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Selective reminding procedure in depression and dementia.

Patients with mild dementia of the Alzheimer's type (DAT), patients with major depression, and normal elderly control subjects were administered a verbal learning task using the selective reminding procedure. Depressed patients were impaired on total recall and the proportion of items retained from one trial to the next without reminding and did not benefit from imagery in retaining items over consecutive trials. The DAT patients were impaired on all measures derived from the test, including storage and recognition memory. With the exception of the ability to benefit from imagery, all of the measures distinguished depressed and mild DAT patients. These findings are consistent with deficient encoding in DAT and performance deficits as a function of effortful cognitive processing in depression.

Aged↗

Is overgeneral autobiographical memory an isolated memory phenomenon in major depression?

The present study explored the relation between overgeneral autobiographical memory (AM) and other aspects of memory functioning in depression. A total of 26 patients with major depressive disorder completed a set of memory tasks measuring AM specificity (AMT; Williams & Broadbent, 1986), working memory, semantic memory, verbal learning, delayed verbal recall, recognition memory, and source memory. Reduced specificity of AM was related to poor working memory (central executive functioning) and poor source memory. The former finding conforms to the idea that the voluntary retrieval of specific autobiographical memories (AMs) involves central executive processes (e.g., Conway & Pleydell-Pearce, 2000). The latter finding replicates and extends recent findings suggesting that overgeneral AM is part of a broader memory deficit in retrieving the specific details of the context in which information was acquired (Ramponi, Barnard, & Nimmo-Smith, 2004). Furthermore, in line with Ramponi et al. (2004), rumination was found to be related to both overgeneral AM and poor source memory.

Adult↗

The Rey AVLT Serial Position Effect: a useful indicator of symptom exaggeration?

This investigation explored the usefulness of serial position patterns during word recall on the Rey Auditory Verbal Learning Test (RAVLT; Rey, 1964) as an indicator of poor effort. Significantly better recall for early (primacy) and recent (recency) material defines the serial position effect (SPE; Rundus, 1971). The SPE on the RAVLT was examined in four groups: normal controls (NC), symptom-coached simulators (SC), test-coached simulators (TC), and a group of moderate to severe subacute traumatic brain injury (TBI) patients. Normal control participants and TBI patients demonstrated the expected SPE. Only the SC simulators clearly suppressed the primacy effect. The SPE appears neither sensitive nor specific enough to be used independently of more sensitive symptom validity tests in the detection of suboptimal effort. It may be especially problematic when used with clients presenting with sophisticated styles of exaggeration and in settings with lower base rates of compromised effort.

Adult↗

Memory performance of children with dyslexia: a comparative analysis of theoretical perspectives.

This study examined the memory performance of children with reading disabilities (RD) using methodology representative of three theoretical perspectives on RD subtypes: the phonological deficit, dual route, and phonological-core variable-difference models. Analyses compared the serial memory, verbal learning, and abstract visual-spatial memory performance of 45 children with RD to that of chronological-age (CA)- and reading-level (RL)-matched controls, using subtype identification methods from each of the theoretical models to classify children with RD. Phonological deficit and dual route comparisons indicated that children with RD, regardless of subtype, performed more poorly than CA- and better than RL-matched participants on all memory tasks. Phonological-core variable-difference methodology yielded three RD subtypes, two of which exhibited distinctive memory deficits relative to both CA and RL control groups. The phonological-core variable-difference model accounted for more variance in memory performance than either of the other two models.

Attention↗

Multiple memory systems: evidence from stroke.

In this report, we describe the "fractionation of memory systems" in a 62-yr.-old woman following a left anterior stroke. Despite the presence of a significant, persistent declarative memory (verbal learning) deficit, this patient exhibited relatively intact procedural learning. The latter was manifested over a 4-day period by improved performance on a maze task executed under "mirror-tracing" conditions. By the final set of trials, the patient's performance approximated that of a normal control subject with respect to speed, although not errors. The selective preservation of particular learning abilities in brain-damaged patients has implications for rehabilitative interventions.

