Attention dysfunction in cirrhotic patients: An inquiry on the role of executive control, attention orienting and focusing

被引:59
作者
Amodio P. [1 ,4 ]
Schiff S. [1 ,2 ]
Del Piccolo F. [1 ]
Mapelli D. [1 ,3 ]
Gatta A. [1 ]
Umiltà C. [3 ]
机构
[1] Department of Clinical and Experimental Medicine, Cirmanmec University of Padova
[2] Department of Neurological and Vision Science, University of Verona
[3] Department of General Psychology, Cirmanmec University of Padova
[4] Clinica Medica 5, 35128 Padova, Via Giustiniani
关键词
Attention; Attention focusing; Attention orienting; Divided attention; EEG; Liver cirrhosis; TMT-A;
D O I
10.1007/s11011-005-4149-3
中图分类号
学科分类号
摘要
Attention alterations are reported in cirrhotics. Aiming at clarifying attention functioning in cirrhotics, an inquiry on the functioning of the anterior (AAS) and the posterior (PAS) attention system was performed. Thirty-six cirrhotics without overt hepatic encephalopathy (24 with EEG or TMT-A alterations) and 16 matched control subjects were enrolled. The AAS was studied by the Stroop task measuring selective attention control, the PAS was studied by the Posner task and the Focus task measuring automatic covert orienting and visual focusing of attention respectively. Cirrhotics presented a task-dependent psychomotor slowing (Stroop > Posner > Focus) with an increased percentage of errors in the incongruent condition of the Stroop task [F(1, 57) = 4.9, p < 0.03]. Class C patients had both a selective slowing [F(1, 33) = 4.3, p < 0.05] and an increased percentage of errors in the incongruent condition [F(1, 34) = 5.1, p < 0.05] compared to Class A-B patients and controls. The patients with an altered EEG performed the Stroop test significantly slowly than those without EEG alterations [F(1, 41) = 8.9, p < 0.01] and with a clear trend for a higher number of errors in the incongruent condition [F(1, 39) = 3.8, p < 0.06]. In contrast, attention orienting and focusing were maintained. In conclusion, the AAS is more sensitive than the PAS to the early stages of hepatic encephalopathy. © 2005 Springer Science+Business Media, Inc.
引用
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页码:115 / 127
页数:12
相关论文
共 31 条
[1]  
Amodio P., Marchetti P., Del Piccolo F., Sartori G., Prior M., Merkel C., Gatta A., Visual attention orienting in liver cirrhosis without overt hepatic encephalopathy, Metab. Brain Dis., 10, pp. 335-345, (1995)
[2]  
Amodio P., Marchetti P., Del Piccolo F., Campo G., Rizzo C., Iemmolo R.M., Gerunda G., Caregaro L., Merkel C., Gatta A., Visual attention in cirrhotic patients: A study on covert visual attention orienting, Hepatology, 27, pp. 1517-1523, (1998)
[3]  
Amodio P., Del Piccolo F., Marchetti P., Angeli P., Iemmolo R., Caregaro L., Merkel C., Gerunda G., Gatta A., Clinical features and survivial of cirrhotic patients with subclinical cognitive alterations detected by the number connection test and computerized psychometric tests, Hepatology, 29, pp. 1662-1667, (1999)
[4]  
Amodio P., Marchetti P., Del Piccolo F., De Tourtchaninoff M., Varghese P., Zuliani C., Campo G., Gatta A., Guerit J.M., Spectral versus visual EEG analysis in mild hepatic encephalopathy, Clin. Neurophysiol., 110, pp. 1334-1344, (1999)
[5]  
Amodio P., Wenin H., Del Piccolo F., Mapelli D., Montagnese S., Pellegrini A., Musto C., Gatta A., Umilta C., Variability of trail making test, symbol digit test and line trait test in normal people. A normative study taking into account age-dependent decline and sociobiological variables, Aging Clin. Exp. Res., 14, pp. 117-131, (2002)
[6]  
Benso F., Turatto M., Mascetti G.G., Umilta C., The time course of attentional focusing, Eur. J. Cogn. Psychol., 10, pp. 373-388, (1998)
[7]  
Caregaro L., Alberino F., Amodio P., Merkel C., Bolognesi M., Angeli P., Gatta A., Malnutrition in alcoholic and virus-related cirrhosis, Am. J. Clin. Nutr., 63, pp. 602-609, (1996)
[8]  
Corbetta M., Frontoparietal cortical networks for directing attention and the eye to visual locations: Identical, independent, or overlapping neural systems?, Proc. Natl. Acad. Sci. U.S.A., 95, pp. 831-838, (1998)
[9]  
Elsass P., Lund Y., Ranek L., Encephalopathy in patients with cirrhosis of the liver. A neuropsychological study, Scand. J. Gastroenterol., 13, pp. 241-247, (1978)
[10]  
Ferenci P., Lockwood A., Mullen K., Tarter R., Weissenborn K., Blei A.T., Hepatic encephalopathy - Definition, nomenclature, diagnosis, and quantification: Final report of the working party at the 11th World Congresses of Gastroenterology, Vienna, 1998, Hepatology, 35, pp. 716-721, (2002)