OBJECTIVE: To develop an evaluation tool of cognitive perceptual function for safe driving of the brain injured patients and to check the suitability of the tool. METHOD: Cognitive Perceptual Assessment for Driving (CPAD) was constructed with 8 tasks of depth perception, sustained attention, divided attention, Stroop test, digit span test, field dependence, trail making test A, and trail making test B. The predriving assessment with CPAD and road test were applied to 101 brain injured patients. The reliability and the validity of CPAD, and the cut-off score to resume driving were determined. RESULTS: The CPAD scores of pass group (n=46) and fail group (n=55) for on-road test were 51.67+/-5.53 and 44.30+/-8.44 respectively (p=0.0001). The internal consistency of the CPAD measured by Cronbach's alpha was 0.85. The cut-off score based on 95% confidence interval was 53 or above for pass group, 42 or below for fail group, 43~52 for borderline group. The positive and negative predictive value was 90.7% and 50.3%, respectively. CONCLUSION: The CPAD could be useful for the evaluation of driving ability of persons with brain injury.
Brain Injuries* ; Brain* ; Cognition ; Depth Perception ; Humans ; Stroop Test ; Trail Making Test

OBJECTIVES: Previous studies reported that attention-deficit hyperactivity disorder (ADHD) resulted from a deficit of selective attention and sustained attention. In this study, we assessed the result of methylphenidate-induced changes of the cerebral frontal executive functions in patients with ADHD. METHODS: The subjects in this study consisted of 16 ADHD patients whose age ranged from 7 to 12. We used ADHD Diagnostic System (ADS) for the attention improvement, and the Stroop Test for the executive function response to pharmacotherapy with MPH. RESULTS: After pharmacotherapy with methylphenidate for 12 weeks, the study group showed improvement in the clinical aspects through Clinical Global Impression-Severity, ADHD-rating scale and Inattention/Overactivity With Aggression Conner's Parents Rating Scale. In the ADS test, only in auditory task there was a decrease of both the response time and the standard deviation of the response time significantly. In the Stroop Test, there was a decrease in the word task, color task and color-word task significantly. CONCLUSION: Our results show that psychostimulant medication improves neuropsychological function, including the cerebral frontal executive function. This study implies that we have to consider the improvement of executive function, as well as attention when evaluating the efficacy of treatment.
Adolescent* ; Aggression ; Child* ; Drug Therapy ; Executive Function ; Humans ; Methylphenidate ; Parents ; Reaction Time ; Stroop Test

OBJECTIVE: To investigate the effects of transcranial direct current stimulation (tDCS) applied over the prefrontal cortex on the improvement of verbal, visuospatial working memory and naming in healthy adults. METHOD: Thirty two healthy adults (15 males and 17 females, mean age 37.3+/-13.0 years) were enrolled in this study. The subjects were divided into four groups randomly. They underwent sham or anodal tDCS over the left or right prefrontal cortex, for 20 minutes at a direct current of 1 mA. Before and immediately after tDCS, the subjects performed the Korean version of the mini-mental state exam (K-MMSE) and stroop test (color/word/interference) for the screening of cognitive function. For working memory and language evaluation, the digit span test (forward/backward), the visuospatial attention test in computer assisted cognitive program (CogPack(R)) and the Korean-Boston Naming Test (K-BNT) were assessed before tDCS, immediately after tDCS, and 2 weeks after tDCS. RESULTS: The stroop test (word/interference), backward digit span test and K-BNT were improved in the left prefrontal tDCS group compared with that of the sham group (p<0.05). The stroop test (interference) and visuospatial attention test were in the right prefrontal tDCS group compared with that of the sham group (p<0.05). Their improvement lasted for 2 weeks after stimulation. CONCLUSION: tDCS can induce verbal working memory improvement and naming facilitation by stimulating the left prefrontal cortex. It can also improve the visuospatial working memory by stimulating the right prefrontal cortex. Further studies which are lesion and symptom specific tDCS treatment for rehabilitation of stroke can be carried out.
Adult ; Female ; Humans ; Male ; Mass Screening ; Memory, Short-Term ; Prefrontal Cortex ; Salicylamides ; Stroke ; Stroop Test