Brain Damage, Chronic↗

Implicit learning in psychotic patients.

Implicit verbal learning of psychotic patients (n = 59) and non-psychotic control patients (n = 20) was studied using stem completion and association tasks in lexical and semantic priming paradigms. Performance on these tasks was contrasted with explicit memory on Rey's verbal learning test. Furthermore, correlations of these aspects of memory with positive and negative symptoms of psychosis were examined. Symptom ratings were based on an interview by a psychiatrist using the CPRS and SANS. As expected, the lexical and semantic priming effects in both patient groups were not significantly different, whereas the psychotic patients compared to the controls were impaired in explicit learning. None of the memory variables was significantly correlated with negative or positive symptoms. These findings are explained by the fact that priming effects, as opposed to explicit learning, depend on automatic memory processes, which do not require conscious effort. Moreover, the findings suggest the intactness of posterior cortical functions in psychotic patients.

Adult↗

Differential effects of lead exposure on components of verbal memory.

AIMS: To determine if verbal learning and memory requiring acquisition and retention of information is differentially affected by lead exposure. METHODS: The Rey Auditory Verbal Learning Test (RAVLT), a test of verbal learning and memory, was administered to 256 English speaking lead smelter workers who had a mean (SD) age of 41 (9.4) years and employment duration of 17 (8.1) years. Lead exposure variables, based on up to 25 years of prior blood lead data, included a mean (SD) current blood lead (PbB) of 28 (8.8) microg/dl, working lifetime time weighted average blood lead (TWA) of 39 (12.3) microg/dl, and working lifetime integrated blood lead index (IBL) of 728 (434.4) microg-y/dl. Associations of these chronic and recent lead exposure variables with measures from the RAVLT were modelled through multiple linear regressions after controlling for age and educational achievement. RESULTS: PbB was not associated with any of the RAVLT variables. However, TWA and IBL contributed significantly to the explanation of variance of measures of encoding/storage and retrieval but not to immediate memory span, attention, and learning. Grouping study participants by RAVLT performance according to three recognised clinical memory paradigms showed significantly higher TWA and IBL in the group with "generalised memory impairment" after adjusting for age and educational achievement. We examined recall mechanisms in each group by serial position in the word list and found stronger primacy (recall of words from the beginning of the list) in the "no impairment" and "retrieval difficulties" groups while the "generalised memory impairment" group had better performance on recency (recall of words from the end of the list). CONCLUSIONS: Lead exposure over years and not PbB interfered with the organisation and recall of previously learned verbal material. Chronic lead exposure affects encoding/storage and retrieval of verbal information.

Adult↗

Psychological consequences of blunt head injury.

89 severely closed head injured cases were tested on measures of verbal learning, and verbal and nonverbal intelligence, and their performance was compared with that of 30 orthopaedic cases. Head injured cases had severe deficits on all the tests. Severity of injury (judged by post-traumatic amnesia duration) was significantly related to poor performance on the learning and nonverbal intelligence tests, but not on the verbal intelligence test. The effect of injury on the family was studied in a further group of 35 head injured cases, showing that family burden within six months of injury was related to the presence of childish behaviour and loss of interest in the patient, together with other behavioural and affective changes. Physical deficits were not significant in this respect.

Adolescent↗

The relationship between literacy and cognition in well-educated elders.

