Changes in verbal and nonverbal learning following a single left or right unilateral electroconvulsive treatment.
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Adult↗
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Temporal entrainment of cognitive functions: musical mnemonics induce brain plasticity and oscillatory synchrony in neural networks underlying memory.
In a series of experiments, we have begun to investigate the effect of music as a mnemonic device on learning and memory and the underlying plasticity of oscillatory neural networks. We used verbal learning and memory tests (standardized word lists, AVLT) in conjunction with electroencephalographic analysis to determine differences between verbal learning in either a spoken or musical (verbal materials as song lyrics) modality. In healthy adults, learning in both the spoken and music condition was associated with significant increases in oscillatory synchrony across all frequency bands. A significant difference between the spoken and music condition emerged in the cortical topography of the learning-related synchronization. When using EEG measures as predictors during learning for subsequent successful memory recall, significantly increased coherence (phase-locked synchronization) within and between oscillatory brain networks emerged for music in alpha and gamma bands. In a similar study with multiple sclerosis patients, superior learning and memory was shown in the music condition when controlled for word order recall, and subjects were instructed to sing back the word lists. Also, the music condition was associated with a significant power increase in the low-alpha band in bilateral frontal networks, indicating increased neuronal synchronization. Musical learning may access compensatory pathways for memory functions during compromised PFC functions associated with learning and recall. Music learning may also confer a neurophysiological advantage through the stronger synchronization of the neuronal cell assemblies underlying verbal learning and memory. Collectively our data provide evidence that melodic-rhythmic templates as temporal structures in music may drive internal rhythm formation in recurrent cortical networks involved in learning and memory.
Brain↗
Neurocognitive performance and functional disability in the psychosis prodrome.
OBJECTIVE: This study evaluates the pattern of neuropsychological deficits and their association with clinical symptomatology and social functioning in individuals identified as ultra-high-risk (UHR) for psychosis. METHODS: A sample of 45 UHR individuals was identified using the Structured Interview for Prodromal Syndromes (SIPS) from consecutive referrals to the Staglin Music Festival Center for the Assessment and Prevention of Prodromal States (CAPPS) at UCLA. Participants were administered a neurocognitive test battery, as well as measures of global (Strauss-Carpenter Outcome Scale) and social functioning (UCLA Social Attainment Survey). RESULTS: Participants showed significant deficits in speed of processing, verbal learning and memory, and motor speed. Poorer verbal learning and memory performance was significantly associated with poorer social functioning, and there was a trend for poorer performance on reasoning and problem solving to be associated with poorer global functioning. Verbal memory independently predicted social functioning over and above severity of negative symptoms. Cognitive deficits were not associated with severity of clinical symptomatology. CONCLUSIONS: Despite the absence of fully psychotic symptoms, UHR individuals experience significant cognitive deficits, particularly on tasks requiring speeded information-processing and efficient recall from memory, and these deficits appear to be associated with functional disability in a manner parallel to that observed in patients with established psychotic illness.
Adolescent↗
Neurocognitive impairments associated with ambiguous handedness in the chronically mentally ill.
One form of atypical handedness, ambiguous handedness, is found in roughly one-quarter of chronic schizophrenic patients. Despite its prevalence, relatively little is known about the neurocognitive underpinnings of ambiguous handedness. In the present study we examined the performance of ambiguous (n = 19) and non-ambiguous (n = 39) handed chronically mentally ill inpatients on selected measures of verbal learning, motor learning and manual dexterity. The results revealed that ambiguous handers were more impaired than non-ambiguous handers in verbal learning, but not motor learning. Group differences in manual dexterity were significant for the entire sample, but not when analyses were limited to males. These findings suggest that impairments in verbal learning may be linked to the pathogenesis of ambiguous handedness in chronic psychiatric patients.
Adult↗
Individual differences in the functional neuroanatomy of verbal discrimination learning revealed by positron emission tomography.
