NEUROLOGY - LABORATORY AND CLINICAL RESEARCH DEVELOPMENTS COGNITIVE IMPAIRMENT: CAUSES, DIAGNOSIS AND TREATMENT No part of this digital document may be reproduced, stored in a retrieval system or transmitted in any form or by any means. The publisher has taken reasonable care in the preparation of this digital document, but makes no expressed or implied warranty of any kind and assumes no responsibility for any errors or omissions. No liability is assumed for incidental or consequential damages in connection with or arising out of information contained herein. This digital document is sold with the clear understanding that the publisher is not engaged in rendering legal, medical or any other professional services. NEUROLOGY – LABORATORY AND CLINICAL RESEARCH DEVELOPMENTS SERIES Intracranial Hypertension Stefan Mircea Iencean and Alexandru Vladimir Ciurea 2009 ISBN: 978-1-60741-862-7 (Hardcover Book) Intracranial Hypertension Stefan Mircea Iencean and Alexandru Vladimir Ciurea 2009 ISBN: 978-1-60876-549-2 (Online Book) Cerebral Blood Flow Regulation Nodar P. Mitagvaria and Haim (James) I. Bicher 2009 ISBN: 978-1-60692-163-0 Cerebral Ischemia in Young Adults: Pathogenic and Clinical Perspectives Alessandro Pezzini and Alessandro Padovani (Editors) 2009 ISBN: 978-1-60741-627-2 Dizziness: Vertigo, Disequilibrium and Lightheadedness Agnes Lindqvist and Gjord Nyman (Editors) 2009: ISBN 978-1-60741-847-4 Somatosensory Cortex: Roles, Interventions and Traumas Niels Johnsen and Rolf Agerskov (Editors) 2009. ISBN: 978-1-60741-876-4 Cognitive Impairment: Causes, Diagnosis and Treatment Melanie L. Landow (Editor) 2009. ISBN: 978-1-60876-205-7 NEUROLOGY - LABORATORY AND CLINICAL RESEARCH DEVELOPMENTS COGNITIVE IMPAIRMENT: CAUSES, DIAGNOSIS AND TREATMENT MELANIE L. LANDOW EDITOR Nova Biomedical Books New York Copyright © 2009 by Nova Science Publishers, Inc. All rights reserved. No part of this book may be reproduced, stored in a retrieval system or transmitted in any form or by any means: electronic, electrostatic, magnetic, tape, mechanical photocopying, recording or otherwise without the written permission of the Publisher. For permission to use material from this book please contact us: Telephone 631-231-7269; Fax 631-231-8175 Web Site: http://www.novapublishers.com NOTICE TO THE READER The Publisher has taken reasonable care in the preparation of this book, but makes no expressed or implied warranty of any kind and assumes no responsibility for any errors or omissions. No liability is assumed for incidental or consequential damages in connection with or arising out of information contained in this book. The Publisher shall not be liable for any special, consequential, or exemplary damages resulting, in whole or in part, from the readers‘ use of, or reliance upon, this material. Independent verification should be sought for any data, advice or recommendations contained in this book. In addition, no responsibility is assumed by the publisher for any injury and/or damage to persons or property arising from any methods, products, instructions, ideas or otherwise contained in this publication. This publication is designed to provide accurate and authoritative information with regard to the subject matter covered herein. It is sold with the clear understanding that the Publisher is not engaged in rendering legal or any other professional services. If legal or any other expert assistance is required, the services of a competent person should be sought. FROM A DECLARATION OF PARTICIPANTS JOINTLY ADOPTED BY A COMMITTEE OF THE AMERICAN BAR ASSOCIATION AND A COMMITTEE OF PUBLISHERS. Library of Congress Cataloging-in-Publication Data Available upon request ISBN: 978-1-61470-115-6 (eBook) Published by Nova Science Publishers, Inc. New York Contents Preface vii Chapter I Cognitive Aspects in Idiopathic Epilepsy 1 Sherifa A. Hamed Chapter II Cognitive Impairment in Children with ADHD: Developing a Novel Standardised Single Case Design Approach to Assessing Stimulant Medication Response 39 Catherine Mollica, Paul Maruff and Alasdair Vance Chapter III Novel Therapies for Alzheimer's Disease: Potentially Disease Modifying Drugs 73 Daniela Galimberti, Chiara Fenoglio and Elio Scarpini Chapter IV Cognitive Interventions to Improve Prefrontal Functions 97 Yoshiyuki Tachibana, Yuko Akitsuki and Ryuta Kawashima Chapter V Insights from Proteomics into Mild Cognitive Impairment, Likely the Earliest Stage of Alzheimer’s Disease 119 Renã A. Sowell and D. Allan Butterfield Chapter VI Animal Models for Cerebrovascular Impairment and its Relevance in Vascular Dementia 141 Veronica Lifshitz and Dan Frenkel Chapter VII The Critical Role of Cognitive Function in the Effective Self-Administration of Inhaler Therapy 161 S. C. Allen Chapter VIII Foetal