working memory, executive functions, verbal learning, verbal memory, visual learning, visual memory, language, speed of information processing, and visuospatial abilities. Analyses revealed significant neurocognitive effects associated with PTSD, although these ranged widely in magnitude, with the largest effect sizes in verbal learning (d = -.62), speed of information processing (d = -.59), attention/working memory (d = -.50), and verbal memory (d =-.46). Effect-size estimates were significantly larger in treatment-seeking than community samples and in studies that did not exclude participants with attention-deficit/hyperactivity disorder, and effect sizes were affected by between-group IQ discrepancies and the gender composition of the PTSD groups. Our findings indicate that consideration of neuropsychological functioning in attention, verbal memory, and speed of information processing may have important implications for the effective clinical management of persons with PTSD. Results are further discussed in the context of cognitive models of PTSD and the limitations of this literature. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

A quantitative meta-analysis of neurocognitive functioning in posttraumatic stress disorder.

As of December 2012, Operation Enduring Freedom (OEF) in Afghanistan and Operation Iraqi Freedom (OIF) in Iraq have resulted in the deployment of about 22 million troops; there have been 2,222 US fatalities in OEF and Operation New Dawn (OND)1 and 4,422 in OIF The numbers of wounded US troops exceed 16,000 in Afghanistan and 32,000 in Iraq In addition to deaths and morbidity, the operations have unforeseen consequences that are yet to be fully understoodIn contrast with previous conflicts, the all-volunteer military has experienced numerous deployments of individual service members; has seen increased deployments of women, parents of young children, and reserve and National Guard troops; and in some cases has been subject to longer deployments and shorter times at home between deployments Numerous reports in the popular press have made the public aware of issues that have pointed to the difficulty of military personnel in readjusting after returning from Iraq and Afghanistan Many of those who have served in OEF and OIF readjust with few difficulties, but others have problems in readjusting to home, reconnecting with family members, finding employment, and returning to schoolIn response to the return of large numbers of veterans from Iraq and Afghanistan with physical-health and mental-health problems and to the growing readjustment needs of active duty service members, veterans, and their family members, Congress included Section 1661 of the National Defense Authorization Act for fiscal year 2008 That section required the secretary of defense, in consultation with the secretary of veterans affairs, to enter into an agreement with the National Academies for a study of the physical-health, mental-health, and other readjustment needs of members and former members of the armed forces who were deployed in OIF or OEF, their families, and their communities as a result of such deploymentThe study consisted of two phases The Phase 1 task was to conduct a preliminary assessment The Phase 2 task was to provide a comprehensive assessment of the physical, psychologic, social, and economic effects of deployment on and identification of gaps in care for members and former members, their families, and their communities The Phase 1 report was completed in March 2010 and delivered to the Department of Defense (DOD), the Department of Veterans Affairs (VA), and the relevant committees of the House of Representatives and the Senate The secretaries of DOD and VA responded to the Phase 1 report in September 2010 Returning Home from Iraq and Afghanistan: Assessment of Readjustment Needs of Veterans, Service Members, and Their Families fulfills the requirement for Phase 2

Returning Home from Iraq and Afghanistan: Preliminary Assessment of Readjustment Needs of Veterans, Service Members, and Their Families

Executive function and memory in posttraumatic stress disorder: a study of Bosnian war veterans.

A previous study of ours (Koso & Hansen, 2006) indicated remarkably large decrements in neuropsychological functioning in Bosnian war veterans with posttraumatic stress syndrome (PTSD). The present study assessed attention (Sustained Attention to Response Task), executive function (Trail Making Test), and memory (Rivermead Behavioural Memory Test) in an additional group of veterans with (n = 45) or without (n = 34) PTSD. Replicating our prior study, sizeable performance decrements were observed. Furthermore, multivariate analyses revealed that (a) good verbal IQ partly buffered against the harmful effect of PTSD on more fluid cognitive functions, (b) cognitive impairment was related to PTSD symptom severity (Posttraumatic Diagnostic Scale scores) and to (c) difficulties in everyday cognitive functioning (Cognitive Failures Questionnaire scores).

/pdf/neuropsychological-performance-psychiatric-symptoms-and-qt4avfbj0c.pdf

Maida Koso

Papers

Executive function and memory in posttraumatic stress disorder: a study of Bosnian war veterans.

Neuropsychological performance, psychiatric symptoms, and everyday cognitive failures in Bosnian ex-servicemen with posttraumatic stress disorder