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Low alpha power (7.5-9.5 Hz) changes during positive and negative affective learning.

There is evidence that the positive and the negative word lists of the Affective Auditory Verbal Learning Test (AAVL) are useful with regard to mood induction. To date, however, changes in brain activation, as indicated by quantitative electroencephalographic recording, have not been examined. Thus, changes in low alpha power (7.5-9.5 Hz) were examined during and after completion of the positive or the negative learning list of the AAVL among 37 undergraduate men and women. Three primary findings from the study include the following: (1) Previously reported recall patterns were replicated; (2) participants who completed the negative list reported a significant decline in mood state at the end of the session; and (3) participants who completed the negative word list evidenced a significant reduction in low alpha power (in comparison with baseline) within the parietal regions. The findings noted above are seemingly counter to contemporary theories of mood regulation (i.e., asymmetrical changes in anterior activity, rather than changes in parietal regions). Although the AAVL may have limited utility as a tool for mood induction, it may serve as a functional tool for examination of the cerebral processes associated with affective verbal memory.

Adolescent↗

Dissociation of frequency and recency processing from list recall after severe closed head injury in children and adolescents.

To investigate judgment of the frequency and recency of events relative to word list recall in children following closed head injury (CHI), 124 children and adolescents, including 79 severe CHI patients (mean age at test = 13.2 years), 27 mild CHI cases (mean age at test = 12.1 years), and 18 uninjured comparison subjects (mean age = 12.8 years) were studied. The mean postinjury interval was 63.6 months for the severe and 46.7 months for the mild CHI groups. The experimental tasks included estimation of the frequency of presentation of words and designs and recency judgment to select the most recently presented of two stimuli on verbal (words) and nonverbal (faces) tasks. To compare frequency and recency judgments to performance on a task which has been shown to be sensitive to CHI severity and age at test, verbal recall was tested using the California Verbal Learning Test-Children's Version. Severity of CHI (group) affected verbal recall across trials and after delays, but had no effect on estimating frequency and isolated effects on judgment of recency. Age was also primarily related to verbal recall. A subgroup of severe CHI patients with frontal lesions was impaired on delayed recall. The results are discussed in relation to previous research on the effects of CHI on processing the frequency and recency of events.

Adolescent↗

Learning people's names following severe closed-head injury.

Although problems remembering people's names rank highly among the subjective complaints of patients with closed-head injuries, very few studies have examined their memory for people's names by objective measurements. An experiment is reported in which patients with severe closed-head injuries and normal controls learned the same set of words, either as names or as possessions, for unfamiliar faces. Name learning proved to be impaired in the patients. Patient recall of meaningless names and possessions which were described by nonwords was equally poor. The patients, but not the controls, recalled significantly fewer names than possessions if these items were described by concrete nouns. This last finding suggests that the patients' problems with learning people's names can not be fully explained by a general verbal learning impairment.

Adult↗

Executive function in fluency and recall measures among children with Tourette syndrome or ADHD.

This study assessed two relevant aspects of executive dysfunction in children with either Tourette syndrome (TS) or ADHD. Process variables derived from existing neuropsychological measures were used to clarify the executive function construct. Clustering of responses on measures of verbal fluency, figural fluency, and verbal learning was examined to assess strategic response organization. Rule breaks, intrusions, and repetition errors were recorded to assess inhibition errors. No significant differences were found among the three groups (TS, ADHD, and controls) on tasks of response organization (clustering). In our sample, both the ADHD and the TS groups were largely free from executive function impairment, and their performance on the fluency and list learning tasks was in the average range. There was a significant group difference on one of the disinhibition variables, with both TS and ADHD groups showing significantly more intrusions on verbal list learning trials than controls. When more traditional total score variables were analyzed among the three groups, there were no significant differences; however, analysis of effect size revealed medium-to-large effect sizes for Letter Word Fluency total score differences (ADHD vs. controls), and for Semantic Word Fluency total score differences (ADHD vs. TS), with the ADHD group having weaker performance in both comparisons. Results provide some support for the use and analysis of process variables-particularly those related to inhibition and intrusion errors, in addition to the total score variables when assessing executive function deficits in children with ADHD and TS. While group differences may be found, children with uncomplicated TS should not routinely be considered to have significant executive function impairments, and when deficits are found, they may be attributable to other comorbid disorders.

