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Recovery of memory and learning functions following traumatic brain injury.

Twenty-four traumatically brain-injured males, of whom eight had sustained right-sided, eight left-sided, and eight bilateral or diffuse closed head injuries, took a battery of neuropsychological tests within the first six months, the second six months, the second year and the third year post injury. Performances on WAIS Digits Forward and Backward and Rey's Auditory-Verbal Learning Test were classified as within or below normal range. Comparisons were made (1) between time periods and tests and (2) between subgroups formed by severity, site of lesion, and age. The findings give an overall picture of wide performance variability with consistent improvement in immediate memory span and learning. Recovery varied with the specific nature of the tested function, task complexity, and severity of injury. Neither age, site of injury, not recency were associated with improvement.

Adult↗

Initial and final work performance in schizophrenia: cognitive and symptom predictors.

Studies have shown that cognitive functioning may limit the rate, tenure, and type of work performed by people with schizophrenia. The present study tested the hypothesis that cognitive abilities needed for initial improvement in work performance would differ from those needed in later vocational development. Ninety-six outpatients with schizophrenia or schizoaffective disorder who participated in a work rehabilitation program were administered neuropsychological testing at intake. Their work performance was evaluated biweekly for 26 weeks. Cognitive test variables were entered into regressions predicting the slope of individual performance curves from weeks 1 to 13 and 13 to 26. Neuropsychological variables accounted for 28% of the variance in slope during the initial period. The strongest predictor was a Continuous Performance Task variable that measures inattentiveness. Other important variables were measures of idiosyncratic thinking, cognitive flexibility, and verbal memory. Neuropsychological variables accounted for 19% of the variance in the slope during the final period. The strongest predictor was verbal learning, while measures of cognitive impulsivity and psychomotor functioning were also significant contributors. There was no relationship between work performance and symptoms for weeks 1 to 13 or 13 to 26. These findings suggest that while attention is more important for initial success, verbal memory becomes more important for sustained improvement. Remediating or accommodating such deficits in a time-sensitive fashion may be a necessary feature for successful rehabilitation.

Adult↗

Cognitive impairment and olfactory panic from occupational exposure to VOCs.

BACKGROUND: A Canadian government clerical worker in her early thirties developed frontal lobe dysfunction from inhalation of volatile organic compounds off-gassed during an office renovation. METHODS: Pulmonary function, bronchial provocation, allergy testing, and a brain (SPECT) scan were performed. RESULTS: SPECT scanning showed frontotemporal hypoperfusion and neuropsychologic testing revealed deficits in verbal learning and poor organizational memory. CONCLUSIONS: A significant component of this worker's impairment was the development of "olfactory panic," a debilitating aversion to odor accompanied by symptoms of panic. The Ontario Workplace Safety and Insurance Appeals Tribunal granted entitlement for her cognitive difficulties and olfactory panic as a result of her toxic exposure.

Adult↗

Performance on tests of diencephalic-hippocampal verbal memory function in schizophrenia, Korsakoff's syndrome and personality disorder.

Performance on selected scores from the California Verbal Learning Test (CVLT) was compared in schizophrenia, Korsakoff's syndrome, and personality disorder patients. Five CVLT scores sensitive to dysfunction in the diencephalic-hippocampal memory system and one attention-sensitive variable were examined. The patient groups were matched on age, education, and verbal ability (WAIS-R). Schizophrenia patients differed consistently from Korsakoff patients on diencephalic-hippocampal memory variables. However, they did not differ significantly from patients with personality disorders. The three groups were comparable on immediate memory. Results are discussed in terms of the nature of memory problems in schizophrenia and the extent to which these problems reflect dysfunctional subcortical processing.

Adult↗

Executive control of learning and memory in children with bilateral spastic cerebral palsy.

Executive control of learning and memory was examined in children with bilateral spastic cerebral palsy (SCP). We hypothesized that SCP-related brain damage would disrupt executive but not associative aspects of learning and memory. To test this hypothesis, the California Verbal Learning Test-Children's Version was administered to 16 children with bilateral SCP and 19 control children ranging from 6 to 18 years of age. Controlling for general verbal ability, the groups did not differ in initial learning and retention of information over time, suggesting that associative learning and memory processes subserved by medial temporal brain regions were relatively intact in children with SCP. In contrast, impairments in learning over repeated trials, strategic processing, and inhibition in the SCP group pointed to disruptions in prefrontally-mediated executive aspects of learning and memory. The inhibitory deficit was more pronounced in younger children with SCP, suggesting a developmental delay in this ability.

Adolescent↗

Alzheimer-type dementia and verbal memory performances: influence of selegiline therapy.

