Cognitive transfer in verbal learning. II. Transfer effects after prefamiliarization with integrated versus partially integrated verbal-perceptual structures.
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Adolescent↗
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California Verbal Learning Test: performance by patients with focal frontal and non-frontal lesions.
Although frontal lobe lesions do not cause classic amnesia, they may disrupt learning and memory in a number of ways. To investigate in finer detail the regions of frontal injury that are associated with impaired learning and to define the cognitive processing deficits specific to each region that disrupt memory, we compared 33 patients with focal frontal injury with patients with non-frontal injury and with normal controls on a standard neuropsychological instrument, the California Verbal Learning Test (CVLT). Subgroups of patients with distinct lesion site profiles were compared in a number of learning measures. All of the subgroups of patients with frontal lesions (with one exception) had inefficient learning due to poor implementation of a strategy of subjective organization. Despite this organizational deficiency, the performance of patients with frontopolar lesions normalized across trials. Only the subgroups with lesions centred either on the left posterior dorsolateral frontal region or the posterior medial frontal region had overall impaired learning and recall. The left posterior dorsolateral frontal group was most significantly impaired on all measures. This recall impairment was secondary to a mild lexical-semantic deficit. A recognition memory deficit in the same group was due to an abnormal response bias. Several groups had a modest increase in perseverative recalls; the underlying mechanisms differed. Disruption of different cognitive processes associated with specific frontal regions underlies the varied patterns of memory impairment. This study has demonstrated even finer differentiations within the frontal region than previously known.
Cerebrovascular Disorders↗
The detection of faked deficits on the Rey Auditory Verbal Learning Test: the effect of serial position.
The ability of subjects to fake deficits on the Rey Auditory Verbal Learning Test (AVLT) was evaluated. Subjects were randomly assigned to one of two malingering groups - one with a financial incentive (N = 30) and one without (N = 28) - or a control group (C) (N = 28), and a group of closed head injury patients (CHI) (N = 18) was matched on age, sex, and education level. The two malingering groups did not differ significantly and were combined into a single malingering group (M) (N = 57). There was a significant serial position (the pattern of "recency" and "primacy" effects in recall) by group interaction effect, which may be the most promising indicator of deliberate distortion. When only level of performance was examined, the M group could fake believable deficits, but when the serial position effect was examined, it revealed that this was accomplished by suppression of recall from the first third of the word list (reducing the "primacy effect"), a recall pattern which did not occur in either the C or CHI group and may be an indication of malingering.
Clinical Trial↗
Proton magnetic resonance spectroscopy of the inferior frontal gyrus and thalamus and its relationship to verbal learning task performance in patients with schizophrenia: a preliminary report.
Previous research has found frontal lobe involvement in memory impairment in schizophrenia. In the present study, proton magnetic resonance spectroscopy was performed in 13 young patients with schizophrenia and 13 normal control subjects. Spectra were obtained from a voxel of 2 x 2 x 1.5 cm(3) in the bilateral inferior frontal gyrus and thalamus. Subjects were given a verbal learning task and stimulus category repetition (SCR) was calculated from the performance of the task. Significantly reduced N-acetylaspartate (NAA)/choline-containing compounds ratios were found in the left inferior frontal cortex of patients compared with controls. The total number of words recalled by patients was significantly lower than that recalled by controls. In all subjects, SCR scores were positively correlated with NAA/phosphocreatine ratios of the left inferior frontal cortex, which showed a trend towards a decrease in patients. These results support the notion of metabolic abnormalities in the left inferior frontal region related to verbal memory deficits in patients with schizophrenia.
Adolescent↗
Relationship of IQ to verbal learning and memory: test and retest.
The relationship between Wechsler Adult Intelligence Scale-Revised (WAIS-R) IQ and performance on measures of memory was examined in 64 adults tested twice at a 2-week interval. Repeated measures analyses of variance revealed that individuals with Low-Average WAIS-R Full Scale IQ scores performed significantly more poorly than did individuals with Average and High-Average Full Scale IQs on memory measures including the Wechsler Memory Scale-Revised (WMS-R) General Memory and Delayed Recall indices, as well as California Verbal Learning Test (CVLT) Total Words. Learning Slope, and Discriminability. Although all three groups demonstrated significant practice effects on each memory measure, group differences in performance persisted at retest. Multiple regression analyses revealed that WAIS-R factor scores Verbal Comprehension and Freedom from Distractibility accounted for up to 42% of the variance in WMS-R and CVLT indices. Moreover, WAIS-R performance at initial testing accounted for 22-41% of the variance in memory performance at retest. These results are discussed in the context of the construct stabilities of intelligence and memory, as well as the psychometric precision of the tests used to measure these constructs.
