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PubMed1994

Dissociation between delayed alternation and memory after pediatric head injury: relationship to MRI findings.

This study investigated the usefulness of a delayed alternation task in characterizing the cognitive sequelae of closed head injury in children and adolescents. Verbal learning and memory (California Verbal Learning Test) were also studied for comparison. Sixty-two closed head injury patients (mean age, 9.6 years), who were studied after an average postinjury interval of 20 months, were divided according to both their lowest postresuscitation Glasgow Coma Scale score (3 to 8 versus 9 to 15) and age range (5 to 7 years versus 8 to 16 years) at the time of testing. Magnetic resonance imaging was performed to evaluate the relationship of focal brain lesions to cognitive and memory performance. Fifty-six neurologically normal children (mean age, 9.9 years) were tested on the same measures. The results disclosed no relationship between delayed alternation performance and severity of injury. In contrast, verbal memory was impaired in the severely-injured patients, relative to both controls and less severely-injured patients. Frontal lobe (but not extrafrontal) lesion size incremented the Glasgow Coma Scale score in predicting verbal memory, but there was no relationship between focal brain lesions and delayed alternation performance. In contrast to the tendency for more efficient delayed alternation performance in the 5- to 7-year-old subjects than in the 8- to 16-year-old subjects, verbal memory significantly improved with age in the closed head injury and control groups. Notwithstanding our essentially negative findings for delayed alternation, it is possible that this task may be useful for assessing frontal lobe injury in younger children or infants.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

The neuropsychology of de novo patients with idiopathic Parkinson's disease: the effects of age of onset.

One hundred de novo patients with Parkinson's disease (PD) were classified into two groups according to age of onset of symptoms. Seventy two patients were under 70 years and 28 were 70 years and over. All patients were given neurological and neuropsychological assessments, and the severity of the signs was rated on a modified Columbia scale. The neuropsychological assessment was also administered to 50 age-and-education-matched controls. The neuropsychological test battery included tests of verbal learning, visual memory, verbal fluency, visuospatial skill, simple and choice reaction time, language and maze learning. The late-onset patients had significant impairment in nonverbal reasoning, auditory verbal learning, visual memory and choice reaction time in contrast to early-onset patients and controls. A relationship was found between bradykinesia and widespread cognitive impairment. Severity of tremor was found to be significantly correlated with impairment in auditory verbal learning, visual memory and increased choice reaction time, while rigidity was found to be associated with cognitive impairment in verbal fluency and visuospatial skill. Using DSM II criteria, 39% of the late-onset and 8% of the early-onset group were classified as demented. Dementia was more common in patients with bilateral symmetrical disease and in those patients with marked tremor and bradykinesia. The pattern of cognitive impairment in PD was consistent with that associated with a subcortical dementia. This study confirms that the expression of PD is markedly influenced by the age of onset.

Age Factors↗
PubMed1980

Word memory in non-psychotic depression.

Two diverging explanations can be given for the fact that depressed persons often show deficits on verbal learning tasks: (a) researchers have suggested that memory deficits are the result of interference in the transfer from short- to long-term memory; (b) other researchers have suggested that depressives may not have cognitive deficits but may instead simply show deficits in performance. The present study assessed differences in recognition memory, free recall, organization in multitrial free recall, and final free recall among short-term and long-term non-psychotic depressives (ns = 15) to determine whether such depressed adults show deficits on verbal learning tasks. No verbal learning deficits wee demonstrated for 30 depressives relative to 30 nondepressives. The implications of these findings are discussed in terms of interference and the possibility that poor verbal learning in depression is a problem of performance and not learning.

Adult↗
PubMed2004

Cognitive changes in patients with Huntington's disease (HD) and asymptomatic carriers of the HD mutation--a longitudinal follow-up study.