In a double blind randomized crossover trial lasting 6 months selegiline, a selective MAO-B inhibitor, was tested against placebo for activity on verbal memory performances in Alzheimer-type dementia (DAT). Verbal memory was assessed with the Rey-Auditory-Verbal Learning Test at the start of treatment, at the time scheduled for crossover (90 days) and at the end of the trial (180 days). The results suggest that selegiline possesses significant activity on some memory parameters, which seems to depend on an improvement both in information processing abilities and in learning strategies at the moment of acquisition.

Alzheimer Disease↗

Functional correlates of verbal memory deficits emerging during nicotine withdrawal in abstinent adolescent cannabis users.

BACKGROUND: Cannabis remains the most widely used illicit substance by adolescents and is typically consumed by this population in the context of ongoing tobacco use. Human studies have shown that both cannabis and tobacco exert effects on cognitive function; however, little is known about possible interacting effects of these drugs on brain function and cognition during adolescent development. METHODS: Verbal learning and memory were assessed in 20 adolescent users of tobacco and cannabis and 25 adolescent tobacco users with minimal history of cannabis use. Functional magnetic resonance imaging was used to examine brain function and functional connectivity while a subset of these subjects performed a verbal working memory task. RESULTS: Delayed recall of verbal stimuli deteriorated during nicotine withdrawal among cannabis users but not among comparison subjects. During high verbal working memory load, nicotine withdrawal selectively increased task-related activation of posterior cortical regions and was associated with disruption of frontoparietal connectivity in adolescent cannabis users relative to comparison subjects. CONCLUSIONS: These observations suggest that cannabis use during adolescent development may disrupt neurocircuitry supporting verbal memory formation and that deficits associated with disruption of these neurocircuits are unmasked during nicotine withdrawal.

Adolescent↗

Verbal memory deficits in children with less than 750 g birth weight.

Numerous studies have documented memory deficits in very low birthweight (VLBW, < 1500 g) children, yet we know little about the nature of these memory problems. To clarify memory sequelae and examine memory deficits in relation to the degree of low birth weight, we administered the California Verbal Learning Test-Children's Version (CVLT-C) to a regional sample of 57 < 750 g birthweight children and to groups of 53 750-1499 g birthweight children and 49 term-born controls. Group comparisons revealed significant differences between the < 750 g birthweight group and term-born children on measures of list learning, delayed recall, and inaccurate recall. In addition, the percentage improvement in correct recognitions relative to long-term delayed recall was greater in the < 750 g group than in the term-born controls. Similar differences were observed between VLBW children with and without abnormal neonatal cerebral ultrasounds (high- and low-risk groups). Differences in learning rate between the VLBW and term-born groups, and between high- and low-risk VLBW children, were evident even when vocabulary skill was covaried or when children with neurosensory deficits or IQ < 80 were excluded from analysis. The findings document deficits in verbal memory in the subset of VLBW children at greatest biological risk, and suggest that acquisition processes are selectively impaired.

Attention↗

Relative memory deficits in recurrent versus first-episode major depression on a word-list learning task.

Although memory deficits are associated with major depressive disorder, few studies have identified which patient characteristics predict impairment. Because recurrent depression appears related to more severe cerebral dysfunction, the present study tested whether recurrent depressed individuals have worse memory function than first-episode depressed individuals. Two groups of young-adult, nonpsychotic, depressed inpatients (20 single episode [SE] and 46 recurrent episode [RE]) were administered the California Verbal Learning Test within a broader battery of neuropsychological tests. The groups were equivalent in age, education, estimated IQ, severity of depression, and demographic composition. The RE group demonstrated memory deficits relative to both the SE group and published norms, but no other significant difference was found across the battery. Data indicate that abnormal memory performance is associated with recurrent depression, whereas memory deficits are not prominent in first-episode depressed individuals.

Acute Disease↗

Declarative and procedural learning, quantitative measures of the hippocampus, and subcortical white alterations in Alzheimer's disease and ischaemic vascular dementia.

This research investigated whether subjects with Alzheimer's disease (AD) and ischaemic vascular dementia (IVD) associated with periventricular and deep white matter alterations can be dissociated on tests of declarative and procedural memory, as well as on MRI indices of white matter alterations and the size of the hippocampal formation. The California Verbal Learning Test (CVLT) and the Pursuit Rotor Learning Tests (PRLT) were used to measure declarative and procedural memory, respectively. Subjects with IVD obtained a higher score on the CVLT recognition discriminability index; however, on the PRLT total time on target, carry-over between trial blocks, and slope calculated for all test trials was low. Subjects with AD exhibited the opposite profile. MRI studies indicated that subjects with IVD had considerably greater white matter alterations, but larger hippocampal formations than subjects with AD. Higher scores on the CVLT recognition discriminability index were correlated with increased size of the body of the hippocampus and parahippocampal gyrus. By contrast, as the severity of white matter alterations increased the slope on the PRLT declined. In sum, subjects with AD and IVD can be dissociated on the basis of differing patterns of impairment on tests of declarative and procedural memory, and MRI indices of white matter alteration and the integrity of the hippocampal formation.