Why do some people have better memory abilities than others? This issue has been of long-standing interest to scientists and lay people. However, using purely behavioral methods, psychologists have made little progress in illuminating it. Now that functional brain imaging techniques have become available to study mind/brain relations, there is a new promise of understanding individual differences in learning and memory in terms of corresponding differences in brain activity. In this paper, we will present a positron emission tomography (PET) study designed to examine individual differences in learning and memory abilities. The basic assumption is that different patterns of brain activity serve as strong predictors of memory performance. Two specific questions were addressed in this study: (i) Can PET illuminate the relations between memory processes and their neuroanatomical correlates among individual learners and rememberers? and (ii) if so, how are these relations affected by the stage of practice on a given memory task? Our PET study examined individual differences in the neuroanatomical correlates of multi-trial verbal discrimination learning in 16 young healthy subjects. The results identified patterns of brain regions in which blood flow correlated with subjects' retrieval performance. However, these regions did not correlate with performance during all learning trials. Instead, a gradual shift was observed from one pattern of brain regions to another over the course of learning. These results suggest that individual differences in memory performance are related to differences in neural activity within specific brain circuits.
Adult↗
Memory functioning in polysubstance dependent women.
BACKGROUND: The vast majority of studies on polysubstance abuse or dependence have utilized male participants; therefore, the specific neuropsychological effects of polysubstance dependence in women are relatively unknown. The goal of the present study is to examine the effects of polysubstance dependence on women's verbal and visual memory ability. METHODS: Data were collected from 109 women (46 controls and 63 polysubstance dependence women who were similar in ethnic identification, education, age, and verbal ability). A series of multiple regressions were run to test whether group membership significantly predicted performance on the Benton Visual Retention Test and the California Verbal Learning Test after controlling for important demographic characteristics. RESULTS: The primary results indicated that the polysubstance dependent women had significantly poorer verbal learning ability (ranging from p<.005 to .05) than the control group, while no differences were found in visual memory ability. Further, significant bivariate relationships were observed between frequency of alcohol and cocaine use and verbal learning, delayed recall, and recognition ability. CONCLUSIONS: The results confirm that polysubstance dependence is associated with deficient encoding of verbal information. In addition, past year frequent use of alcohol and cocaine was associated with more severe deficits in delayed recall and recognition ability among polysubstance dependent women at the bivariate level.
Adult↗
Field-dependence/independence and active learning of verbal and geometric material.
Field-independent individuals generally perform better on learning and memory tasks than field-dependent persons. One explanation for this superiority is that field-independent subjects take a more active approach to learning, while field-dependent subjects take a more passive, spectator approach. In the present study, field-dependent and independent subjects were asked to sort geometric and verbal material into pigeon holes according to category exemplars, forcing both groups to take an active role in learning. Subsequently, they were asked to recall the locations of the categories. Both groups excelled at the sorting task; however, field-dependent subjects were poorer at it. On the recall task, there was a continued superiority in performance by field-independent subjects. The results suggest that memory differences between the two groups cannot be reduced to active versus passive learning styles. To the contrary, active learning may interfere with the memory of field-dependent persons by increasing demands for processing.
Adult↗
Donepezil in a chronic drug user--a potential treatment?
The objective of the current study was to explore the potential cognitive benefits of an anticholinesterase inhibitor, donepezil, in a former chronic drug user. A neuropsychological test battery composed of the vocabulary and matrix reasoning subtests of the Wechsler adult intelligence scale-III, measures of everyday executive functioning (behavioural assessment of the dysexecutive syndrome [BADS]), and verbal learning and memory tasks (California verbal learning test-II; Rivermead behavioural memory test) was completed at baseline, at 3 months after introducing donepezil, and at 3 months after donepezil was discontinued. After donepezil treatment, substantial improvements were found on tasks of nonverbal fluid reasoning (i.e. matrix reasoning) and other executive functioning tests (i.e. BADS). At entry into the study, poor academic performance and subjective problems with memory and concentration were reported, particularly after amphetamine use (i.e. MDMA and crystal methamphetamine); after donepezil treatment, dramatic increases in memory, concentration and academic achievement were observed. The finding of improvements in tests of executive functioning and in academic performance in this case study, together with the minimal adverse side effects of donepezil, warrants the investigation of controlled studies of cholinergic enhancement in chronic amphetamine and other drug users.
Adult↗
Neuropsychological profiles in schizophrenia: paranoid versus undifferentiated distinctions.