Attention Deficit Disorder with Hyperactivity↗

Remediation of memory disorders in schizophrenia.

BACKGROUND: Memory deficits are commonly experienced by patients with schizophrenia, often persist even after effective psychotropic treatment of psychotic symptoms and have been demonstrated to interfere with many aspects of successful psychiatric rehabilitation. Because of significant impact on functional outcome, effective remediation of cognitive deficits has been increasingly cited as an essential component of comprehensive treatment. Efforts to remediate memory deficits have met with circumscribed success, leaving uncertain whether schizophrenia patients can be taught, without experimental induction, independently to employ semantic encoding or a range of other mnemonic techniques. METHOD: We examined the feasibility of using memory and problem solving teaching techniques developed within educational psychology--techniques which promote intrinsic motivation and task engagement through contextualization and personalization of learning activities--to remediate memory deficits in a group of in-patients with chronic schizophrenia spectrum disorders. RESULTS: Although our memory remediation group significantly improved on the memory remediation task, they did not make greater gains on measures of immediate paragraph recall or list learning than the control groups. CONCLUSIONS: Targeted remediation of memory appears to yield task specific improvement but the gains do not generalize to other memory tasks. Subjects receiving memory remediation failed to independently activate mnemonic encoding strategies learned and used successfully within training tasks to other general measures of verbal learning and memory.

Adult↗

Cognitive impairment in primary and secondary progressive multiple sclerosis.

The aim of this study was to use neuropsychological data to characterize two subtypes of multiple sclerosis (MS) patients in a large patient sample. We studied patients with primary-progressive MS (PPMS) and secondary-progressive MS (SPMS). A group of 121 MS patients (36 PPS, 85 SPMS) and 40 healthy controls were administered a brief battery of cognitive tests. Executive functioning, memory and attention were studied. Results demonstrate that PPMS patients exhibited slightly more impairment than patients with SPMS, although this difference is not significant (50% vs 37%). However, PPMS patients revealed a significantly poorer performance in verbal learning (p < 0.05) and in verbal fluency (p < 0.05). Whereas PPMS patients had significantly shorter disease durations (p < 0.05), there was no statistical difference in disability between both groups. We conclude from our study that cognitive deficits in progressive MS are frequent. Patients with PPMS tend to be more frequently and severely affected than SPMS patients. Our findings of high prevalence of cognitive involvement in PPMS have not been reported previously

Adult↗

Hippocampal sclerosis and verbal encoding ability following anterior temporal lobectomy.

Previous research has shown that the degree of verbal memory decline following left anterior temporal lobectomy (ATL) is inversely related to the extent of neuronal dropout in resected left hippocampus. The goal of this investigation was to clarify further the nature of the free recall impairment and to determine the relative contribution of verbal retrieval and encoding processes. Seventy-six patients who underwent left (n = 46) or right (n = 30) ATL were classified according to the presence or absence of hippocampal sclerosis and pre- to postoperative changes in free recall, cued recall and recognition memory for verbal material were examined. Surgically induced free recall impairments were selectively associated with resection of nonsclerotic left hippocampus and represented a 29-35% decline in verbal learning ability. These free recall deficits were due to postoperative impairment in verbal encoding efficiency, not retrieval difficulties. Assessment of false positive recognition errors indicated that resection of nonsclerotic left hippocampus selectively impaired the ability to encode stimulus uniqueness within correct semantic fields. The clinical and theoretical significance of these results are discussed.

Adult↗

Proactive inhibition and semantic organization: relationship with verbal memory in patients with schizophrenia.