OBJECTIVE: Objective information about the onset and progression of cognitive impairment in Huntington's disease (HD) is very important in the light of appropriate outcome measures when conducting clinical trials. Therefore, we evaluated the progression of cognitive functions in HD patients and asymptomatic carriers of the HD mutation (AC) over a 2.5-year period. We also sought to detect the earliest markers of cognitive impairment in AC. METHODS: A prospective study comparing HD patients, clinically asymptomatic HD mutation-carriers (AC) and non-carriers (NC). These groups were examined three times during a period of 2.5 years. At baseline the study sample consisted of 49 subjects. Forty-two subjects (19 HD patients, 12 AC and 11 NC) completed three assessments. A battery of neuropsychological tests measuring intelligence, attention, memory, language, visuospatial perception, and executive functions was performed. RESULTS: The performance of HD patients deteriorated on the following cognitive tests: Symbol Digit Modalities Test (SDMT), Stroop Colour and Word, Boston Naming Test (BNT), Object and Space Perception and Trail Making Test-B. Longitudinal comparison of AC and NC revealed that performances on SDMT, Block Span, Digit Span Backwards, Hopkins Verbal Learning Test (learning and delayed recall) and Conditional Associative Learning Test are impaired in AC. CONCLUSIONS: Tasks measuring mainly attention, object and space perception and executive functions adequately assess the progression of HD disease. Other cognitive functions do not significantly deteriorate. Furthermore, problems in attention, working memory, verbal learning, verbal long-term memory and learning of random associations are the earliest cognitive manifestations in AC.

Adult↗
PubMed2001

Metacognition in motor learning.

Research on judgments of verbal learning has demonstrated that participants' judgments are unreliable and often overconfident. The authors studied judgments of perceptual-motor learning. Participants learned 3 keystroke patterns on the number pad of a computer, each requiring that a different sequence of keys be struck in a different total movement time. Practice trials on each pattern were either blocked or randomly interleaved with trials on the other patterns, and each participant was asked, periodically, to predict his or her performance on a 24-hr test. Consistent with earlier findings, blocked practice enhanced acquisition but harmed retention. Participants, though, predicted better performance given blocked practice. These results augment research on judgments of verbal learning and suggest that humans, at their peril, interpret current ease of access to a perceptual-motor skill as a valid index of learning.

Adult↗
PubMed1993

[Recovery of psychomotor and cognitive functions following anesthesia. Propofol/alfentanil and thiopental/isoflurane/ alfentanil].

Recent changes in the medical system have resulted in a significant increase of ambulatory surgical procedures. Therefore, a safe and short postoperative recovery period and, especially, the full recovery of complex psychological function after general anaesthesia have become increasingly important. In the present study we investigated the recovery of psychomotor and cognitive function after general anaesthesia with propofol/alfentanil and thiopentone/isoflurane/alfentanil. PATIENTS AND METHODS. Institutional approval and informed consent was obtained in 40 female ASA I or II patients undergoing diagnostic laparoscopy. As oral premedication the patients received chloracepat (10-20 mg) 45 min before the start of anaesthesia. Anaesthesia was induced in group I with propofol (2.5 mg/kg) and maintained with propofol (6-12 mg/kg/h)/alfentanil (0.05 mg/kg) and 50% N2O in O2. The patients of group II received thiopentone (5 mg/kg) for induction and isoflurane (0.5-1.5 vol%)/alfentanil (0.05 mg/kg) and 50% N2O in O2 for maintenance of general anaesthesia. In particular we measured the following parameters: (1) The recovery time, defined as the interval between the termination of the anesthetic and the patient's correct recall of her birth date. (2) The choice reaction times to optical stimuli (red or green light), which was used as a parameter for attention and psychomotor function. (3) The score in the "Zahlen-Verbindungs-Test" in which the patients had to connect numbers from 1 to 90 in correct order. This is also a parameter to quantify attention and psychomotor function. (4) The digit span which is a value derived from the number of correctly reproduced digits from a list presented to the patients. It is a measure of numerical memory. (5) The Munich Verbal Learning Test, which is the German version of the California Verbal Learning Test. It represents the number of correctly reproduced words from a previously presented list and is a measure of the verbal memory. (6) The Wisconsin Card Sorting Test, which serves to test the ability to plan and act and to form terms and concepts. (7) The State-Trait Anxiety Inventory, to quantify state anxiety. (8) Pain score, using a visual analogue scale. The tests were performed at four measurement points: the day before the operation and 30, 60, and 240 min after recovery. The "Zahlen-Verbindungs-Test", the digit span and the Munich Verbal Learning Test were presented in four parallel forms to minimize learning effects. For statistical analysis of the data the Wilcoxon test was employed within groups and the Mann-Whitney test between groups. RESULTS. The groups were comparable in age, weight, height and level of education. No significant difference was found between them in operation or anaesthesia time or in the total dosage of alfentanil. Recovery time in the propofol group was, at 10 min, significantly shorter than in the isoflurane group, with 16 min. Choice reaction times were significantly increased 30 min after recovery from anaesthesia in both groups. In the propofol group they returned to normal after 60 min, whereas in the isoflurane group significant increases could be observed even 240 min after recovery from the anaesthetic. Choice reaction times were significantly longer in the isoflurane group than in the propofol group 60 min and 240 min after anaesthesia. In the "Zahlen-Verbindungs-Test" the patients showed significantly worse results 30 min and 60 min after anaesthesia. The propofol group tended to be better than the isoflurane group, but the difference did not reach statistical significance. Also in the digit span, the scores were significantly lower 30 min after recovery from the anaesthetic. Here again the propofol group tended to be a little better than the isoflurane group 30 min, 60 min and 240 min after anaesthesia. In the Munich Verbal Learning Test both groups had lower scores 30 min and 60 min, the isoflurane group also 240 min, after recovery...