Research on schizophrenia has searched for subtype-specific cognitive dysfunction to elucidate the neurodevelopmental underpinnings of the disorder. The neuropsychological distinctions between 21 paranoid and 15 undifferentiated schizophrenics were studied. The paranoid group had significantly better Verbal IQ, executive functioning on the Wisconsin Card Sorting Test, and memory for spoken language on the Sentence Repetition Test compared to undifferentiated schizophrenics. While the paranoid subtype showed trends toward better performance on a wide variety of tasks, both subtypes showed impairments on tasks requiring continuous auditory attention and fine motor speed and coordination. Despite the paranoid subjects' more intact verbal skills, both groups showed significant deficits in verbal learning on the Rey Auditory Verbal Learning Test. This suggests that temporal-hippocampal system dysfunction may be a common denominator in both schizophrenic subtypes. These findings were not accounted for by subtype differences in the level of education, depression or severity of illness.
Adult↗
Neuropsychological functioning in first-episode psychosis--evidence of specific deficits.
Neuropsychological impairment is ubiquitous in schizophrenia even at the first presentation of psychotic symptoms. We sought to elucidate the nature of the neuropsychological profile at the onset of the illness by examining the neuropsychological functioning of 40 patients experiencing their first episode of psychosis and 22 matched controls. All participants completed a battery of neuropsychological tasks designed to assess attention, verbal learning/memory, non-verbal memory, spatial ability, psychomotor speed, and executive function. First-episode patients showed significant impairment on tasks of executive function, including those requiring the ability to form and initiate a strategy, to inhibit prepotent responses, and to shift cognitive set, and also on tasks of verbal fluency. Memory impairments were seen on verbal learning and delayed non-verbal memory only. Impairment on tasks of psychomotor speed suggests that there may be a significant amount of cognitive slowing even at the first onset of psychosis. We suggest that our patients may be experiencing difficulty in specific aspects of executive functions, including the ability to form and execute a strategy, and these difficulties may be mediating the deficits observed on tasks of verbal learning.
Adolescent↗
Cognitive factors in schizophrenia: causes, impact, and treatment.
Greater attention has been given to the cognitive dimension in schizophrenia in recent years. This has resulted from increased recognition that cognitive impairment and negative symptoms of the disease have a greater impact on quality of life (QOL) compared to positive symptoms. Successful treatment of positive symptoms in patients with schizophrenia has not been shown to robustly translate into improvements in employment status or social relationships, while cognitive improvements are strongly associated with these important aspects of QOL and independence. These findings are based on extensive testing with standard cognitive tests for measuring executive function, verbal learning and memory, word recall, verbal working memory, spatial working memory, attention, and vigilance. Verbal learning and executive function, in particular, have been found to be valid predictors of employment success independent of the degree of severity of positive symptoms.
Antipsychotic Agents↗
EEG and memory effects of low-dose infusions of propofol.
The purpose of this study was to identify EEG changes associated with low-dose propofol infusion producing only sedative effects, and to describe the memory effects of low-dose propofol infusion. Ten healthy volunteers underwent EEG monitoring (at Fz, Cz, Pz and Oz electrode sites) before, during and after propofol 0.5 mg kg-1 i.v. bolus and 75 micrograms kg-1 min-1 as an infusion. Mean serum concentration of propofol during infusion was 0.86 (SD 0.14) micrograms ml-1. The EEG changed significantly during infusion, with increased power in the beta 1 (15-20 Hz), beta 2 (20.5-30 Hz) and delta (1-3.5 Hz) frequencies. Beta 1 and beta 2 power changes were most marked at the Fz and Cz electrodes. Subjects were sedated, but able to complete cognitive tasks. Visual analogue scales of attention and sleepiness were obtained throughout the study and demonstrated a sedative effect during propofol infusion, but were not a significant factor in memory performance or EEG changes. A verbal learning task (Rey Auditory-Verbal Learning Task) administered before, during and after infusion showed a marked reduction in short-term memory capacity and dramatically impaired free recall and recognition during infusion. Nine of 10 subjects had partial amnesia for complex visual scenes presented during infusion, recalling less than 50% of the material. Stronger cueing was required to retrieve information presented during propofol infusion, with an increase in mean retrieval time from 95.4 (41.2) s to 426.8 (83.1) s. EEG and memory effects resolved quickly after the end of infusion.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Sensitivity and specificity of some neuropsychological markers of Alzheimer dementia.