Compared to other cognitive functions in schizophrenia, evidence suggests that verbal memory is particularly impaired. This study used the California Verbal Learning Test (CVLT) to examine proactive inhibition (PI) and semantic processing in verbal memory in 29 patients with schizophrenia and 29 healthy controls. Patients showed significantly less PI, but also did not organize (cluster) their recall according to semantic category. Controls and patients demonstrated small retroactive inhibition (RI) effects regardless of semantic content. Although both groups made similar types and numbers of free recall intrusion errors patients committed more phonemic and nonshared recognition errors. Results suggest that reduced semantic processing prevented build of PI, and contributes to defective memory in schizophrenia. The anatomic-physiologic abnormalities that underlie these findings may be particularly pronounced in prefrontal and temporal-parietal cortical areas.

Adult↗

Cognitive impairment in adults with Down's syndrome: similarities to early cognitive changes in Alzheimer's disease.

Postmortem studies of brains from adults with Down's syndrome (DS) reveal a dramatic age-dependent increase in the incidence of neuropathology associated with Alzheimer's disease (AD). By the age of 40 years, virtually all DS individuals have AD neuropathology. Documentation of cognitive correlates of this phenomenon has been difficult, partly because of the preexisting mental retardation in DS. In the current study, we compared a group of adults with DS, 22 to 51 years old, with a matched control group on various behavioral measures such as savings scores, which are known to be sensitive in detecting early dementia in AD patients. By using the short delayed savings score from the California Verbal Learning Test (a test of verbal memory), a subgroup of DS adults was identified as memory-impaired. This group demonstrated a decline in performance on various other cognitive tests with advancing age, whereas another group identified as having non-memory-impaired DS, and the non-DS controls, showed no evidence of decline with age. These results provide evidence for the presence of early dementia among adults with DS within an age range in which neuropathologic manifestations of AD are predicted to be developing.

Adult↗

The utility of neuropsychological tests in evaluation of Attention-Deficit/ Hyperactivity Disorder (ADHD) versus depression in adults.

A comparison was made between adults with depression and with Attention-Deficit/Hyperactivity Disorder (ADHD) on a battery of cognitive tests of attention span and memory. Both the ADHD and depression groups were subdivided with regard to comorbid depression in the ADHD group and developmental learning disorder in both groups. Utilizing Discriminant Function Analysis, it was found that variables derived from the California Verbal Learning Test, the Paced Auditory Serial Addition Test, and the Stroop Test discriminated among the various subgroups at a level significantly exceeding chance. However, although the great majority of the ADHD participants were correctly classified, there were numerous misclassifications among the depressed groups. It was concluded that the tests used were highly sensitive to ADHD, but were also sensitive to a subgroup of depressed individuals.

Adult↗

Comparative cognitive effects of bilateral subthalamic stimulation and subcutaneous continuous infusion of apomorphine in Parkinson's disease.

Bilateral subthalamic deep brain stimulation (STN-DBS) and continuous subcutaneous infusion of apomorphine (APM-csi) can provide a comparable improvement on motor function in patients with advanced Parkinson's disease (PD), but the mechanisms by which both therapies exert their effects are different. We analyzed the cognitive effects of APM-csi. We also compared neuropsychological effects induced by STN-DBS and APM-csi in advanced PD to ascertain the neuropsychological aspects relevant in determining the therapeutic procedure that is the most appropriate in a particular patient. We studied 9 patients treated with STN-DBS and 7 patients with APM-csi. Neuropsychological measures included Rey's Auditory-Verbal Learning, Stroop, Trail Making, phonetic verbal fluency, and Judgment of Line Orientation tests. In the APM-csi group, significant changes were not observed in the neuropsychological tests performance. By contrast, in the STN-DBS group, moderate worsening was found in phonetic verbal fluency and Stroop Naming scores that was partially reversible at long-term follow-up and did not have consequences on regular activities. Consequently, these findings could be interpreted as being not relevant in deciding the most suitable treatment in a given patient.

Aged↗

Determinants of cognitive disorders in Autosomal Dominant Cerebellar Ataxia type 1.