Adult↗
PubMed1987

Slow negative potential shifts indicating verbal cognitive learning in a concept formation task.

It is well-known clinically that patients with left frontal lesions are impaired in their verbal-cognitive learning ability. Starting from such observations, it is of particular interest whether the event-related cerebral potential shifts recorded in healthy human subjects would indicate a left frontal lobe involvement in verbal-cognitive learning tasks. In a concept formation paradigm, subjects learned by trial and error to transform letters into Morse codes. This cognitive performance was accompanied by a slow negative potential shift (SP) that in frontal recordings was lateralized towards the left hemisphere. off results show in a later stage of learning, in which the experience of the preceding trial and error learning could be integrated, an increasing slow negativity over the frontal cortex. Ss also participated in a control task with already known letter/Morse code combinations. Again, a negative potential shift occurred within the stimulus-response interval, however, it was smaller in amplitude.

Adult↗
PubMed2002

Case-control study of neurocognitive function in euthymic patients with bipolar disorder: an association with mania.

BACKGROUND: Neurocognitive impairments in euthymic patients with bipolar disorder may represent trait rather than state variables. AIMS: To test the hypothesis that euthymic patients with bipolar disorder would exhibit impairment in verbal learning and memory and executive function compared with healthy controls matched for age, gender and premorbid IQ. METHOD: Twenty euthymic patients with bipolar disorder were matched, on a case-by-case basis, to twenty healthy community controls. Cases and controls were tested with a battery of neuropsychological tests. RESULTS: Impairments were found in cases compared with controls in tests of verbal learning and memory. Verbal learning and memory correlated negatively with the number of manic episodes. CONCLUSIONS: Impaired verbal learning and memory may be a trait variable in bipolar disease. There are implications for adherence to medication and relapse and for the role of early treatment interventions. Prospective designs and targeting first-episode groups may help to differentiate trait v. disease process effects.

Adolescent↗
PubMed2005

The relation of self-report of mood and anxiety to CVLT-C, CVLT, and CVLT-2 in a psychiatric sample.