A standardized neuropsychological test battery was administered to 167 patients with different forms of mild-to-moderate dementia: probable Alzheimer dementia (AD: n = 49), multi-infarct dementia (n = 43), idiopathic Parkinson disease with dementia (n = 35), depressive pseudodementia (n = 26), and progressive supranuclear palsy (n = 14). Results obtained were used (a) to analyze the profiles of cognitive impairment shown by the different dementia groups; (b) to assess the incidence of some neuropsychological patterns that we hypothesized to be more characteristic of AD, in the various groups; and hence (c) to evaluate the reliability of these patterns as diagnostic markers of AD. Four of the patterns investigated were derived from a verbal learning task (Rey's Auditory Verbal Learning test): (1) absence of the primacy effect; (2) tendency to produce intrusion errors during free recall of a word list; (3) absolute decay of memory trace; and (4) tendency to produce false alarms during delayed recognition of the same word list. Two additional patterns were derived from visual-spatial tasks (copying drawings and Raven's Coloured Progressive Matrices): (5) occurrence of the closing-in phenomenon in copying drawings; and (6) tendency to choose globalistic or odd responses in Raven's matrices. Though all the six patterns were somewhat useful for identifying AD patients, no pattern met the criteria of being both highly sensitive and highly specific, which should characterize an ideal marker. In fact, intrusions and false alarms were observed in many AD patients, but also in patients affected by other forms of dementia. The absence of the primacy effect, the closing-in phenomenon, and the absolute decay of memory trace were more specific, but could be observed in only one-third of AD patients. We also computed the number of positive patterns shown by each patient and assumed the presence of two or more patterns as a global index suggestive of a dementia of the Alzheimer type. With this cumulative method, a higher level of sensitivity and specificity was achieved in the identification of AD patients.
Aged↗
Effects of vasopressin and desmopressin on memory. A double-blind study in 40 healthy volunteers.
In a study involving 40 healthy student volunteers, 10 subjects were given lysine vasopressin at a dose of 0.4 ml (23 IU) per day in 3 divided doses for 15 days by the nasal route. Ten subjects were given desmopressin at a dose of 0.2 ml (20 micrograms) per day in a single dose for 15 days by the nasal route. Twenty subjects were given placebo by the nasal route. Memory tests were conducted under the same conditions before and after treatment (verbal span, verbal retention, visual retention, visual learning, verbal learning). Only the contents of the tests were varied, so as to avoid familiarity. Statistical analysis did not show any significant change in the scores between the first and the second series of tests, between the two treated groups, or between them studied separately and the control subjects.
Adult↗
Long-term safety and efficacy of risperidone for the treatment of disruptive behavior disorders in children with subaverage IQs.
OBJECTIVE: The objective of this study was to investigate the long-term safety and efficacy of risperidone in disruptive behavior disorders in children with subaverage IQs. Disruptive behavior disorders were defined as oppositional defiant disorder, disruptive behavior disorder, and conduct disorder as per the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. METHODS: This was a 48-week open-label (OL) extension study of risperidone in 77 children diagnosed with a disruptive behavior disorder, and either borderline intellectual function or mild or moderate mental retardation who had participated in a previous 6-week, double-blind (DB) study and completed at least 2 weeks of DB therapy. Children, aged 5 to 12 years inclusive, who had: 1) a DSM-IV Axis I diagnosis of conduct disorder, oppositional defiant disorder, or disruptive behavior disorder- not otherwise specified; 2) a parent-assessed rating of > or =24 in the Conduct Problem Subscale of the Nisonger-Child Behavior Rating Form(28); 3) a DSM-IV Axis II diagnosis of mild or moderate mental retardation or borderline intellectual functioning with an IQ > or =36 and < or =84; and 4) a score of < or =84 on the Vineland Adaptive Behavior Scale. Participants received oral solution risperidone given at a once daily dose of between 0.02 and 0.06 mg/kg for a maximum of 48 weeks. Participants in the DB study who had been randomized would have had a maximum of 54 weeks of risperidone therapy. Study visits were scheduled at entry, weekly for the first month, and monthly for the