We assessed neuropsychological performances of 22 patients affected by Autosomal Dominant Cerebellar Ataxia type 1. All subjects completed a comprehensive battery of standardized tests requiring a verbal response, without time constraints. In order to verify the hypothesis that disease severity is the major factor in determining the cognitive status in this syndrome, patients were divided into three groups according to the severity of the clinical picture, as evaluated by the Inherited Ataxias Progression Scale (IAPS). Statistical analysis of the three groups' raw scores showed a significant decrement in patients with more severe clinical pictures on verbal short-term memory tasks. A similar trend, but not significant, was seen for general intelligence tests and verbal learning tasks. The decrement of verbal short-term memory could be related to motor speech problems. On the other hand, the decline of cognitive abilities over the course of the Autosomal Dominant Cerebellar Ataxia type 1 was not homogeneous enough to ensure statistically reliable trends. Therefore, this cross-sectional study suggests that the progression of the disease is a necessary factor in determining cognitive decline, but it is not sufficient. Other disease-related factors (age at onset, genotypic variety) could play a critical role: among these, the size of the expanded CAG repeats is significantly related to a decline of verbal intelligence and short-term memory in SCA2 patients.

Adult↗

Odor learning, recall, and recognition memory in young and elderly adults.

use of an odor learning test and the California Verbal Learning Test in young and elderly adults enabled comparison of age-related effects on recall and recognition memory. Assessment of odor identification further enabled study of which odor function (recall, identification, recognition) is most affected by aging, the odor functions' interrelationships, and predictors of odor recall. Results suggested that both recall and recognition were significantly affected by aging and that the odor-recall decline cannot simply be referred to poor identification. Very similar age-related effect sizes were found for the 3 types of odor functions. Finally, the combined ability to encode, store, and retrieve odors appears to predict overall recall performance (including its identification component) better than do identification and recognition.

Adolescent↗

Cognitive screening for silent cerebral infarction in children with sickle cell disease.

Silent cerebral infarctions have been shown to cause major morbidity in children with sickle cell disease, suggesting that silent infarctions are not as "silent" as once thought. The current definition of silent infarction includes signal changes on magnetic resonance imaging, the absence of overt abnormalities on neurologic examination, and no history of focal neurologic event. Using a decision tree algorithm, we identified a cognitive profile distinguishing children with (n=16) and without (n=49) silent infarctions. The best model combined learning slope from the California Verbal Learning Test-Children's Version and Block Design from the Wechsler Abbreviated Scale of Intelligence. Accuracy was 75%, with 75% sensitivity and 76% specificity. Administration of a brief cognitive battery may be the most feasible approach to screen for silent infarctions in children with sickle cell disease.

Adolescent↗

Neurobehavioral sequelae of high voltage electrical injuries: comparison with traumatic brain injury.

Eighteen survivors of high voltage electrical injuries (HVEI) underwent neuropsychological evaluation in the acute, short-term or long-term epochs Deficits in verbal learning and delayed recall of verbal information were present across various epochs No other cognitive performances were in the impaired range for the HVEI group, although many individual patients also had compromised attention Depression, anxiety and irritability were widespread among HVEI patients, especially beyond the acute period Extreme irritability was accompanied by assaultive behavior in several patients The neurobehavioral effects of HVEI were very similar to those of a closely matched traumatic brain injury (TBI) control group in each epoch The only significant difference between the groups was less successful immediate visual retention by TBI patients in the long-term epoch.

Journal Article↗

Personality profile and neuropsychological test performance in chronic cocaine-abusers.