Aged↗

Neuropsychological performance over time in people at high risk of developing schizophrenia and controls.

BACKGROUND: Neuropsychological assessments of relatives of schizophrenics have shown subtle impairments in verbal memory, executive and intellectual function, which are stable in those beyond the age of maximum risk for the disorder. We sought to: (1) determine baseline neurocognitive predictors of psychosis, and (2) compare performance over time between relatives within the age of maximum risk, and controls. METHODS: (1) and (2) were examined in 118 individuals at familial high risk of schizophrenia (HR) and 30 controls (C), using one-way analyses of variance (ANOVAs) and repeated measures analyses of covariance (ANCOVAs), controlling for intelligence quotient, time between and number of assessments, and correcting for multiple comparisons. RESULTS: HR who became ill (n = 13) performed nonsignificantly less well at baseline than HR who did not (n = 105) on a test of verbal learning (t(109) = 2.1, p = .03). Across assessments, C performed significantly better than the entire HR group on immediate (F(3,133) = 5.11, p = .002) and delayed (F(3,133) = 5.02, p = .002) story recall. There were no significant interactions of time by group. CONCLUSIONS: Results suggest greater verbal memory impairment in HR who go on to develop schizophrenia. Stable differences between groups over time suggest a trait deficit, which is relatively unaffected by the presence of psychotic symptoms and psychosis onset. Alternatively, small numbers may have precluded detection of group by time interactions.

Adult↗

Perseveration in schizophrenia: failure to generate a plan and relationship with the psychomotor poverty subsyndrome.

Although perseveration in the Wisconsin Card Sorting Test (WCST) has been studied extensively in schizophrenia, the underlying cognitive dysfunctions are not yet clear. In schizophrenia, perseveration has been found to relate to frontal and striatal abnormalities. Therefore, both a failure to generate a plan as seen in patients with frontal abnormalities, or a failure to execute a plan as observed in Parkinson patients, who suffer primarily from striatal abnormalities, could explain perseveration in schizophrenia. The aim of the present study was to distinguish between these two cognitive dysfunctions, which are described by Frith in his routes-to-action model. The main difference between these dysfunctions is the ability to use external guidance. In the present study, 39 schizophrenic patients and 36 healthy controls were assessed with the California Verbal Learning Test (CVLT) and the WCST, in which use of external guidance can be measured, and with the Positive and Negative Syndrome Scale (PANSS) to determine the relationship with symptomatology. The results showed that half of the schizophrenic patients showed perseveration, which could be explained by a failure to generate a plan and was related to the psychomotor poverty subsyndrome. No evidence was found for a failure to execute a plan. Type of antipsychotic medication used (atypical vs. typical) proved not relevant. The results are discussed in the light of evidence for involvement of the dorsolateral prefrontal cortex in perseveration in schizophrenia.

Adult↗

Cognitive impairment in relapsing and primary progressive multiple sclerosis: mostly a matter of speed.

Based on the assumption that cognitive impairment in MS is consistent with subcortical dementia, a battery of neuropsychological tests was assembled that included measures of executive function (Tower of London and Wisconsin Card Sorting Test), verbal learning and memory (a paired associates learning test), and speeded information processing (Stroop Color Word Interference Test). The battery was administered to patients with relapsing and primary progressive MS and to healthy controls. Differences between patients and controls occurred on several of the measures. However, when differences with respect to fatigue and depression were statistically controlled, the only differences that remained significant involved measures relating to the speed of information processing. Patients performed more slowly than controls, with the disparity being greater for relapsing patients than for those with primary progressive disease. The slowing was evident on measures of automatic as well as controlled processing and regardless of whether speed was an explicit feature of successful performance or recorded unobstrusively while the patient concentrated on planning a correct solution to a problem. Parallels were noted between cognitive slowing associated with MS and that of normal aging.

Adult↗

Neurobehavioral function and tibial and chelatable lead levels in 543 former organolead workers.

