Korsakoff Centre of Expertise Atlant, Beekbergen, The Netherlands.
Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.
Clin Neuropsychol. 2020 May;34(4):740-754. doi: 10.1080/13854046.2020.1738554. Epub 2020 Mar 19.
: Patients with Korsakoff's syndrome (KS) show executive dysfunction and neuropsychiatric symptoms. This study investigates whether specific executive subcomponents (shifting, updating, and inhibition) predict variance in neuropsychiatric symptoms. We hypothesized that shifting deficits, in particular, are associated with neuropsychiatric symptoms.: Forty-seven patients participated (mean age 61.5; 11 women). Executive function (EF) was measured using six component-specific tasks. Neuropsychiatric symptoms were measured with the Neuropsychiatric Inventory - Questionnaire (NPI-Q). General cognitive functioning was assessed with the Montreal Cognitive Assessment (MoCA). First, factor analysis was conducted to examine shared variance across the EF tasks. Subsequently, a regression analysis was performed with the EF factors and the MoCA as predictors and the NPI-Q as the dependent variable. It was also investigated whether an interaction effect between the EF factors and the MoCA was present.: The prevalence of neuropsychiatric symptoms was high (85.7% of the KS patients showed at least one symptom). A two-factor model was extracted with a shifting-specific factor and a combined updating/inhibition factor. The overall regression model was not significant, and no interaction was found between the EF factors and general cognitive functioning. However, a significant relationship between general cognitive functioning and neuropsychiatric symptoms ( = -.43; <.01) was detected. Results point at an association between neuropsychiatric symptoms and general cognitive functioning. Possibly, diminished cognitive differentiation in these patients with severe cognitive dysfunction accounts for the absence of a significant association between EF and neuropsychiatric symptoms. While the results should be interpreted with caution due to a limited sample size, the found association highlights the need to further unravel the underlying cognitive mechanisms of neuropsychiatric symptoms in patients with KS.
: 科萨科夫氏综合征(KS)患者表现出执行功能障碍和神经精神症状。本研究旨在探讨特定的执行子成分(转换、更新和抑制)是否能预测神经精神症状的变化。我们假设,特别是转换缺陷与神经精神症状有关。: 共有 47 名患者参与(平均年龄 61.5 岁,女性 11 人)。使用六项特定于组件的任务来衡量执行功能(EF)。神经精神症状使用神经精神疾病问卷(NPI-Q)进行测量。一般认知功能使用蒙特利尔认知评估(MoCA)进行评估。首先,进行因子分析以检查 EF 任务之间的共同方差。随后,进行回归分析,以 EF 因素和 MoCA 作为预测变量,以 NPI-Q 作为因变量。还研究了 EF 因素与 MoCA 之间是否存在交互作用。: 神经精神症状的患病率很高(85.7%的 KS 患者表现出至少一种症状)。提取出一个具有转换特异性因子和更新/抑制综合因子的两因素模型。总体回归模型不显著,EF 因素和一般认知功能之间也没有发现交互作用。然而,检测到一般认知功能与神经精神症状之间存在显著关系(=-.43;<.01)。结果表明,神经精神症状与一般认知功能之间存在关联。可能是这些严重认知功能障碍患者的认知分化能力下降,导致 EF 与神经精神症状之间没有显著关联。由于样本量有限,结果应谨慎解释,但所发现的关联突出表明需要进一步阐明 KS 患者神经精神症状的潜在认知机制。