Papers by Anthony Stringer
Congenital Heart Disease, Dec 13, 2016
Objective: Adults with congenital heart disease (CHD) are at increased risk of psychological diso... more Objective: Adults with congenital heart disease (CHD) are at increased risk of psychological disorders and cognitive deficiencies due to structural/acquired neurological abnormalities and neurodevelopmental disorders as children. However, limited information is known about the neuropsychological functioning of adults with CHD. This study screened neuropsychological abilities and explored group differences related to cardiac disease severity and neurological risk factors in adults with CHD. Design: Participants completed brief neuropsychological testing. Information about neurobehavioral and psychological symptoms, employment, education, and disability were also collected from the patient and a family member. Results: Forty-eight participants with adult CHD completed neuropsychological testing. Visuospatial skills and working memory were worse than expected compared to the typical population. Frequency of neurological comorbidities (e.g., stroke, seizures) was higher in those with more severe heart disease (e.g., single ventricle or cyanotic disease), and executive functioning was weaker in those with neurological comorbidities. Those with more severe heart disease were more likely to be unemployed and to receive disability benefits, but educational attainment did not differ. Those who received disability performed worse on tasks of executive functioning. Conclusions: Findings suggest concerns about neuropsychological functioning that need to be more comprehensively assessed in adults with CHD. Understanding the cognitive limitations of this aging population can help guide access to resources, transition of care, and medical care engagement, thus improving quality of care and quality of life. K E Y W O R D S adult congenital heart disease, adult transition, cognitive functioning, executive functioning, neurodevelopmental outcomes, neuropsychological outcomes 1 | INTRODUCTION The increased risk of socioemotional, cognitive, and academic problems in children and adolescents with congenital heart disease (CHD) has been well-documented. Variability in outcomes is tremendous across the pediatric years, with subtle to severe concerns, and evolving challenges across the lifespan as demands increase. School age children may require grade retention, placement in the special education classroom, and they may be diagnosed with learning disabilities, attention-deficit/hyperactivity disorder, and executive functioning problems. 1-5 Compared with typical teens, they are unable to participate in competitive team sports and are not as physically active. 6,7 Social challenges and psychological problems continue into the teen years, and many need remedial supports to finish high school. 8 Quality of life is impacted across the lifespan for many of those with CHD. 9-11 In a large adult and geriatric survey study, dementia was reported to be the comorbidity of CHD with the highest magnitude, with a hazards ratio of 3.24. 12
American Psychological Association eBooks, 2023
... Manual of Clinical Psychopharmacology, 3rd ed., edited by Alan F. Schatzberg, MD, Jonathan O.... more ... Manual of Clinical Psychopharmacology, 3rd ed., edited by Alan F. Schatzberg, MD, Jonathan O. Cole, MD, and Charles DeBattista, DMH, MD Washington, DC, Ameri-can Psychiatric ... Consider the chapter on Dr. Edith Jackson, who is one of the 10 patients Roazen discusses. ...
American Journal of Psychiatry, Oct 1, 1983
Two hospitalized patients with antisocial personality disorder (by DSM-III) and histories of chil... more Two hospitalized patients with antisocial personality disorder (by DSM-III) and histories of childhood attention deficit disorder became less aggressive during trials of methylphenidate. The authors suggest a link between the childhood disorder and one subgroup of antisocial personality disorder.
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring, Nov 11, 2017
Introduction: We present findings of a novel and ecologically relevant associative memory test, t... more Introduction: We present findings of a novel and ecologically relevant associative memory test, the Object Location Touchscreen Test (OLTT), which was posited as sensitive to early medial temporal lobe compromise associated with mild cognitive impairment (MCI). Methods: A total of 114 participants, including healthy young and older controls and patients with MCI, completed the OLTT and standard neuropsychological testing. The OLTT required participants to recall the location of objects under free and cued recall conditions, with accuracy evaluated using distance measures (i.e., a continuous error score), and a standard recognition format. Correlations between performance and volumetric data were evaluated from a subset of 77 participants. Results: Significant age effects were dwarfed by MCI effects across all test conditions. OLTT Cued Recall was strongly and specifically related to the volume of disease-relevant medial temporal lobe regions, generally more than traditional memory tests.