OBJECTIVE: To evaluate the associations between tibial lead, dimercaptosuccinic acid (DMSA)-chelatable lead, and neurobehavioral function in former organolead manufacturing workers with past exposure to organic and inorganic lead. METHODS: Data were collected from 543 subjects with a mean age of 58 years and an average of 17.8 years since last lead exposure. Years since last exposure to lead was used to estimate tibial lead levels in the year of last occupational lead exposure, termed "peak tibial lead." Current tibial lead levels, measured by x-ray fluorescence, were extrapolated back using a clearance half-time of lead in tibia of 27 years, assuming first-order clearance from tibia. RESULTS: Peak tibial lead levels ranged from -2.2 to 105.9 microg Pb/g bone mineral, and DMSA-chelatable lead levels were between 1.2 and 136 microg. After adjustment for confounding variables, peak tibial lead was a significant negative predictor of performance on the Wechsler Adult Intelligence Scale-Revised vocabulary subtest (p = 0.02), serial digit learning test (p = 0.04), Rey Auditory-Verbal Learning Test (immediate recall and recognition, p = 0.03 for each), Trail Making Test B (p = 0.03), finger tapping (dominant hand [p = 0.02] and nondominant hand [p < 0.01]), Purdue pegboard (dominant hand, nondominant hand, both hands, and assembly, p < 0.01 for each), and Stroop Test (p < 0.01). Moreover, with one exception, average neurobehavioral test scores were poorer at higher peak tibial lead levels. DMSA-chelatable lead was only significantly associated with choice reaction time (p = 0.01). CONCLUSION: Peak tibial lead was consistently associated with poorer neurobehavioral test scores, particularly in the domains of manual dexterity, executive ability, verbal intelligence, and verbal memory.

Adult↗

Relation of cortical language distribution and cognitive function in surgical epilepsy patients.

PURPOSE: To investigate the relation between the number and spatial distribution of language sites and specific patient-and epilepsy-related variables. METHODS: Patients with stimulation-induced reading or naming errors from anterior or inferior temporal cortex (i.e., atypical temporal language sites) were compared with those with language sites confined to Wernicke's area (WA) in the posterosuperior temporal and inferior parietal perisylvian area. In a consecutive series of 44 left hemisphere language dominant patients with complex partial seizures before left temporal lobectomy, correlations were compared between cortical language distribution and measures of cognitive function. RESULTS: Patients with atypical temporal language sites (group 1) had significantly fewer years of education that did patients with language sites in WA (group 2). Patients in group 1 had poorer verbal learning and fluency than did patients in group 2. Patients with IQ <80 were significantly more likely to have multiple sites where stimulation disrupted language than did patients with normal IQ. Number of language sites had significant negative correlations with full-scale IQ, and measures of confrontation naming, verbal fluency, and immediate verbal memory. CONCLUSIONS: Language cortex has a wider spatial distribution in epilepsy surgery patients with lower intelligence, poorer education, and worse verbal and memory skills.

Adult↗

Reliability and validity of the Mini-Mental State Exam in neurologically intact elderly.

Reliability and validity of MMSE were explored in a sample of 122 healthy, community-residing elderly volunteers between the ages of 57 and 85, who were tested with a battery of neuropsychological tests over three annual probes. Test-retest reliability ranged between .45 and .50 over a 1-year interval and was .38 over a 2-year period. Change on the MMSE of more than 5 points over a 2-year period was associated with a neurological disorder. Significant correlations were found with many neuropsychological measures, especially with a measure of verbal learning.

Aged↗

Role of the hippocampus in sex differences in verbal memory: memory outcome following left anterior temporal lobectomy.

The authors examined the neural and cognitive bases for sex differences in verbal memory in 57 patients who underwent left anterior temporal lobectomy (ATL) for the treatment of intractable seizures. On the California Verbal Learning Test (D. C. Delis, J. H. Kramer, E. Kaplan, & B. A. Ober, 1987), women recalled more words than men both before and after surgery, regardless of the extent of hippocampal damage. Extent of hippocampal sclerosis was related to memory loss in both men and women. Women's superiority in verbal memory appears to result in part from their use of an efficient encoding strategy. Women were more likely than men to use semantic clustering both before and after ATL, and sex differences in word recall were attenuated after scores were adjusted for semantic clustering. There was no effect of ATL on semantic clustering. Taken together, these results suggest that sex differences in verbal memory are not due to differences in the integrity of the left hippocampus.

Adult↗

Mechanisms of attentional cueing during observational learning to facilitate motor skill acquisition.

We examined the effectiveness of different cueing conditions during observational learning of a soccer accuracy pass. Sixty participants (30 males, 30 females) were randomly assigned and stratified by sex into one of six groups: discovery learning, verbal instruction, video model with visual cues, video model with verbal cues, video model with visual and verbal cues, and video model only. Each participant completed eight blocks of 10 trials each, with trial blocks 1 and 2 representing the practice phase (no manipulation), trial blocks 3, 4, 5 and 6 the acquisition phase (manipulation administered) and trial blocks 7 and 8 the retention phase (24 h after acquisition, with no manipulation). Absolute error, variable error and kicking form were recorded. The results indicated that those who used video modelling with visual and verbal cues collectively displayed less error and more appropriate form across acquisition and retention trial blocks compared with other groups. Our findings suggest that verbal information in addition to visual cues enhances perceptual representation and retention of modelled activities to improve task reproduction capabilities. Future research directions are proposed with implications for both direct and indirect perception accounts of skill acquisition through observed behaviours.

Adolescent↗