Little is known about the association between personality disorders and neuropsychological test performance in chronic cocaine users. The aims of the present study were to (1) pinpoint the specific neuropsychological characteristics of chronic cocaine abusers, (2) analyze their personality profile, and (3) explore the association between personality traits and neuropsychological test performance. A sample of 42 drug-abusers (mean age = 34.15; SD = 6.73; mean educational level = 11.44; SD = 2.01) was selected from a state rehabilitation facility and was compared to a control group (mean age = 34.53; SD = 9.01; mean educational level = 12.29; SD = 1.31). The following information was collected for each subject: (1) A clinical history adapted from Horton (1996). (2) The Personality Assessment Inventory (PAI) (Morey, 1991). (3) A neuropsychological test battery including: Arithmetic and Digits subtests from the WAIS-R, California Verbal Learning Test, Trial Making Test, Verbal Fluency tests, Rey-Osterrieth Complex Figure, Wisconsin Card Sorting Test, Benton Visual Retention Test, Stroop Neurological Screening Test and Hooper Visual Organization. Thirty-seven of the drug-dependent subjects obtained an abnormal score in at least one PAI scale. The personality profile of the drug-dependent subjects found via the PAI pointed to a Borderline/Antisocial personality, frequently associated with mania features. In six of the drug-abusers, a normal personality profile was observed. Neuropsychological test performance scores were within the low average or borderline range. The most abnormal scores were observed in attention, memory, and executive functioning tests. The results did not show any robust association between personality profile and neuropsychological test performance.

Adult↗

[Effect of methylprednisolone on emotional functioning of patients with multiple sclerosis].

UNLABELLED: The effects were examined of high doses of intravenous methylprednisolone (MP; 1 g daily, administered for 5 days) on emotional functions in multiple sclerosis (MS) patients with clinical relapse. Thirty two patients with relapsing-remitting disease were included. The mean age was 39.4 (20-56) years, mean disease duration and mean Expanded Disability Status Scale scores were 6.6 (0.8-28) years and 4.1 (2-6.5), respectively. MS patients were subjected twice to psychological tests: immediately after MP treatment and 6 months later. Hamilton Rating Scale for Depression (HRSD) and Hopkins Symptom Check List (HSCL) were used. Thirty two control subjects (mean age 37.2 years) with ischialgia, not receiving steroids, underwent the same testing procedure. On the basis of their results in learning tests (Nonverbal Learning Test and Rey Auditory Verbal Learning Test) upon admission, MS subjects were allocated into 2 different subgroups: 20 patients were included into cognitively preserved group (cpMS) and 12 patient into the group with cognitive decline (cdMS). Immediately after MP treatment, MS patients (total group) achieved significantly higher scores than controls on the HRSD and two subclasses of the HSCL: depression with inhibition and phobic anxiety. There were no significant differences between cpMS and control subjects in HRSD and HSCL tests. CdMS patients, as compared with controls and cpMS subjects upon admission showed depressed mood, obsessive-compulsive disorder, increased anxiety and interpersonal hypersensitivity. Therapy with MP did not markedly change emotional functions in all MS patients (total group, cpMS, cdMS). CONCLUSIONS: 1. Only cdMS patients show emotional disturbances. 2. Therapy with MP does not significantly change the emotional profile of MS patients.

Adult↗

Lisuride treatment of Alzheimer's disease. A preliminary placebo-controlled clinical trial of safety and therapeutic efficacy.

In this article, the authors examine the effect of lisuride on 22 patients with probable Alzheimer's disease (NINCDS/ADRDA criteria) in a randomized double-blind, placebo-controlled, parallel group design. Ten patients received lisuride and 12 patients received placebo. Lisuride was administered in a dose-finding phase of four weeks and an efficacy phase of eight weeks, with a maximum dose of 0.3 mg daily. Outcome measures included global clinical impression, general cognitive function, mood, verbal and visual memory, attention, and psychomotor function. Average decline in Mini-Mental State Examination score after 12 weeks treatment was less often statistically significant in lisuride treated patients than in patients receiving a placebo (p < 0.05). Patients treated with lisuride improved their average total score and short-delay cued recall score on the California Verbal Learning Test, a test of verbal memory, whereas placebo-treated patients showed worse performance compared with baseline. These differences approached statistical significance, with p = 0.06 and p = 0.05, respectively. No other differences between the treatment groups were evident. The authors failed to find a consistent effect of lisuride on symptoms of Alzheimer's disease. However, this study's sample size was relatively small, and larger studies are needed to ascertain the treatment effects of serotonergic antagonists on Alzheimer's disease.

Aged↗