remaining 11 months. RESULTS: Baseline scores on the conduct problem subscale at the start of the previous DB study were similar for both treatment groups: mean values of 33.5 and 33.3 were recorded for placebo- and risperidone-treated participants, respectively. At the time of the OL baseline visit, mean Conduct Problem Subscale scores were lower in those who had been treated with risperidone than in those who remained risperidone-naïve (17.5 and 26.1, respectively). Within 1 week of receiving daily risperidone therapy (mean daily dose: 1.38 mg), those participants who had been risperidone-naïve at OL entry showed a rapid improvement in the Conduct Problem Subscale score. At the week 1 assessment, the mean change from baseline for those who had been risperidone-naïve at OL entry was similar in magnitude to the change from DB baseline recorded for participants who had received risperidone in the DB study. This mean improvement was sustained in both groups throughout the remainder of the OL study. At study endpoint, those participants who had been risperidone-naïve at OL entry experienced a highly significant mean decrease from OL baseline in the mean Conduct Problem Subscale score of 10.6 +/- 2.18. The response to risperidone in the OL trial remained stable in those participants who had been treated with risperidone in the previous DB trial; in this group, the mean change at study endpoint from OL baseline was a nonsignificant decrease of 1.26 +/- 1.45. At DB baseline, 68% of participants had a Clinical Global Impression assessment rated as marked, severe, or extremely severe. By DB study endpoint, only 17% of participants (15% of whom had received placebo and 19% of whom had been treated with risperidone in the previous study) had this severe an assessment; 63% of participants had symptoms rated as either none, very mild, or mild. Similarly, highly significant decreases from baseline in the Vineland Adaptive Behavior Scale rating of the most troublesome symptom (often identified as either aggression (hitting, fighting, or temper tantrums) were observed by study endpoint after 48 weeks of risperidone therapy. For those participants who had received placebo in the previous study, a mean decrease of 47.1 +/- 4.87 mm from a DB baseline of 79.4 +/- 2.69 mm was observed. In those who had received risperidone, a mean decrease of 43.5 +/- 4.57 mm from a DB baseline of 79.3 +/- 3.66 mm was observed. Five subgroup analyses of the primary efficacy outcome were performed. These included analysis by diagnosis (conduct disorder, oppositional defiant disorder, and disruptive behavior disorder-not otherwise specified), degree of mental retardation (borderline, mild, moderate), and presence or absence of somnolence, attention-deficit/hyperactivity disorder, and psychostimulants. The results showed that the efficacy of risperidone was not affected by type of disorder, level of retardation, presence/absence of somnolence or attention-deficit/hyperactivity disorder, or use of psychostimulants. Adverse events were reported for 76 participants; none were serious and most were mild/moderate in severity. Somnolence (52%), headache (38%), and weight gain (36%) were the most common adverse events. The degree of sedation was mild and not associated with cognitive deterioration. In fact, for most parameters assessed on the modified California Verbal Learning Test (a test for verbal learning and memory), there were statistically significant improvements relative to both OL and DB baselines in the mean scores. In addition, statistically significant improvements over baseline were also seen for some Continuous Performance Task (which is a test for attention and impulsivity) parameters. Overall, no deterioration of cognitive function was observed while participants were treated with risperidone. Almost half of the 8.5 kg gained was attributable to normal growth. Asymptomatic peak prolactin levels were observed within 4 weeks of beginning risperidone treatment and declined over time to within normal range. At study endpoint, mean prolactin levels were statistically significantly greater than baseline only in male participants but still <20 ng/mL, which is within the normal range. Twenty participants experienced mild or moderate extrapyramidal symptoms, although none withdrew for this reason. CONCLUSIONS: Risperidone, administered as an oral solution at a mean dose of 1.38 mg/d (range: 0.02-0.06 mg/kg/d) for 1 year, was well tolerated, safe, and showed maintenance of effect in the treatment of disruptive behavior disorders in children aged 5 to 12 years with subaverage IQs.
Antipsychotic Agents↗
The impact of aging on cognitive functions. An 11 year follow-up study of four age cohorts.