Adult↗
The impact of American content on California Verbal Learning Test performance: a New Zealand illustration.
The assessment of verbal memory is a core component of neuropsychological assessment, and is often assessed through the use of list-learning tasks. As with other neuropsychological tests, list-learning tasks may be impacted by cultural relevance of test content. This study examined the extent to which the American content of the California Verbal Learning Test (CVLT) impacts upon the verbal memory performance of New Zealanders. Participants included 90 healthy New Zealand adults who ranged in age from 17 to 81 years. Each participant completed the CVLT and a new version of this test that was modified to reflect New Zealand content (NZ-VLT). Performance on the two measures was not significantly impacted by gender, cultural identity (European/Pakeha; Maori or Pacific Islander), or version of the test administered first. Poorer performances on all scores for both measures were significantly related to increased age, with larger correlation coefficients produced for the New Zealand version of the task. Within-subject comparisons revealed that participants performed significantly better on the New Zealand version of the task for short-delay free recall, long-delay free recall, and recognition trials. Implications of these findings are presented to aid clinicians in future applications of the CVLT in New Zealand.
Adolescent↗
Metabolic thalamocortical correlations during a verbal learning task and their comparison with correlations among regional volumes.
Methods based on the analysis of metabolic and volumetric interregional correlations have been used in neuroimaging research, yet metabolic and volumetric interregional correlations for identical regions of interest have never been compared in the same group of subjects. Magnetic resonance and [18F]-fluorodeoxyglucose positron emission tomography brain images were acquired in 59 healthy subject. Correlation matrices for relative glucose metabolic rates during a verbal learning task and for relative gray matter volumes were compiled between the manually traced mediodorsal, centromedian, and pulvinar nuclei of the thalamus and 39 cortical Brodmann's areas. Metabolic correlations between the cortex and these thalamic nuclei followed the known patterns of anatomical connectivity in non-human primates. Intercorrelations of the mediodorsal nucleus were widespread with the prefrontal cortex (9 out of 10 Brodmann's areas in the left hemisphere) and temporal lobe (10 out of 11 Brodmann's areas in the left hemisphere) while the pulvinar correlated only with the parietal and occipital cortical areas. Different correlation patterns were observed for the regional gray matter volumes whereby only the pulvinar yielded extensive cortical intercorrelations, primarily with the occipital, parietal, anterior cingulate, and orbitofrontal areas in the right hemisphere. Metabolic thalamocortical correlations were much more extensive for the mediodorsal and centromedian nuclei whereas structural correlations were more extensive for the pulvinar. Therefore, metabolic and volumetric correlational methods are sensitive to different aspects of interregional relations in the brain and their comparison in the same group of subjects may render complementary and only partially overlapping connectivity information.
Adult↗
Mayo's Older Americans Normative Studies: Age- and IQ-Adjusted Norms for the Auditory Verbal Learning Test and the Visual Spatial Learning Test.
Although normative data sets for standardized neuropsychometric instruments frequently feature adjustments for subject variables, there are reasons to believe that improvements in interpretive accuracy that result from such adjustments are less than optimal. In particular, years of education may be less closely associated with test performances than is overall intellectual functioning. In this last of four reanalyses of results from the Mayo Clinic's Older Americans Normative Studies (MOANS) databases, age-adjusted scores for the Rey Auditory Verbal Learning Test and the Visual Spatial Learning Test were found to be more strongly related to Mayo age-adjusted WAIS-R Full Scale IQ scores (rs=.150 to .395) than to education (rs=.060 to .236) for healthy older examinees between 56 and 99 years of age. Although AVLT-FSIQ correlations were greatest at moderate levels of intelligence, VSLT-FSIQ correlations consistently increased in strength as intelligence increased (cf. Dodrill, 19971999). Based on these results, we present tables of age- and IQ-adjusted percentile equivalents of Mayo age-adjusted AVLT index scores and MOANS age-adjusted AVLT and VSLT scaled scores for ten age ranges and either seven (AVLT) or five (VSLT) IQ ranges.
Acoustic Stimulation↗
Dorsal striatal size, shape, and metabolic rate in never-medicated and previously medicated schizophrenics performing a verbal learning task.
