Latent learning in End Stage Renal Disease (ESRD)

Abstract

Cognitive functions such as attention and memory are known to be impaired in End Stage Renal Disease (ESRD), but the sites of the neural changes underlying these impairments are uncertain. Patients and controls took part in a latent learning task, which had previously shown a dissociation between patients with Parkinson's disease and those with medial temporal damage. ESRD patients (n=24) and age and education-matched controls (n=24) were randomly assigned to either an exposed or unexposed condition. In Phase 1 of the task, participants learned that a cue (word) on the back of a schematic head predicted that the subsequently seen face would be smiling. For the exposed (but not unexposed) condition, an additional (irrelevant) colour cue was shown during presentation. In Phase 2, a different association, between colour and facial expression, was learned. Instructions were the same for each phase: participants had to predict whether the subsequently viewed face was going to be happy or sad. No difference in error rate between the groups was found in Phase 1, suggesting that patients and controls learned at a similar rate. However, in Phase 2, a significant interaction was found between group and condition, with exposed controls performing significantly worse than unexposed (therefore demonstrating learned irrelevance). In contrast, exposed patients made a similar number of errors to unexposed in Phase 2. The pattern of results in ESRD was different from that previously found in Parkinson's disease, suggesting a different neural origin.

Understanding the impact of haemodialysis on UK National Health Service patients’ well‐being: A qualitative investigation

“…Others have noted that this is especially problematic in the case of fluid intake when patients become thirsty (Hagren et al., ). However, while patients often confess to eating forbidden foods, skipping medication appears to be less deliberate (Karamanidou et al., ), more likely a consequence of the cognitive deficits associated with ESRD (Jones et al., ). It is important for clinicians to be aware that when patients perceive the restrictions on diet and fluid intake to be unacceptably onerous, they abandon them.…”

“…Qualitative studies investigating the impact of ESRD have provided substantial, useful data; however, because one of the aims of qualitative research was to provide understanding of the meanings and interpretations of behaviour within the specific sample under study, it is of value to conduct further qualitative research with additional samples in order to establish the extent to which similar themes emerge and new themes are revealed. In this study, we were particularly interested in the fluctuations in cognitive abilities caused by HD, reported to us by patients in quantitative studies of cognition (Jones, Butler, Harris, & Vaux, ; Jones, et al., ). In addition, this study aims to provide an understanding of the patient experience in the UK NHS.…”

The nature of impairments of memory in patients with end-stage renal disease (ESRD)

“…Our results are consistent with the view that posterior areas are less affected than temporal areas in ESRD, a hypothesis which could be tested with further brain imaging studies. The vulnerability of temporal regions to the effects of ESRD is also suggested by a study showing that latent learning in patients is different to that in controls (Jones et al, 2015).…”

A potential barrier to adherence? Memory for future intentions is impaired in hemodialysis patients

“…To maintain independence while receiving HD, a patient must be able to monitor their own activities accurately (diet and medication), requiring proficient prospective memory (PM). [7][8][9][10] Impairments of RM have been found in ESRD, both in verbal and visual memory, [11][12][13] learning, 14 and episodic memory. The distinction between PM and retrospective memory (RM) (eg of what one had for dinner last night) has been demonstrated in typical aging, 4,5 showing differences in RM and PM performance between young and older adults, in brain imaging 6 and in neuropsychological studies.…”

“…The distinction between PM and retrospective memory (RM) (eg of what one had for dinner last night) has been demonstrated in typical aging, 4,5 showing differences in RM and PM performance between young and older adults, in brain imaging 6 and in neuropsychological studies. [7][8][9][10] Impairments of RM have been found in ESRD, both in verbal and visual memory, [11][12][13] learning, 14 and episodic memory. 15 In addition, impairments of the executive functions (inhibition, task switching), shown to be important in PM, have been found in ESRD.…”