BACKGROUND: This study was conducted to examine the effects of normal aging and cerebral pathology on the prospective memory and the relationships between the prospective memory and frontal lobe functions. METHODS: The subjects were 30 college students, 30 normal elderly, and 30 Parkinson's disease patients. There was no significant difference in the mean age or education level between the normal elderly and Parkinson's disease patients. The Cambridge Prospective Memory Test and the Prospective and Retrospective Memory Questionnaire were administered to evaluate the prospective memory. The Seoul Verbal Learning Test and Rey Complex Figure Test were given to assess the verbal and visual episodic memories. The subjects also took the Sorting Test, the Korean-Color Word Stroop Test, and the Iowa Gambling Task to assess the frontal lobe functions. RESULTS: The results showed that the prospective memory declines with aging and pathological process. The normal elderly showed significantly lower scores on the time-based prospective memory than the event-based prospective memory, although the college students and Parkinson's disease patients did not show any differences between them. Many significant correlations were found between the prospective memory tests and frontal lobe tests in the normal elderly and Parkinson's disease patients, although only a few correlations were found in the college students. CONCLUSIONS: These quantitative and qualitative changes in the prospective memory by aging and frontal lobe dysfunction would support the de-differentiation hypothesis of aging.
Aged ; Aging ; Frontal Lobe ; Gambling ; Humans ; Iowa ; Memory ; Memory, Episodic ; Parkinson Disease ; Stroop Test ; Verbal Learning

OBJECTIVES: The objective of this study was to investigate the relationship of the Comprehensive Attention (CAT), Stoop Color-Word (STROOP), Children's Color Trails (CCTT), and Wisconsin Card Sorting Tests (WCST) in evaluating the executive function in attention-deficit/hyperactivity disorder (ADHD). METHODS: A total of 197 children and adolescents with ADHD (mean age 10.4+/-3.2 years, 173 boys) and 62 without ADHD (mean age 11.8+/-3.5 years, 48 boys) have completed the Swanson, Nolan, and Pelham-IV questionnaire (SNAP-IV), and also the CAT, STROOP, CCTT and WCST. RESULTS: The selective, sustained, divided attention and Flanker tests of the CAT significantly discriminated between the ADHD and non-ADHD groups. The results of the CCTT were significantly correlated with the results of the CAT only in the ADHD group. The results of the STROOP were associated with selective, sustained, divided attention and Flanker tests. The results of the WCST were significantly correlated with the scores of the Working Memory subtest of the CAT only in the non-ADHD group. CONCLUSION: The results of this study suggest that the CAT has strong discriminant validity and moderate concurrent validity. The CAT could be a tool for the evaluation of the executive function of ADHD.
Adolescent ; Animals ; Cats ; Child ; Executive Function ; Humans ; Memory, Short-Term ; Surveys and Questionnaires ; Stroop Test ; Wisconsin

OBJECTIVES: This study was conducted in order to examine the reliability and validity of the Children's Color Trails Test (CCTT). The objective of the study was also to provide the Korean normative data for the CCTT. METHODS: Normative samples consisted of 766 children and adolescents living in Seoul and aged from 5 to 15 years. Eighty children who were diagnosed with ADHD, based on the DSM-IV criterion, were recruited from Seoul National University Children's Hospital. Among them, 46 ADHD children were receiving medication, while 34 children were drug-free. RESULTS: The scores of the CCTT were significantly correlated with those of the Stroop test. Three factors were extracted through factor analysis.visual tracking and cognitive flexibility, distractibility and susceptibility to interference, and simple attention and impulsivity. The completion time of the CCTT for all children tended to decrease as age increased. There were significant differences in the CCTT scores between the ADHD group receiving medication, the ADHD-drug free group and the normal groups. The CCTT also showed sound test-retest reliability. These results confirmed the relia-bility and validity of the CCTT. Finally, we provided the Korean normative data for the CCTT. CONCLUSION: These results suggest that the CCTT is a reliable and valid test, which can be used to assess frontal function related to child psychiatric disorders in Korean children.
Adolescent ; Aged ; Child ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Pliability ; Reproducibility of Results ; Stroop Test ; Track and Field

OBJECTIVES: Clinical studies have shown cognitive dysfunctions and soft neurological signs in schizophrenic patients and these findings have been suggested as evidence of organic bases in the pathophysiology of schizophrenia. This study was intended to investigate the characteristics of cognitive deficits and soft neurological signs in schizophrenia and, to determine whether any abnormality in these functions can be regarded as a trait marker of the illness which is independent of antipsychotic treatment and clinical improvement. We also investigated the correlation between cognitive deficits and soft neurological signs reflecting cognitive dysmetria, respectively. METHODS: Twenty schizophrenic patients were assessed for the soft neurological signs and cognitive functions before and after neuroleptic treatment. The patients had been medicated for at least 3 weeks with one of the atypical neuroleptics. Cognitive functions were evaluated by Trail making A, B, Stroop test and Word fluency test. Soft neurological signs were assessed by Cambridge Neurological Inventory(Part 2). Positive and Negative Syndrome Scale(PANSS) and Clinical Global Impression(CGI) were used to assess the clinical severity and Extrapyramidal Symtoms Rating Scale was used to estimate the extrapyramidal symptoms. Cognitive functions and soft neurological signs of twenty normal controls were assessed with the same scale. RESULTS: Before treatment, schizophrenic patients showed significant impairments on cognitive function tests(Trail Making A, B, Stroop Test) and soft neurological sign tests(8 items:Grasp reflex, Go/no-go, Finger thumb opposition, Rhythm tapping, Finger agnosia, Fist-edge-palm, Left-right orientation, Extinction). Although significant clinical improvements were observed after the treatment, there were no significant changes in cognitive functions and soft neurological signs(except for Go/no-go test and Finger agnosia). Among the soft neurological signs of the patients, abnormality in Rhythm tapping was significantly correlated with cognitive deficits. CONCLUSION: Schizophrenic patients showed characteristic cognitive deficits and soft neurological signs which were independent of medication and clinical symptoms. And these two characteristics were partly correlated with each other.
Agnosia ; Antipsychotic Agents ; Cerebellar Ataxia ; Fingers ; Humans ; Reflex ; Schizophrenia ; Stroop Test ; Thumb