BACKGROUND: Magnetic resonance imaging and positron emission tomography were used to study the size and metabolic rate of the caudate and the putamen in 18 patients with schizophrenia (n=16) or schizo-affective disorder (n=2) and 24 age- and sex-matched control subjects. METHODS: The patients were either never medicated (n=7) or drug free (n=11) for a median of 3 weeks. During uptake of fludeoxyglucose F 18, all patients performed a serial verbal learning test. Positron emission tomographic and magnetic resonance imaging scans were coregistered, and the caudate and the putamen were traced on the magnetic resonance image. RESULTS: The striatum had a significantly lower relative metabolic rate in schizophrenics than in controls. Never-medicated patients had lower metabolic rates in the right putamen (ventral part of the dorsal striatum) than previously medicated patients. The caudate was significantly smaller in never-medicated patients than in controls and largest in previously medicated patients. Patients with higher relative metabolic rates in the putamen scored higher on the Abnormal Involuntary Movements Scale. CONCLUSIONS: The findings are consistent with reports of striatal enlargement in previously medicated patients and size increases after neuroleptic treatment. Never-medicated patients, in contrast, had ventral striatal structures that were smaller and less active than those observed in controls and previously medicated patients.
Adolescent↗
An examination of the California Verbal Learning Test II to detect incomplete effort in a traumatic brain-injury sample.
Clinical neuropsychologists are frequently called on to distinguish people who appear impaired on neuropsychological testing due to putting forth incomplete effort from those who have genuine cognitive deficits. Because traditional measures of effort are becoming accessible over the Internet and within the legal community and their purpose may be obvious to potential malingerers, nontraditional effort measures have been newly investigated. Using discriminant function analysis, this study explores whether five California Verbal Learning Test-Second Edition (CVLT-II) variables could differentiate between head-injured patients who were putting forth full effort and those who were putting forth incomplete effort. The discriminant function seemed to best predict those who put forth adequate effort while testing (95.6% correct) but not those who failed to put forth adequate effort during testing (only 13.8% correct). Hence, although the overall classification rate was moderately impressive (75.8%), the model's sensitivity in classification of the incomplete effort group was low. Cautious applications for these findings are discussed.
Adolescent↗
Memory performance on the California Verbal Learning Test-II: findings from patients with focal frontal lesions.
Numerous studies have suggested that frontal cortex plays a strategic, rather than an absolute, role in memory performance. Typically, frontal patients are reported to have impaired recall but normal recognition memory. A recent meta-analysis, however, has questioned this conclusion. To further investigate the role of frontal cortex in long-term memory, patients with focal frontal lesions and age- and education-matched controls were tested on a new version of the California Verbal Learning Test (CVLT-II). Frontal patients exhibited a number of deficits on this test, including overall poorer recall, an increased tendency to make intrusions, reduced semantic clustering, and impaired yes/no recognition performance. Further analysis of the error rates in the yes/no recognition task revealed that frontal patients were most likely to mistakenly endorse 2 types of distractors: semantically related words and words from an interference list. These findings are discussed with respect to the role of frontal dysfunction in false recollections and poor source memory, as well as the distinction between the roles of frontal and temporal cortex in long-term memory.
Aged↗
Regression equations for predicting scores of persons over 65 on the rey auditory verbal learning test, the mini-mental state examination, the trail making test and semantic fluency measures.
OBJECTIVES: Scores on neuropsychological tests are often used to detect abnormal changes in cognition in older persons. Accordingly, it is important to have normative data that allow the abnormality of a test score to be determined precisely and accurately. Regression equations that estimate an expected score based on demographic or premorbid factors can be an efficient method of making normative comparisons. Our aim was to compute regression equations with age, gender and estimated premorbid IQ as predictors of scores on the Rey Auditory Verbal Learning Test (AVLT), the Trail Making Test (TMT), Mini-mental State Examination (MMSE) and measures of semantic fluency. DESIGN: All measures were administered to a group of 272 healthy older persons aged between 65 and 90 during the pre-treatment phase of a study evaluating the effect of nutritional supplements on cognition. Premorbid IQ was estimated using the National Ault Reading Test (NART). Stepwise multiple regression procedures were used to determine the weights to be applied to the predictor variables. RESULTS: Age and premorbid IQ were found to be significantly correlated with all test variables; gender correlated significantly with most scores. Regression equations based on the 3 predictor variables explained between 10% and 30% of the variance of the range of test scores. The use of these equations in clinical practice was illustrated. CONCLUSION: The significant correlations between the predictor variables and test scores justified computing a set of equations for use in interpreting data from older persons. The abnormality of the difference between predicted and obtained scores provides a convenient index of an individual's current level of neuropsychological functioning.
Aged↗
ApoE epsilon4 allele and disease duration affect verbal learning in mild temporal lobe epilepsy.
