Cognitive dysfunction
Encyclopedia
Cognitive dysfunction is defined as unusually poor mental function, associated with confusion
, forgetfulness and difficulty concentrating. A number of medical or psychiatric conditions and treatments can cause such symptoms, including heavy metal poisoning
(in particular mercury poisoning
), menopause
, chronic fatigue syndrome
, fibromyalgia
, mood disorder
s, ADHD (primarily inattentive), drug abuse
, and sleep disorder
s (including disrupted sleep). The term brain fog is not commonly used to describe people with dementia
or other conditions that are known to cause confusion and memory problems, but it can be used as a synonym for sleep inertia
or grogginess upon being awakened from deep sleep
.
POCD has been studied through various institutions since the inception of the IPOCDS-I study centred in Eindhoven, Netherlands and Copenhagen, Denmark. This study found no causal relationship between hypoxia and low blood pressure and POCD. Age, duration of anaesthesia, introperative complications, and postoperative infections were found to be associated with POCD.
POCD to be differentiated from postoperative delirium
has a longer duration and no lability or fluctuations in impaired cognitive functioning. Some patients who demonstrated POCD at 10–14 days were found to have improved scores at 3 months, while others continued to demonstrate POCD at periods longer than 1 year. This suggests that in certain at risk patients, POCD may be a permanent alteration of cognitive functioning.
, the mental declining effects associated with hypothyroidism can be corrected with thyroid hormone
replacement therapy, although many times patients continue to endure confusion and a sense of dementia. Additionally, occupational therapy
may be helpful for some people. Neurofeedback
can improve symptoms for some people.
In Fibromyalgia patients, cause for cognitive dysfunction (sometimes referred to as "fibro fog") is often related to the inability to fall into a restorative REM sleep, thus, treatment may include a prescription sleep aid or medication normally prescribed for shift work disorder.
ConFusion
ConFusion is an annual science fiction convention organized by the Stilyagi Air Corps and its parent organization, the Ann Arbor Science Fiction Association. Commonly, it is held the third weekend of January. It is the oldest science fiction convention in Michigan, a regional, general SF con...
, forgetfulness and difficulty concentrating. A number of medical or psychiatric conditions and treatments can cause such symptoms, including heavy metal poisoning
Heavy Metal Poisoning
Heavy Metal Poisoning is a song by American rock band Styx. It was included as the fifth track on their 1983 studio album Kilroy Was Here.The song in the story of Kilroy Was Here has the character of Dr Righteous preaching the evils of rock and roll...
(in particular mercury poisoning
Mercury poisoning
Mercury poisoning is a disease caused by exposure to mercury or its compounds. Mercury is a heavy metal occurring in several forms, all of which can produce toxic effects in high enough doses...
), menopause
Menopause
Menopause is a term used to describe the permanent cessation of the primary functions of the human ovaries: the ripening and release of ova and the release of hormones that cause both the creation of the uterine lining and the subsequent shedding of the uterine lining...
, chronic fatigue syndrome
Chronic fatigue syndrome
Chronic fatigue syndrome is the most common name used to designate a significantly debilitating medical disorder or group of disorders generally defined by persistent fatigue accompanied by other specific symptoms for a minimum of six months, not due to ongoing exertion, not substantially...
, fibromyalgia
Fibromyalgia
Fibromyalgia is a medical disorder characterized by chronic widespread pain and allodynia, a heightened and painful response to pressure. It is an example of a diagnosis of exclusion...
, mood disorder
Mood disorder
Mood disorder is the term designating a group of diagnoses in the Diagnostic and Statistical Manual of Mental Disorders classification system where a disturbance in the person's mood is hypothesized to be the main underlying feature...
s, ADHD (primarily inattentive), drug abuse
Drug abuse
Substance abuse, also known as drug abuse, refers to a maladaptive pattern of use of a substance that is not considered dependent. The term "drug abuse" does not exclude dependency, but is otherwise used in a similar manner in nonmedical contexts...
, and sleep disorder
Sleep disorder
A sleep disorder, or somnipathy, is a medical disorder of the sleep patterns of a person or animal. Some sleep disorders are serious enough to interfere with normal physical, mental and emotional functioning...
s (including disrupted sleep). The term brain fog is not commonly used to describe people with dementia
Dementia
Dementia is a serious loss of cognitive ability in a previously unimpaired person, beyond what might be expected from normal aging...
or other conditions that are known to cause confusion and memory problems, but it can be used as a synonym for sleep inertia
Sleep inertia
Sleep inertia is a physiological state characterised by a decline in motor dexterity and a subjective feeling of grogginess immediately following an abrupt awakening. The impaired alertness may interfere with the ability to perform mental or physical tasks...
or grogginess upon being awakened from deep sleep
Slow-wave sleep
Slow-wave sleep , often referred to as deep sleep, consists of stages 3 and 4 of non-rapid eye movement sleep, according to the Rechtschaffen & Kales standard of 1968. As of 2008, the American Academy of Sleep Medicine has discontinued the use of stage 4, such that the previous stages 3 and 4 now...
.
Postoperative Cognitive Dysfunction
Postoperative Cognitive Dysfunction (POCD) refers to cognitive problems (with memory, learning and the ability to concentrate) following surgery. There has been very limited research into POCD, but existing reports suggest that the incidence of POCD increases with age, it can last for long periods of time, with 2–3 months considered long-term.POCD has been studied through various institutions since the inception of the IPOCDS-I study centred in Eindhoven, Netherlands and Copenhagen, Denmark. This study found no causal relationship between hypoxia and low blood pressure and POCD. Age, duration of anaesthesia, introperative complications, and postoperative infections were found to be associated with POCD.