The literature on longitudinal studies of aging and cognitive performance is reviewed. The review reveals some ambiguity which seems primarily to be due to selection bias in the study groups and insufficient statistical modelling and parameterization. The main purpose of this study was to analyze the impact of aging on cognitive performance of the general adult population. In addition, the following problems are considered: If an aging impact is found, is it then evenly distributed across different age cohorts and different cognitive functions? Is the effect of different subject-related and situational factors on the test parameters stable over time? Is it possible to eliminate the impact of the examiner in cognitive testing? Moreover, do certain background factors such as age (generation), sex, schooling, etc. or test performance in an earlier examination have predicting power for the participation at a later stage in the study? The analysis was made using a longitudinal design with four successive age cohorts born in 1952, 1942, 1932, and 1922. 1,026 subjects were examined in 1982-83 and 711 were re-examined in 1993-94. At both occasions the subjects were tested by means of the Cognitive Function Scanner method. Attrition was found in all four age cohorts but most profound in the oldest cohort. Attrition occurred most frequently among subjects with only primary schooling and low social status. Age (generation), Sex, Schooling, Occupational Activity Status, Smoking Status, Psychic Stress, and questionnaire positive Cardiovascular Disease in the 1982-83 study all had significant relation to non-participation in the follow-up, either because of death, refusal to participate or because the subjects did not turn up on the agreed date for examination. Also a few test parameters, primarily in the attention tests and concentration tests, were found to be significantly related to non-participation in the follow-up. The results of the follow-up study, in which each subject was his own reference, showed two different tendencies. One tendency indicated some decline in performance. It was found in parameters for non-verbal learning and memory, retention of verbal memory, visuomotor and visuospatial speed, concentration, and reaction time. The other tendency indicated some improvement in performance in relation to verbal learning and memory, visuomotor and visuospatial precision, and to visual perception. It was a general tendency that performance becomes more scattered with increasing age. The follow-up study showed that Generation, Sex, and Schooling are the most important subject-related factors to take into consideration in the evaluation of test results. The significant impact of the Generation factor indicates that cognitive performance depends not only on aging but is also modulated to a large extent by generation specific factors. In spite of intensive training and special focus on communication it was evident that the situational Examiner factor plays a significant role in all of the cognitive tests. The strong impact of the Examiner factor makes the use of test norms questionable. Norms should be used only as rough guidelines. In the individual psychological assessment, focus should be on the subject's problem solving strategies. This can be reached by supplementing the traditional psychometric scores with a range of response process observations obtained by recording the natural steps of the subject's response flow combined with latencies for each step, and analyzing the response chains by pattern analysis. The computer is considered the most appropriate tool for recording response flows.
Adult↗
Predicting memory decline following epilepsy surgery: a multivariate approach.
BACKGROUND: While some patients experience a decline in memory function following an anterior temporal lobe resection, there is considerable individual variation in the extent, nature, and direction of postoperative memory change. Patients with surgically remediable temporal lobe epilepsy differ in etiology, the extent and type of underlying pathology, and on demographic and epilepsy-related variables, all of which may have an impact on their pre- and postoperative neuropsychological functioning. This study examined the relationship between these variables and postoperative memory decline. METHODS: Logistic regression was used to examine the effects of age, laterality of surgery, age of onset of epilepsy, underlying pathology and preoperative level of memory function on postoperative verbal learning in 288 patients who had undergone an anterior temporal lobe resection. One hundred twenty-five patients underwent a right temporal lobe resection (RTL), 163 patients underwent a left temporal lobe resection (LTL). RESULTS: In the group as a whole, 25% of the patients demonstrated a significant postoperative deterioration in verbal learning. Postoperative deterioration in verbal learning was significantly associated with higher levels of preoperative function in both the RTL and LTL groups. Older age at the time of the operation and a lower verbal IQ were additional significant predictors for the RTL group. The presence of cortical dysgenesis was a significant predictor of postoperative decline in the LTL group. The logistic regression models accurately identified 3/4 of those who experienced a postoperative decline in memory, using a cutoff of 0.25 or above to identify high risk. CONCLUSIONS: Our analyses suggest that the majority of patients with a high risk of significant postoperative memory decline can be reliably identified preoperatively. These models are valuable tools helping patients make an informed decision regarding surgery.
Epilepsy↗
Word frequency and pronunciation and the verbal-discrimination learning of nonretarded and retarded children.
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Adolescent↗