PURPOSE: To clarify the possible role of other factors including the ApoE epsilon4 allele for memory decline in temporal lobe epilepsy (TLE). METHODS: We conducted a neuropsychological and molecular study in 138 consecutive patients (78 female patients; mean age, 50.2 years, SD +/- 17.9; range, 14 to 87 years) with mild nonlesional TLE, who rarely or never had seizures at long-term follow-up. The mean age at seizure onset was 33.0 years (SD, +/-21.7), and the mean duration of epilepsy was 17.1 years (SD, +/-15.7). RESULTS: Thirty-four (25%) of 138 patients had test scores indicating verbal learning deficit (VLD). The presence of an ApoE epsilon4 allele was associated with an increased risk of VLD (OR, 4.18; 95% CI, 1.66-10.55). The effect of the ApoE genotype was independent of both the age at epilepsy onset and disease duration as well as of a low educational level, which were separately associated with VLD (p values = 0.045, 0.001, and 0.001, respectively). A significant linear trend (p = 0.005) was seen in the relation between disease duration and cognitive impairment, with the highest risk being in patients with an epilepsy duration > or =25.5 years (OR, 7.06; 95% CI, 1.67-29.85), especially if they carried the epsilon4 allele (OR, 32.29; 95% CI, 5.23-195.72). CONCLUSIONS: These results provide evidence for an alteration in cognitive performance as a function of the presence of the ApoE epsilon4 allele and point to the critical role of disease duration itself for cognitive impairment in TLE.
Adolescent↗
The effect of learning verbal labels for stimuli on their later discrimination.
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Humans↗
[Studies on some conditions of verbal learning in children and adolescents].
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Adolescent↗
Identifying retrieval problems using the California Verbal Learning Test.
Wilde, Boake, and Sherer (1995) examined the discrepancy between Long Delayed Free Recall (LDFR) and Recognition Discriminability (RD)--the California Verbal Learning Test (CVLT) index thought to indicate the presence of memory retrieval problems--and found little evidence to recommend its use in traumatic brain injury (TBI). The present investigation re-examined this index from the perspective of a continuum of retrieval deficit severity. CVLT performance was examined in 122 TBI patients, and 2 retrieval deficit indicators of varying severity were evaluated. Memory-impaired control groups were matched with retrieval deficit groups on initial acquisition and demographic characteristics. Individuals with a LDFR/RD discrepancy did not show predicted differences on other CVLT indices of retrieval problems, similar to the findings of Wilde et al. (1995). In contrast, individuals with a consistent discrepancy between free recall and semantic cued recall (Short and Long Delay) had greater improvement with recognition cueing and made fewer intrusive errors than controls. Individuals who benefited from semantic cues (where retrieval of the target word is still required) also benefited from recognition cues (where retrieval demands are minimal). Evidence supported the existence of a continuum of retrieval deficit severity. An LDFR/RD discrepancy without performance improvement from semantic cueing appears to indicate a more severe retrieval deficit, whereas performance improvement from both recognition and semantic cueing indicates less severe retrieval deficits.
Adult↗
Characterization of memory impairment following closed-head injury in children using the Rey Auditory Verbal Learning Test (AVLT).
Memory impairment following closed-head injury (CHI) in children is well documented. Characterization of the memory deficits of children with CHI could contribute to the prediction of academic performance and rehabilitation of these children. Twenty-five children who sustained closed-head injury and 25 matched controls were administered the Rey Auditory Verbal Learning Test (AVLT). The advantage of this memory test is that a number of memory components are measured simultaneously, thus enabling us to study the relations between different aspects of memory within the same patient sample. The findings indicate that the Rey AVLT is a good test for characterization of impaired verbal memory in children following CHI. Transformation of scores derived from the Rey AVLT to Z-scores enables us to determine the relative effect of CHI in children on different memory scores. Raw scores were more vulnerable than relational ones, derived as the difference between two raw scores (e.g., learning, Trial 5 - 1), to closed-head injury in children, and scores reflecting word span were the least vulnerable. The results are discussed in terms of the possible contribution of the frontal lobes, which are frequently affected in closed-head injuries, to memory performance.
Acoustic Stimulation↗
Norms for depressed patients for the California verbal learning test: associations with depression severity and self-report of cognitive difficulties.
This study provides norms for depressed subjects for a widely used test of verbal memory, the California Verbal Learning Test (CVLT). Subjects were 156 outpatients with major depression tested during a drug washout period. Mean CVLT memory scores for these patients were generally between one-half and one standard deviation below age- and sex-corrected norms for nondepressed populations. Severity of depression in the patients was not associated with memory performance, but was associated with self-report of cognitive difficulties. A table of age-, sex-, and education-specific norms for the CVLT is provided.
Journal Article↗