The relation between mood and cognitive status has been examined extensively over the years suggesting a significant impact of mood and potentially anxiety on memory. This relation is of particular interest to practitioners conducting evaluations in settings that regularly treat individuals diagnosed with psychiatric disorders. With this in mind, the present study sought to evaluate the impact of self-report of depression and anxiety on the California Verbal Learning Test-children's version (CVLT-C), the California Verbal Learning Test (CVLT), and the California Verbal Learning Test-2nd edition (CVLT-2) in a mixed psychiatric sample. Records from 107 patients aged 6-78 evaluated in an outpatient psychiatry unit were examined. Results indicated minimal predictive utility was provided from self-report symptoms of anxiety or depression on CVLT-C, CVLT, or CVLT-2: Trial 1, Trial 5, total score, Short Delay Free Recall, Short Delay Cued Recall, long delay free recall, or long delay cued recall performance above the variance predicted by age, gender, and Full Scale IQ. Additional variance predicted by depression as measured by the Beck Depression Inventory (BDI) and the Child Depression Inventory (CDI) or anxiety as measured by the State-Trait Anxiety Inventory (STAI) was less than 3.0% over that accounted for by the covariates for the great majority of measurements from the various CVLT versions. Exceptions included the CDI that tended to account for approximately 5.0% of the variance on all of the CVLT-C measures and the STAI that accounted for approximately 5.0-10.0% additional variance on the short and long delay measures of the CVLT-2. The present results suggest that performance on the various forms of the CVLT are minimally predicted by self-reported depression and anxiety in a psychiatric setting.

Adolescent↗
PubMed2006

Executive dysfunction and memory in older patients with major and minor depression.

Executive function, known to be impaired during late-life depression, is dependent on frontostriatal pathways. Memory is also frequently observed to be impaired among late-life depressed patients, so we assessed the possibility that executive function mediates the learning and recall deficit as a "downstream" effect of the frontostriatal compromise in executive function. A cross-sectional sample of minor and major depressed patients (N=95) and nondepressed volunteers (N=71), screened for other Axis I disorders, dementia, medical comorbidity, and severity of depression, completed a neuropsychological battery that included the California Verbal Learning Test and other tests selected for convergent and divergent validity testing. Depressed patients differed from controls on learning the word list and on verbal and nonverbal executive tasks. Executive function was a mediator for depressed patients verbal learning scores (z=-2.67, p=.01). A nonverbal executive score also mediated verbal learning (z=-2.18, p=.03) indicating convergent validity of executive dysfunction during verbal learning exercises. In conclusion, the verbal memory deficits typically attributed to late-life depression may result from impaired executive functioning during the learning phase of the recall task.

Age of Onset↗
PubMed2004

Cognitive functioning in young people with first episode psychosis: relationship to diagnosis and clinical characteristics.

OBJECTIVE: To examine the extent and nature of neuropsychological deficits in adolescents and young people with first episode psychosis (FEP), and to determine whether the pattern and extent of neuropsychological deficits varied according to diagnosis. METHOD: A total of 83 FEP subjects aged 13-25 years, and 31 healthy controls completed a comprehensive battery of neuropsychological tests, grouped into 10 cognitive domains. First episode psychosis subjects were stratified into three diagnostic groups (schizophrenia, affective disorders, substance-induced psychosis) and differences in cognitive profiles were examined. The contribution of demographic and clinical characteristics to cognitive performance was also explored. RESULTS: The schizophrenia group demonstrated significantly worse performance on tasks of verbal learning and memory than the affective disorders group. Compared to healthy controls, the schizophrenia group also demonstrated global impairment across the majority of cognitive domains. The substance-induced group's performance lay between that of the schizophrenia and affective disorders groups. Analyses of differential deficits revealed that verbal learning, verbal memory and current intellectual functioning were selectively impaired in the schizophrenia group, whereas the affective disorders group demonstrated a selective deficit in speeded processing. Premorbid intellectual functioning, negative symptomatology and medication levels were the strongest predictors of cognitive performance in FEP subjects. CONCLUSIONS: Verbal memory deficits differentiate individuals with schizophrenia from those with psychotic affective disorders. Although significant cognitive deficits are evident across all diagnostic FEP groups, individuals with schizophrenia appear to have more generalized impairment across a broad array of cognitive functions than other psychotic diagnoses. Lower premorbid intellectual functioning does not appear to contribute to greater cognitive deterioration following onset of psychosis, but severity of illness may be a more important factor than levels of mood disturbance.