The Annals of Thoracic Surgery, Apr 1, 2019
BACKGROUND Patients undergoing aortic arch replacement are at high risk for neurologic injury. Th... more BACKGROUND Patients undergoing aortic arch replacement are at high risk for neurologic injury. This study compared two different established neuroprotective strategies in patients undergoing elective transverse hemiarch replacement. METHODS Twenty patients undergoing hemiarch replacement were prospectively randomized to receive deep hypothermic circulatory arrest with retrograde cerebral perfusion (DHCA+RCP) or moderate hypothermic circulatory arrest with antegrade cerebral perfusion (MHCA+ACP). All patients received neurologist-adjudicated examinations and magnetic resonance imaging before discharge. The primary end point was a composite of stroke, transient ischemic attack, and magnetic resonance imaging-adjudicated injury. Secondary end points were transient neurologic dysfunction, and the National Institutes of Health Stroke Scale, and neurocognitive scores. RESULTS Randomization resulted in 11 DHCA+RCP patients and 9 MHCA+ACP patients. There was no difference in cardiopulmonary bypass, cross-clamp, or circulatory arrest times. MHCA+ACP patients underwent circulatory arrest at significantly warmer temperatures (26.3° ± 1.8°C) than DHCA+RCP patients (19.9° ± 0.1°C, p < 0.0001). There were no deaths or renal failure in either group. There was 1 stroke in each group. National Institute of Health stroke scale scores and neurocognitive test results were equivalent. Diffusion-weighted magnetic resonance imaging demonstrated lesions in 100% (9 of 9) of MHCA+ACP patients compared with 45% (5 of 11) of DHCA+RCP patients (p < 0.01). MHCA+ACP patients had a significantly higher number of lesions than DHCA+RCP patients (p < 0.01). The primary end point was achieved in 100% of MHCA+ACP patients compared with 45% of DHCA+RCP patients (p < 0.01). CONCLUSIONS Although there was no significant difference in clinically evident neurologic injury, this pilot study suggests that MHCA+ACP may be associated with a higher incidence of radiographic neurologic injury than DHCA+RCP in patients undergoing elective hemiarch replacement.
Clinical neuropsychologist, Apr 1, 1987
... Functionai development of the prefrontal cortex in early life and the problem of neuronal pla... more ... Functionai development of the prefrontal cortex in early life and the problem of neuronal plasticity. Experimental Neurology, 32, 366-387. Goldman, PS, Rosvold, HE, Vest, B., & Galkin, TW (1971). ... Journal of Genetic Psychology, 109, 135-145. Kohn, B., & Dennis, M. (1974). ...
Neuropsychological Rehabilitation, Oct 1, 2013
Brain Injury, 1993
This study examined whether survivors of traumatic brain injury differ from normal, non-injured c... more This study examined whether survivors of traumatic brain injury differ from normal, non-injured controls in the regulation of food intake in their natural environment. Caregivers of 20 brain-injured subjects and 20 controls recorded in diaries: caloric intake, time of meals, subjective hunger ratings, and the number of persons present during meals for 7 consecutive days. Brain-injured subjects ate larger meals and more total (overall) calories per day compared with controls. In addition, the presence of other people during a meal, or social factor, was a significant predictor of meal size for the control subjects, but not for the brain-injured subjects. Brain-injured subjects also differed from control subjects in their response to pre-meal stomach content.
Neuropsychology (journal), May 1, 2012
Objectives-To evaluate the efficacy of mnemonic strategy training versus a matched-exposure contr... more Objectives-To evaluate the efficacy of mnemonic strategy training versus a matched-exposure control condition and also to examine the relationship between training-related gains, neuropsychological abilities, and medial temporal lobe volumetrics in patients with amnestic mild cognitive impairment (aMCI) and age-matched healthy controls. Methods-Twenty-three of 45 screened healthy controls and 29 of 42 screened aMCI were randomized to mnemonic strategy or matched-exposure groups. Groups were run in parallel, with participants blind to the other intervention. All participants completed five sessions within two weeks. Memory testing for object-location associations was performed during sessions one and five and at a one-month follow-up. During sessions 2-4, participants received either mnemonic strategy training or a matched number of exposures with corrective feedback for a total of 45 object-location associations. Structural MRI was performed in most participants and medial temporal lobe volumetrics were acquired.
Journal of The International Neuropsychological Society, Oct 21, 2010
Alzheimers & Dementia, Jul 1, 2014
were between the left ACC and the right precentral gyrus and the left precuneus and bilateral mid... more were between the left ACC and the right precentral gyrus and the left precuneus and bilateral middle occipital gyrus. Decreases were found between the left precuneus and parahippocampal gyrus. We also found correlations between FC and Stroop scores. Conclusions: The AD group showed more posterior DMN activity and the HC group showed more frontal activity preceding errors on the Stroop task, suggesting that the neural activity surrounding errors of SA differs between AD and HC. In AD, task related changes observed in the precuneus resulted in FC changes that correlated with poor performance on the Stroop task. These findings help identify neural correlates underlying SA deficits in AD.
Springer eBooks, 2018
also known as H.M. or Henry M., was born on February 26, 1926 to middleclass parents in Mancheste... more also known as H.M. or Henry M., was born on February 26, 1926 to middleclass parents in Manchester, CT. When he was 9-years old, he was involved in a bicycle accident, sustaining a laceration of the left supra-orbital region with an approximate 5-min loss of
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Papers by Anthony Stringer