Steven P. Cercy, Ph.D.

Putative mechanisms of cognitive dysfunction in chemotherapy-naive diffuse large B-cell lymphoma: a case report and review of the literature
Cercy, Steven P; Bronson, Brian
2010 Jul;17(3):223-233, Applied neuropsychology
Cognitive impairment is now recognized as a frequent consequence of treatments for cancers localized outside the central nervous system (CNS). In contrast, little attention has been given to the potentially deleterious cognitive effects from non-CNS cancers themselves. The present case study proposes that cognitive deficits occur in a subset of treatment-naive patients with diffuse large B-cell lymphoma in whom no gross evidence of lymphoma-related CNS involvement is apparent. Evidence is presented from a case study and elaborate putative mechanisms centering on deleterious effects of B-cell-mediated inflammatory cytokine secretion on neurons. Moreover, this case study speculates that genetic variability involving apolipoprotein E or other factors may mediate cognitive variability among these patients
— id: 112046, year: 2010, vol: 17, page: 223, stat: Journal Article,

Diagnostic accuracy of a new instrument for detecting cognitive dysfunction in an emergent psychiatric population: the Brief Cognitive Screen
Cercy, Steven P; Simakhodskaya, Zoya; Elliott, Aaron
2010 Mar;17(3):307-315, Academic emergency medicine
OBJECTIVES: In certain clinical contexts, the sensitivity of the Mini-Mental State Examination (MMSE) is limited. The authors developed a new cognitive screening instrument, the Brief Cognitive Screen (BCS), with the aim of improving diagnostic accuracy for cognitive dysfunction in the psychiatric emergency department (ED) in a quick and convenient format. METHODS: The BCS, consisting of the Oral Trail Making Test (OTMT), animal fluency, the Clock Drawing Test (CDT), and the MMSE, was administered to 32 patients presenting with emergent psychiatric conditions. Comprehensive neuropsychological evaluation served as the criterion standard for determining cognitive dysfunction. Diagnostic accuracy of the MMSE was determined using the traditional clinical cutoff and receiver operating characteristic (ROC) curve analyses. Diagnostic accuracy of individual BCS components and BCS Summary Scores was determined by ROC analyses. RESULTS: At the traditional clinical cutoff, MMSE sensitivity (46.4%) and total diagnostic accuracy (53.1%) were inadequate. Under ROC analyses, the diagnostic accuracy of the full BCS Summary Score (area under the curve [AUC]=0.857) was comparable to the MMSE (AUC=0.828). However, a reduced BCS Summary Score consisting of OTMT Part B (OTMT-B), animal fluency, and the CDT yielded classification accuracy (AUC=0.946) that was superior to the MMSE. CONCLUSIONS: Preliminary findings suggest the BCS is an effective, convenient alternative cognitive screening instrument for use in emergent psychiatric populations
— id: 109044, year: 2010, vol: 17, page: 307, stat: Journal Article,

Gelastic epilepsy and dysprosodia in a case of late-onset right frontal seizures
Cercy, Steven P; Kuluva, Joshua E
2009 Oct;16(2):360-365, Epilepsy & behavior
Gelastic epilepsy (GE) is an uncommon type of seizure disorder characterized by stereotyped, unprovoked, inappropriate ictal laughter. GE is most frequently associated with hypothalamic hamartoma, with onset almost invariably occurring during childhood. GE also occurs occasionally with temporal and frontal cortical seizure foci. We describe an unusual case of senescent-onset GE with a right frontal seizure focus. In addition to laughter, dysprosodia was a clinical feature. Clinical and electroencephalographic evidence of seizure activity ceased on levetiracetam, and the patient showed concurrent improvement in cognitive function. We review the evidence for the cerebral representation of laughter and prosody, and discuss issues bearing on the differential diagnosis and management of GE
— id: 103152, year: 2009, vol: 16, page: 360, stat: Journal Article,

Prominent Neuroleptic Sensitivity in a Case of Early-onset Alzheimer Disease due to Presenilin-1 G206A Mutation
Cercy, Steven P; Sadowski, Martin J; Wisniewski, Thomas
2008 Sep;21(3):190-195, Cognitive & behavioral neurology
OBJECTIVE: We describe atypical motor and cognitive features in a case of familial Alzheimer disease (FAD) due to presenilin-1 (PS-1) mutation. BACKGROUND: Extrapyramidal signs (EPS) typically are a late-presenting feature of sporadic Alzheimer disease (AD), but relatively little data are available regarding EPS in FAD. METHOD: A 59-year-old, right-handed man of Caribbean-Hispanic descent underwent brain imaging studies, laboratory tests for AD, and serial neurologic and neuropsychologic evaluations. RESULTS: The patient presented with recent-onset delusional ideation associated with cognitive decline. Prominent EPS developed soon after initiation of an atypical neuroleptic agent. Neuropsychologic evaluation revealed global cognitive deficits; he was found to be a carrier of a PS-1 point mutation at position G206A. EPS resolved completely after discontinuing the neuroleptic agent and coincided with improved motor speed, set initiation, and verbal fluency. CONCLUSIONS: Severe neuroleptic sensitivity and associated deficits of cognitive speed occurred in response to a dopaminergic antagonist agent; both responded readily to withdrawal of the offending agent. Patients with PS-1 AD may be at substantially increased risk of neuroleptic-induced EPS. That feature underscores the heterogeneity of the FAD clinical phenotype
— id: 83107, year: 2008, vol: 21, page: 190, stat: Journal Article,