BACKGROUND: Literacy is correlated with general intelligence and is often used to estimate premorbid intelligence in persons with dementia. However, little is known about the relationship between literacy and specific cognitive domains. METHODS: Study participants were 664 community-living adults aged 65 years or older who were participating in a community-based study of health and function in Sonoma, California. Literacy was measured using the North American Adult Reading Test, which evaluates the ability to pronounce words with irregular spellings (such as indict). Cognitive function was assessed using a neuropsychological test battery that included the Mini-Mental State Examination and measures of attention and executive function (Trails B, Stroop, Digit Symbol), verbal learning and memory (California Verbal Learning Test), and verbal fluency (letter "s," animals). RESULTS: The mean age of the participants was 76 years, 50% were women, 97% were white, and 92% had 12 or more years of education. A strong, linear association was observed between literacy and all cognitive measures (all p <.001). Results were similar after adjustment for age, sex, education, and health-related covariates and were consistent in subgroups of the study population (e.g., women vs men; English vs other native languages). Education was not associated with most cognitive measures after adjustment for literacy. CONCLUSIONS: Literacy is strongly associated with cognitive function across all cognitive domains in well-educated, elderly white persons. Future studies should determine whether interventions to improve lifetime literacy may help prevent cognitive deterioration with age.

Aged↗

Implicit strategy affects learning in children with heavy prenatal alcohol exposure.

BACKGROUND: Learning and memory deficits are commonly reported in children with heavy prenatal alcohol exposure. Our recent work suggested that children with heavy prenatal alcohol exposure retained information as well as controls on a verbal learning test but not on a test of nonverbal learning and memory. To better understand the cause of this differential pattern of performance, the current study re-analyzed data from our previous study to determine if the presence of an implicit learning strategy may account, at least in part, for the finding of spared retention. METHODS: The current study examined verbal learning and memory abilities in 35 children with Fetal Alcohol Spectrum Disorders (FASD) and 34 nonexposed controls (CON) matched for age (9-16 years), sex, ethnicity, handedness, and socioeconomic status. Groups were compared on two measures of verbal learning, one with an implicit strategy (California Verbal Learning Test-Children's Version; CVLT-C) and one without (Verbal Learning subtest of the Wide Range Assessment of Memory and Learning; VL-WRAML). RESULTS: Children with FASD learned less information overall than children in the CON group. Both groups learned a greater percentage of information and reached a learning plateau earlier on the CVLT-C compared with the VL-WRAML. Groups also showed comparable rates of retention after a delay on the CVLT-C. In contrast, on the VL-WRAML, children with FASD showed poorer retention rates than children in the CON group. Interestingly, children with FASD did not differ from children in the CON group on CVLT-C semantic clustering scores for learning trials 1 through 3, and greater utilization of semantic clustering was correlated with better learning and memory performance in both groups. This overall pattern of results was not related to overall intellectual level. CONCLUSIONS: The finding of spared retention of verbal information on the CVLT-C in our earlier studies may be related to test characteristics of the CVLT-C rather than a finding of spared verbal retention per se, given that spared retention was not found on a separate test of verbal learning and memory without an implicit learning strategy. These results suggest that the use of an implicit strategy positively affected the ability of alcohol-exposed children to learn and retain new verbal information.

Adolescent↗

Word frequency and the intentional-incidental verbal-discrimination learning of nonretarded and mentally retarded individuals.

MA-matched nonretarded and mentally retarded persons were given a verbal-discrimination learning task and an associative matching task. In the verbal-discrimination learning task, word frequency was manipulated by having one-half of the participants in each IQ group pronounce for 20 trials the words that were later used in the verbal-discrimination learning task (i.e., the high-frequency condition). The remaining participants pronounced words that were not a part of the task (i.e., the low-frequency condition). Based on an implication derived from frequency theory, I predicted that retarded persons would be more adversely affected by the high-frequency condition than would nonretarded persons; however, results indicated that both groups were adversely affected. The associative matching task was used to test the incidental learning hypothesis. Results revealed a significant Intelligence X Frequency interaction, which indicated that the retarded group exhibited an incidental learning deficit but only under the high-frequency condition. A possible explanation for this finding was discussed within the context of depth of processing.

Adolescent↗

The neural correlates of intentional learning of verbal materials: a PET study in humans.