POCD to be differentiated from postoperative delirium
Delirium
Delirium or acute confusional state is a common and severe neuropsychiatric syndrome with core features of acute onset and fluctuating course, attentional deficits and generalized severe disorganization of behavior...
has a longer duration and no lability or fluctuations in impaired cognitive functioning. Some patients who demonstrated POCD at 10–14 days were found to have improved scores at 3 months, while others continued to demonstrate POCD at periods longer than 1 year. This suggests that in certain at risk patients, POCD may be a permanent alteration of cognitive functioning.
Treatments
Treatment generally involves correcting any underlying medical conditions. For example, if the patient is found to be suffering a form of hypothyroidismHypothyroidism
Hypothyroidism is a condition in which the thyroid gland does not make enough thyroid hormone.Iodine deficiency is the most common cause of hypothyroidism worldwide but it can be caused by other causes such as several conditions of the thyroid gland or, less commonly, the pituitary gland or...
, the mental declining effects associated with hypothyroidism can be corrected with thyroid hormone
Thyroid hormone
The thyroid hormones, thyroxine and triiodothyronine , are tyrosine-based hormones produced by the thyroid gland primarily responsible for regulation of metabolism. An important component in the synthesis of thyroid hormones is iodine. The major form of thyroid hormone in the blood is thyroxine ,...
replacement therapy, although many times patients continue to endure confusion and a sense of dementia. Additionally, occupational therapy
Occupational therapy
Occupational therapy is a discipline that aims to promote health by enabling people to perform meaningful and purposeful activities. Occupational therapists work with individuals who suffer from a mentally, physically, developmentally, and/or emotionally disabling condition by utilizing treatments...
may be helpful for some people. Neurofeedback
Neurofeedback
Neurofeedback , also called neurotherapy, neurobiofeedback or EEG biofeedback is a type of biofeedback that uses realtime displays of electroencephalography or functional magnetic resonance imaging to illustrate brain activity, often with a goal of controlling central nervous system activity...
can improve symptoms for some people.
In Fibromyalgia patients, cause for cognitive dysfunction (sometimes referred to as "fibro fog") is often related to the inability to fall into a restorative REM sleep, thus, treatment may include a prescription sleep aid or medication normally prescribed for shift work disorder.
See also
- ADHD predominantly inattentiveADHD predominantly inattentiveADHD predominantly inattentive is one of the three subtypes of Attention-deficit hyperactivity disorder . While ADHD-PI is sometimes still called "attention deficit disorder" by the general public, these older terms were formally changed in 1994 in the new Diagnostic and Statistical Manual of...
- Cognitive orthoticsCognitive orthoticsCognitive orthotics are software-based personal reminder systems for people with cognitive impairment, such as memory loss. People who can benefit include the elderly, people who have experienced traumatic brain injury, and anyone who experiences memory loss. These devices may be installed on...
- Depersonalization disorderDepersonalization disorderDepersonalization disorder is a dissociative disorder in which the sufferer is affected by persistent or recurrent feelings of depersonalization and/or derealization. Diagnostic criteria include persistent or recurrent experiences of feeling detached from one's mental processes or body...
- Excessive daytime sleepinessExcessive daytime sleepinessExcessive daytime sleepiness is characterized by persistent sleepiness, and often a general lack of energy, even after apparently adequate night time sleep...
- Four boxes testFour boxes testThe Four boxes test is a computer-based test used to measure reaction times.In the test, a black circle appears in one of four boxes on the screen, and the patient presses the corresponding key on the keyboard as quickly as possible...
- Generalized Anxiety Disorder
- InsomniaInsomniaInsomnia is most often defined by an individual's report of sleeping difficulties. While the term is sometimes used in sleep literature to describe a disorder demonstrated by polysomnographic evidence of disturbed sleep, insomnia is often defined as a positive response to either of two questions:...
- Lyme diseaseLyme diseaseLyme disease, or Lyme borreliosis, is an emerging infectious disease caused by at least three species of bacteria belonging to the genus Borrelia. Borrelia burgdorferi sensu stricto is the main cause of Lyme disease in the United States, whereas Borrelia afzelii and Borrelia garinii cause most...
- Major Depressive Disorder
- Mild cognitive impairmentMild cognitive impairmentMild cognitive impairment is a brain-function syndrome involving the onset and evolution of cognitive impairments beyond those expected based on the age and education of the individual, but which are not significant enough to interfere with their daily activities...
- Mixed Anxiety-Depressive DisorderMixed anxiety-depressive disorderMixed anxiety-depressive disorder is a diagnostic category defining patients who suffer from both anxiety and depressive symptoms of limited and equal intensity accompanied by at least some autonomic features...
- Post-chemotherapy cognitive impairmentPost-chemotherapy cognitive impairmentPost-chemotherapy cognitive impairment describes the cognitive impairment that can result from chemotherapy treatment. Approximately 20–30% of people who undergo chemotherapy experience some level of post-chemotherapy cognitive impairment...
- Pumphead syndrome
- Sluggish cognitive tempoSluggish cognitive tempoSluggish Cognitive Tempo is an unformalized descriptive term which is used to better identify what appears to be a homogeneous sub-subgroup within the formal subgroup "ADHD predominantly inattentive"...
External links
- Study of POCD
- Goteborg
- amsterdam
- blackwell-synergy.com
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2998043/?tool=pubmed An Update on Postoperative Cognitive Dysfunction