OBJECTIVES: Children with attention-deficit hyperactivity disorder (ADHD) have been shown to display more inhibitory deficits and executive function deficits. This study investigated the treatment effects of neurofeedback (NF) training on executive function by comparing the results of neuropsychological tests of the trained children at pre- and post-training. METHODS: Fifteen children with ADHD, aged 6 to 14 years, participated in the study. The NF treatment consisted of slow cortical potential (SCP) training and these sessions took place once a week. The ADHD children performed 20 sessions of NF training within 6 months. Pre-training and post-training assessments encompassed Continuous Performance Test (CPT), Stroop Test, Children's Color Trails Test I&II (CCTT) and Wisconsin Card Sorting Test (WCST). RESULTS: Patients receiving NF training showed significant improvement in visual commission error and standard deviation of auditory response time on CPT ; and total errors on WCST. But there was no significant improvement in the Stroop test and CCTT. CONCLUSION: SCP training using NF improves the self-regulatory capacities and impulsivity in ADHD patient, especially impulsivity in visual stimulation tasks. This study showed evidence of clinical efficacy of NF on executive function in ADHD.
Child ; Executive Function* ; Humans ; Impulsive Behavior ; Neurofeedback* ; Neuropsychological Tests ; Photic Stimulation ; Reaction Time ; Stroop Test ; Wisconsin

OBJECTIVE: This open-label study examined the effects of ramelteon on cognitive functions in 10 outpatients with schizophrenia. METHODS: Ramelteon (8 mg/day) was administered to 10 patients with schizophrenia for six months. The verbal fluency test, Trail-Making Test, the Wisconsin Card Sorting Test, the Stroop Test, the Digit Span Distraction Test, Iowa Gambling Task, the Rey Auditory Verbal Learning Test were evaluated at baseline and 6 months after treatment with ramelteon. RESULTS: Ramelteon improved significantly the scores of Rey Auditory Verbal Learning Test. Additionally, ramelteon exerted improvements in the verbal fluency and Iowa Gambling Task in 4 patients. CONCLUSION: Ramelteon could be a potential therapeutic drug, in adjunctive treatment of learning and memory deficits seen in patients with schizophrenia.
Gambling ; Humans ; Iowa ; Learning ; Memory Disorders ; Outpatients ; Schizophrenia* ; Stroop Test ; Verbal Learning ; Wisconsin

OBJECTIVE: The present study sought to analyze the influence of Levetiracetam (LEV) in cognitive performance by identifying the changes produced by LEV in reaction time, in neuropsychological assessment of attention and memory and in absolute theta power in frontal activity. METHODS: Twelve healthy subjects (5 men and 7 women; mean age, 30.08 years, standard deviation, 4.71) were recruited for this study. The neuropsychological tests: Trail Making Test (A and B), Digit Span (direct and indirect numerical orders/working memory); Stroop test (inhibitory control of attention); Tower of London (planning and decision-making) and a quantitative electroencephalography were applied in 2 different days after and before the participants ingested the capsule of placebo or 500 mg LEV. RESULTS: A two-way-ANOVA was implemented to observe the interaction between conditions (placebo or LEV 500 mg) and moments (pre- and post-ingestion of LEV or placebo). The data were analyzed by the SPSS statistical package (p<0.05). For the neuropsychological parameter, the Trail Making Test (A) was the only test that showed significant difference for condition in the task execution time (p=0.026). Regarding the reaction time in the behavioral parameter, an interaction between both factors (p=0.034) was identified through a two-way-ANOVA (condition versus moment). Electrophysiological measures showed a significant interaction for electrodes: F7, F3, and FZ. CONCLUSION: The findings showed that LEV promotes an important cognitive enhancement in the executive functions.
Electrodes ; Electroencephalography ; Executive Function ; Female ; Humans ; Male ; Memory ; Neuropsychological Tests ; Reaction Time ; Stroop Test ; Trail Making Test