Cognitive dysfunction associated with elemental mercury ingestion and inhalation: a case study
Cercy, Steven P; Wankmuller, Michelle M
2008 ;15(1):79-91, Applied neuropsychology
A 63-year-old man with a history of alcohol dependence ingested elemental mercury as a suicide gesture. Serial abdominal X-rays showed gradual but incomplete clearance of mercury from the colon. Routine chest X-ray showed evidence of punctate radiopaque materials in the lower lobe of the right lung. Blood and urine mercury levels both exceeded thresholds considered to be associated with cognitive dysfunction. Elicited cognitive deficits were most prominent in processing speed, flexibility, and response inhibition. Semantic fluency, visuospatial processing, and recall memory for visual and low-context verbal material were also affected. The deficits may have been attributable primarily to alcohol abuse. Elemental mercury is not readily absorbed from the gastrointestinal tract; however, mercury vapor, which was inhaled inadvertently, readily crosses the blood-brain barrier and is neurotoxic. We argue, therefore, that mercury toxicity is more likely than not to have been a factor contributing to the patient's cognitive dysfunction
— id: 79386, year: 2008, vol: 15, page: 79, stat: Journal Article,

Augmentation of artistic productivity in Parkinson's disease
Walker, Ruth H; Warwick, Robin; Cercy, Steven P
2006 Feb;21(2):285-286, Movement disorders
— id: 96142, year: 2006, vol: 21, page: 285, stat: Journal Article,

Lewy bodies and progressive dementia: a critical review and meta-analysis
Cercy SP; Bylsma FW
1997 Mar;3(2):179-194, Journal of the International Neuropsychological Society
Researchers disagree as to whether Lewy body disease (LBD) constitutes a variant of Alzheimer's (AD) or Parkinson's disease (PD), or alternatively, whether it is an independent disease process. The neuropathological, genetic, and clinical characteristics of LBD are reviewed and compared to those of AD and PD. Data for 150 cases of LBD reported in the literature were compiled and grouped according to neuropathological status. Patients with pure LBD (with limited or no concurrent AD pathology) tend to present at a younger age with extrapyramidal signs followed by dementia, whereas patients with mixed LBD-AD (concurrent LB and AD pathology) are somewhat older and tend to present with dementia. The cognitive profile of LBD patients, and the relationships among LBD, AD, and PD remain unclear due to methodological limitations and the paucity of studies comparing the groups directly
— id: 42778, year: 1997, vol: 3, page: 179, stat: Journal Article,

Simulated amnesia and the pseudo-memory phenomena
Cercy, Steven P; Schretlen, David J; Brandt, Jason
Clinical assessment of malingering and deception New York, NY, US: Guilford Press, 1997,
(from the chapter) reviews some of the nonneurological aberrations of memory and suggests a conceptual framework for appreciating these presentations / describe some methods that may be useful in the identification of pseudo-amnesia and pseudo-remembering / begin with a brief overview of the phenomenology of 'organic' memory disorders / under the rubric of 'nonneurological' amnesia, [the authors] examine (1) the traditional yet controversial diagnosis of dissociative amnesia and (2) the clinical presentation of feigned amnesia / review and critically evaluate the empirical literature on the differentiation of organic memory disorders from dissociative amnesia and feigned amnesia / turn our attention from false forgetting to false remembering / the characteristics of individuals and situations that promote confabulation and the creation of false memories are reviewed /// detection of feigned amnesia [problems in measuring feigned memory impairment, electrophysiological approaches, specific measures of malingered amnesia, traditional psychometric approaches, investigational techniques] (PsycIN
— id: 3342, year: 1997, vol: , page: 85, stat: Chapter,

Integrating memory theory in the detection of dissimulated amnesia: The application of proactive interference
Cercy, Steven Paul
1995 ;55:9B-9B March, Dissertation abstracts international. Section B: the Sciences & Engineering
The development of measures that are sensitive to dissimulated memory impairment is a major problem currently facing clinical neuropsychology. The most commonly used measures to detect malingered amnesia include the Symptom Validity Procedure (SVP) and the Rey 15-Item Memory Test (RMT-15). The major limitation of such measures is that they are essentially atheoretical. Few studies have employed an approach that attempts to capitalize on the power provided by theory in developing predictions for dissimulators' memory performance. The present study applied interference theory derived from the cognitive psychology literature to differentiate the memory performance of dissimulators from closed head-injured (CHI) patients. Hypotheses based on interference theory were generated regarding the effects of proactive interference (PI) on list recall. It was expected that simulators would demonstrate neither a build up of
— id: 45475, year: 1995, vol: 55, page: 9B, stat: Journal Article,

Self-concept and learning: The revised Inventory of Learning Processes
Schmeck, Ronald R; Geisler-Brenstein, Elke; Cercy, Steven P.
1991 ;11(3-4):343-362, Educational Psychology
Examined the reliabilities and intercorrelations of the Inventory of Learning Processes using a sample of 129 undergraduates. A model of student learning based on the results of this study argues that the 2 major routes to academic achievement are reflective processing (RP) and agentic processing (AP)
— id: 45441, year: 1991, vol: 11, page: 343, stat: Journal Article,