Alcohol Spectrum Disorders: The 21st Century Intellectual Disability 175 Teresa Whitehurst vi Contents Chapter IX Where There are no Tests: A Systematic Approach to Test Adaptation 189 Penny Holding, Amina Abubakar and Patricia Kitsao Wekulo Chapter X Paid Personal Assistance for Older Adults with Cognitive Impairment Living at Home: Current Concerns and Challenges for the Future 201 Claudio Bilotta, Luigi Bergamaschini, Paola Nicolini, and Carlo Vergani Chapter XI Neurotoxicity, Autism, and Cognitive Impairment 211 Rebecca Cicha, Brett Holfeld and F. R. Ferraro Index 219 Preface Mild cognitive impairment, also known as incipient dementia, or isolated memory impairment, is a diagnosis given to individuals who have cognitive impairments beyond that expected for their age and education, but that do not interfere significantly with their daily activities. It is considered to be the boundary or transitional stage between normal aging and dementia. Although MCI can present with a variety of symptoms, when memory loss is the predominant symptom it is termed "amnestic MCI" and is frequently seen as a risk factor for Alzheimer's disease. Studies suggest that these individuals tend to progress to probable Alzheimer‘s disease at a rate of approximately 10% to 15% per year. Additionally, when individuals have impairments in domains other than memory it is classified as non-amnestic single- or multiple-domain MCI and these individuals are believed to be more likely to convert to other dementias. This new and important book gathers the latest research from around the globe in this field and highlights related topics such as: cognitive aspects in epilepsy, cognitive impairment in children with ADHD, therapies for Alzheimer's disease, fetal alcohol spectrum disorders, and others. Chapter I - Epilepsy is a common medical problem. Several studies suggest that idiopathic generalized or focal epilepsies can adversely affect mental development, cognition and behavior. Epileptic patients may experience reduced intelligence, attention, problems in memory, language and frontal executive functions. The exact mechanisms of epilepsy-related cognitive dysfunction are poorly understood. Cognitive deficits with epilepsy may be transient, persistent or progressive. Transient disruption of cognitive encoding processes may occur with paroxysmal focal or generalized epileptic discharges while epileptogenesis-related neuronal plasticity, reorganization, sprouting and impairment of cellular metabolism are fundamental determinants for progressive cognitive deterioration. Also antiepileptic drugs (AEDs) have differential, reversible and sometimes cumulative cognitive adverse consequences. AEDs not only reduce neuronal irritability but also may impair neuronal excitability, neurotransmitter release, enzymes and factors critical for information processing and memory. The present article serves as an overview of recent studies in cognition in adult and children patients with epilepsy. In this review, we will also discuss the known adverse mechanisms of epilepsy and AEDs on cognition. Chapter II - Cognitive difficulties are now recognized as a major driver of functional impairment in children with ADHD. However, to date, clinicians remain less aware of viii Melanie L. Landow feasible and appropriate statistical approaches to measure cognitive and behavioural change in their patients. This chapter presents a practical statistical decision making rule and then outlines a clinician-friendly study design for ascertaining stimulant medication response in children with ADHD. Chapter III - The two major neuropathologic hallmarks of Alzheimer‘s disease (AD) are extracellular Amyloid beta (A ) plaques and intracellular neurofibrillary tangles (NFTs). Several additional pathogenic mechanisms likely play a role in the pathogenesis of the disease, including inflammation, oxidative damage, ion disregulation and cholesterol metabolism. A number of compounds have been developed, trying to interfere with the above mentioned altered mechanisms. Conversely to symptomatic drugs available to date, these new compounds are supposed to modify pathological steps leading to AD, thus acting on the evolution of the disease. Some of them are under clinical testing, others are in preclinical phases of development. In this chapter, the main pathogenic steps leading to neurodegeneration will be discussed, together with an update of potentially disease- modifying drugs under testing. Chapter IV - The human prefrontal cortex (PFC) plays major roles in higher cognitive functions necessary for maintaining a healthy social life. Psychological and psychiatric problems are often associated with cognitive impairments associated with PFC. Thus, previous cognitive intervention studies have been