The purpose of this study was to identify the brain regions invoked when subjects attempt to learn verbal materials for a subsequent memory test. Twelve healthy subjects undertook two different tasks: reading and encoding of word pairs, while they were being scanned using [15O]H2O positron emission tomography (PET). As expected, the encoding pairs were remembered much better (recall 39% vs. 8%; P < 0.001) than reading pairs in a subsequent memory test. The encoding scans, as compared to reading scans, showed activation of the left prefrontal cortex, the anterior cingulate cortex and the left medial temporal cortex. The left prefrontal activations were in two discrete regions: (i) a left anterior and inferior left prefrontal (Brodmann's areas 45, 46) which we attribute to semantic processing; and (ii) a left posterior mid-frontal region (BA 6, 44) which may reflect rote rehearsal. We interpret the data to suggest that when subjects use cognitive strategies of semantic processing and rote-rehearsal to learn words, they invoke discrete regions of the left prefrontal cortex. And this activation of the left prefrontal cortex along with the medial temporal region leads to a neurophysiological memory trace which can be used to guide subsequent memory retrieval.

Adult↗

Cognitive functioning in young and middle-aged unmedicated out-patients with major depression: testing the effort and cognitive speed hypotheses.

BACKGROUND: Cognitive deficits are common in major depressive disorder, but their nature is unclear. The effort hypothesis states that performance on effortful tasks is disproportionately impaired compared with the performance on automatic tasks. The cognitive speed hypothesis states that depression is characterized by cognitive slowness, which is a source of cognitive dysfunctioning. The present study investigated both theories in unmedicated adult depressive patients. It was also investigated whether the cognitive deficits can be attributed to more general physical illness-related factors or specifically to depressive disorder. METHOD: Thirty non-psychotic depressive out-patients were compared with 38 healthy control subjects and 25 patients with severe allergic rhinitis. The effects of group on more automatic and more effortful aspects of cognitive tasks measuring cognitive speed (Concept Shifting Task, Stroop Colour Word Test, Memory Scanning Test) and memory retrieval (Visual Verbal Learning Task, Verbal Fluency Test) were evaluated by MANCOVA. Age, sex, education and pre-morbid intelligence were treated as covariates. RESULTS: The depressive group had cognitive deficits in the automatic processing subtask of the Stroop, memory scanning and memory span. Performance on more effortful tasks was not impaired. CONCLUSIONS: Our results are more consistent with the cognitive speed hypothesis. Cognitive functioning in depressive disorder seems to be characterized by a reduced speed of information processing in automatic subtasks.

Adult↗

Neuropsychological consequences of posteroventral pallidotomy for the treatment of Parkinson's disease.

OBJECTIVE: Neuropsychological changes were assessed in patients who had idiopathic PD after unilateral posteroventral pallidotomy. METHODS: Posteroventral stereotactic pallidotomies were performed on 42 PD patients (24 right and 18 left hemisphere). All patients were evaluated in the "on state" before the procedure (n = 42) and at intervals of 3 (n = 26), 6 (n = 27), and 12+ (n = 24) months after surgery. RESULTS: Modest improvement in sustained attention and decline in working memory was observed by 6 months after surgery. Left hemisphere lesions led to a loss of verbal learning (-2.2 SD) and verbal fluency (-1.6 SD) in 60% of patients at their first evaluation at 3 or 6 months. No patients returned to baseline on the verbal fluency task and most (71%) did not recover verbal-learning ability by 12 months after surgery. Right hemisphere lesions led to a loss of visuospatial constructional abilities (-3.5 SD), which fully resolved by 12 months for all but one patient. Evidence of further decline of frontal-executive functioning was noted within other tasks but not on a "direct" test (i.e., Conditional Associative Learning). Lastly, behavioral changes of a "frontal nature" were reported in 25% to 30% of patients. These cognitive and emotional costs increased dependence in these domains and negatively affected some patients' relations with caregivers and restricted their ability to function properly at work or in social settings. Caregivers, particularly, and patients who were aware of their resulting changes had difficulty adjusting after surgery. CONCLUSIONS: Although patients and caregivers were generally pleased with the clinical neurologic outcome of the procedure, the neurologic benefits of unilateral pallidotomy must be weighed against modest cognitive and behavioral risks.

Adult↗