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Objective Soroxchi/Acute Mountain Sickness (AMS) is a condition that can result in cerebral and pulmonary hypoxia. Neuropsychological research on AMS is minimal and the long-term effects on cognition and behavior are unclear. AMS is associated with cognitive impairments in processing speed, attention, and executive functions as well as neurobehavioral symptoms. This case study delineates the neuropsychological and neurobehavioral changes secondary to bilateral globus pallidus (GP) lesions associated with AMS. Case Description Patient is a 51-year old, primarily Spanish-speaking, male of Mexican descent with 9 years of education, and who had traveled to La Paz, Bolivia (4,070 MASL) for work. Upon arrival, fatigue and dizziness led to hospitalization to treat acute pulmonary edema and hypoxia. Brain MRI revealed hyperintense bilateral GP lesions. Medical history was notable for hyperlipidemia. Psychiatric history was unremarkable. Neuropsychological assessment 4 months post-AMS revealed impairments in visuo-conceptual and speeded complex visuospatial abilities, executive functions, and confrontation naming. Cognitive improvements were noted in delayed recall of non-contextual verbal information and confrontation naming ten months post-AMS. Significant mood and personality changes were reported; patient endorsed anhedonia, fatigue, alexithymia, avolition, and sleep difficulties. Family described patient as depressed, apathetic, and socially withdrawn. Pharmacological and psychotherapy treatments were recommended and initiated. Diagnostic Impressions and Outcomes Findings were consistent with a diagnosis of Mild Neurocognitive Disorder. His family denied neurobehavioral improvements post interventions. Discussion This case study is the first to characterize the long-term neuropsychological and neurobehavioral changes following bilateral GP lesions secondary to AMS. Declines in visual-conceptual abilities reveal a new finding for this type of cerebral incident. [ABSTRACT FROM AUTHOR]

Objective Fergenbaum et al. 2009 found that obesity was linked to increased cognitive issues in otherwise healthy individuals, while another study found obesity to be neuroprotective in a sample of dementia patients (Fitzpatrick et al. 2009). The present study explores whether obesity is associated with worse cognitive dysfunction in those with Multiple Sclerosis (MS). Method This study examined archival neuropsychological test data of 40 patients diagnosed with MS. Participants were separated into two groups based on their BMI: healthy/overweight individuals and obese/morbidly obese. ANOVA was performed to compare performances between groups on tasks measuring learning and memory, processing speed, and executive functioning; areas commonly affected in MS. Results Significant differences between groups were noted on only portions of two different tests; unstructured verbal learning (p =.003) and mental sequencing (p =.048), but no differences were found in other tasks. Particularly, performance was statistically equal between groups on measures of response inhibition (p =.887), visual processing speed (p =.182), visuospatial learning (p =.118), visuospatial free recall (p =.205), simple auditory attention (p =.630), working memory (p =.223), psychomotor speed (p =.969), and complex divided attention (p =.202). Conclusion Obese patients with MS scored significantly better on the majority of tasks that we reviewed. These results seem to contradict a study that examined healthy subjects but seems to replicate findings in at least one clinical population; those with dementia. It is possible that increased BMI in clinical populations may indicate better overall health leading to better cognition, though if it is actually neuroprotective and only limited to MS and dementia is uncertain. Future research endeavors are discussed. [ABSTRACT FROM AUTHOR]

There is a high rate of medical and psychiatric comorbidities in the HIV population (Kilbourne et al, 2001), many of which complicate the clinical picture, especially with respect to cognitive functioning (Milanini & Valcour, 2017). It is important to be aware of the impact multiple disorders can have on formulating impressions and treatment planning. We reviewed the records of 35 consecutive patients with HIV seen in our neuropsychology clinic in a county hospital. The 30 men and 5 women had a mean age of 49 (SD = 13.7), with mean education of 13.5 years (SD = 2.0). Average age of HIV diagnosis was 33 (SD = 9.3). Patients had an average of eight major comorbid medical and psychiatric diagnoses, including ADHD (45%), mood disorders (62%), developmental disorders (11%), substance abuse or dependence (45%), sleep apnea (11%), TBI (31%), stroke (14%), cardiovascular disease (51%), and hepatitis (20%). Neuropsychological data were available for 33 patients. Performance on CVLT Trial 5 and Delayed Recall, Rey-Ostereith Copy, WAIS-IV Information and Digit Span, as well as Trail Making A and B were used to measure memory and executive functioning. 21% of the sample obtained one score that was >2 SD below the normative means, and 45% obtained 2 or more scores >2 SD below the mean.In this clinical sample referred for evaluation of cognitive functioning, there was a high rate of comorbid diagnoses. This review highlights the point that comorbid diagnoses are a common presentation and must be considered when discussing etiology of cognitive impairment and treatment planning. [ABSTRACT FROM AUTHOR]