Adolescent↗
PubMed1995

Larger nondeclarative than declarative deficits in learning and memory in human aging.

This study used classical conditioning as a measure of nondeclarative learning and compared it with verbal learning as a declarative measure. Eighty participants were tested using 1 of 2 paradigms (400-ms and 750-ms delay) for eyeblink classical conditioning (EBCC) and the California Verbal Learning Test (CVLT). Large age differences were observed in the nondeclarative EBCC task, even in the 750-ms paradigm, which is more optimal for older adults. Age differences in the nondeclarative EBCC task were larger in the 400-ms paradigm and equal in the 750-ms paradigm to the magnitude of age differences in the declarative CVLT task. Partial correlations (removing the variance that was due to age) showed no relation between performance on the nondeclarative and declarative tasks. The results contradict the common assumption that, in the same participants, nondeclarative learning and memory are more resistant to the effects of aging than are declarative learning and memory and suggest that nondeclarative learning and memory are not unitary.

Adolescent↗
PubMed2000

Learning and memory impairment in cocaine-dependent and comorbid schizophrenic patients.

Impairments in verbal learning and memory functioning have been found to be cardinal features among individuals with schizophrenia as well as among non-schizophrenic cocaine abusers. Cognitive deficits in these areas, moreover, have been associated with poor treatment response and short-term outcome. Little is known, however, about the acute effects of cocaine abuse on schizophrenic patients' learning and memory functioning. Consequently, a potentially reversible and treatable source of cognitive impairment has been virtually ignored. The present study examined the extent of verbal learning and memory impairment in a group of cocaine-dependent schizophrenic patients (n=42) and a group of non-schizophrenic cocaine-dependent patients (n=21) within 72 h of the last cocaine use using the California Verbal Learning Test (CVLT). Schizophrenic patients (n=34) without any substance-use disorders were also tested in an identical time frame and served as a comparison group. Results revealed that all groups demonstrated significant learning and memory impairment relative to CVLT published age and gender corrected norms. Both cocaine-dependent and non-substance abusing schizophrenic groups presented a very similar pattern of impaired learning and recall performance across all CVLT task domains. Comorbid patients, in contrast, presented with marked deficits in their ability to learn and recall verbal information relative to either schizophrenic or cocaine-only groups. Moreover, the cocaine-abusing schizophrenic patients showed significant forgetfulness of the information that they did acquire during delayed recall conditions. The performance deficits exhibited by cocaine-abusing schizophrenic patients differed not only in relative severity of impairment, but also qualitatively in their increased rates of forgetfulness of acquired information. These results are interpreted in terms of the neurobiological substrates of learning and memory and the neurobiological impact of cocaine on schizophrenic patients' cognition during the early phase of inpatient hospitalization. These results suggest that comorbid patients should be targeted for specialized remediation efforts at the beginning phases of inpatient treatment.

Acute Disease↗
PubMed1996

Cognitive therapy for multiple sclerosis: a preliminary study.

BACKGROUND: Drug treatments for multiple sclerosis are expensive, may cause side effects, and do not have demonstrated efficacy for cognitive deficits associated with this disease. OBJECTIVE: To test the effectiveness of a multimodal cognitive therapy on cognitive and physical measures known to be affected in multiple sclerosis. DESIGN: Quasi-experimental wait-list control. SETTING: Alternative medicine clinic. PATIENTS: 27 persons with clinically definite multiple sclerosis. INTERVENTION: Multimodal cognitive therapy. MAIN OUTCOME MEASURES: Neuropsychological measures of verbal learning and memory, abstraction, vocabulary, and information processing speed; Beck Depression Inventory; tactile sensitivity of the hands; grip strength; and visual acuity. MAIN RESULTS: 12 of 14 patients in the therapy group and 10 of 13 patients in the control group completed 24 weeks of treatment and all assessments. Patients who received therapy showed significantly greater improvement in verbal learning, verbal abstraction, depression, and some measures of grip strength and tactile sensitivity than did patients in the untreated control group. The groups did not differ in the magnitude of change on vocabulary, information processing speed, or visual acuity. CONCLUSION: Cognitive therapy appears to be a promising treatment for ameliorating some symptoms of multiple sclerosis. A larger study with a randomized design and additional outcome measures is warranted.

Adult↗
PubMed2004

Specific cognitive deficits are common in children with Duchenne muscular dystrophy.

A neuropsychological assessment was conducted to study cognition, with emphasis on memory, information processing/learning ability, and executive functions in boys with Duchenne muscular dystrophy (DMD). A group of 20 boys with DMD, aged 7 to 14 years (mean age 9 years 5 months, SD 2 years 2 months), was contrasted with 17 normally developing age-matched comparison individuals, using specific neuropsychological tests (Block Span, Digit Span, Story Recall, Rey Auditory Verbal Learning Test, Rey Complex Figure Test, Spatial Learning Test, Verbal Fluency, Trail Making Test, Tower of London, Memory for Faces, and Raven's Coloured Progressive Matrices). The DMD group performed significantly worse on all aspects of memory, learning, and executive functions. There was no significant difference in general intellectual ability between the two groups. Analyses of group differences indicate that problems in short-term memory are the most apparent, suggesting specific cognitive deficits. The differences between the groups were similar for both verbal-auditory and visuospatial tests, thus contradicting the idea that cognitive deficits are related to type of stimulus presented. It is concluded from this study that short-term memory deficits might play a critical role in the cognitive impairment and intellectual development seen in those with DMD.

Adolescent↗
PubMed2005

A longitudinal study of cognition change during early menopausal transition in a rural community.

OBJECTIVE: To characterize changes in cognition that occur during the hormonal transitions of menopause. METHOD: We conducted a longitudinal population-based study in Kinmen, Taiwan, recruiting all women age 40-54 years who were premenopausal and without a history of hormone replacement therapy (HRT) or hysterectomy. The cognitive measures used to assess function included the Auditory-Verbal Learning Test, visual memory, verbal fluency, Trail Making Test and digit span. RESULTS: A total of 694 eligible women participated in the baseline study, and 573 women (83%) completed follow-up 18 months later. After excluding 78 women who received hysterectomy or HRT, the final sample was composed of 495 subjects, of whom 114 (23%) progressed to perimenopause during follow-up. Women who remained premenopausal were younger than those who became perimenopausal (44.7 +/- 2.3 years versus 47.1 +/- 3.0 years, p < 0.01). All follow-up cognitive scores in women who entered perimenopause were slightly better than baseline measures except for Rey Auditory-Verbal Learning Test, which decreased by 0.23 (S.D. = 2.9, p = 0.3). At follow-up, cognitive function except for verbal fluency did not differ significantly between women who stayed premenopausal and those became perimenopausal after controlling for age, education, and baseline cognitive scores. Women who entered perimenopause have an average of 1.3 items (S.D. = 0.4) less in verbal fluency measures as compared with their premenopausal peers at the follow-up period. CONCLUSIONS: The menopausal transition might not accompany significant cognitive decline except for verbal fluency.

Adult↗
PubMed2000

Impaired verbal category learning in amnesia.

Amnesic patients and controls listened to verbal descriptions of imaginary animals and then classified novel descriptions according to whether they belonged to the studied category. Controls performed well, but the amnesic patients did not acquire categorical knowledge. These findings contrast with previous demonstrations of intact category learning by amnesic patients for dot patterns, artificial grammars, and cartoon animals. It appears that category knowledge can be acquired implicitly when training exemplars are presented visually and when the similarities among items can be readily perceived. Verbal category learning requires the extraction and retention of meaning from training exemplars that are separated in time and may make demands on declarative memory that are beyond the capacity of amnesic patients.

Amnesia↗