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Effects of smoking and smoking abstinence on cognition in adolescent tobacco smokers.

BACKGROUND: In adult animals and humans, nicotine can produce short-term cognitive enhancement and, in some cases, neuroprotection. Recent work in animals, however, suggests that exposure to nicotine during adolescence might be neurotoxic. We tested for evidence of acute and chronic effects of tobacco smoking on cognition in adolescents who smoked tobacco daily and were compared with adolescent nonsmokers. METHODS: Verbal working memory, verbal learning and memory, selective, divided, sustained attention, mood, symptoms of nicotine withdrawal, and tobacco craving were examined in 41 adolescent daily smokers and 32 nonsmokers who were similar in age, gender, and education. Analyses were controlled for general intelligence, reading achievement, parental educational attainment, baseline affective symptoms, and lifetime exposure to alcohol and cannabis. RESULTS: In adolescent smokers, cessation of tobacco use increased tobacco craving, symptoms of nicotine withdrawal, and depressed mood. Adolescent smokers were found to have impairments in accuracy of working memory performance irrespective of recency of smoking. Performance decrements were more severe with earlier age of onset of smoking. Adolescent smokers experienced further disruption of working memory and verbal memory during smoking cessation. As a group, male smokers initiated smoking at an earlier age than female smokers and were significantly more impaired during tests of selective and divided attention than female smokers and nonsmokers. CONCLUSIONS: Adolescent daily tobacco smokers experience acute impairments of verbal memory and working memory after smoking cessation, along with chronic decrements in cognitive performance that are consistent with preclinical evidence that neurotoxic effects of nicotine are more severe when exposure to nicotine occurs at earlier periods in development.

Adolescent↗

Relationship between memory strategies and motor symptoms in Parkinson's disease.

Patients with Parkinson's disease(PD) show a serious decrease in performance on tasks which lack explicit guidelines and which necessitate the subject to develop his or her own strategy. Using the California Verbal Learning Task(CVLT) we have found evidence that this phenomenon becomes also manifest in learning and memory. The goal of the present study on PD was to investigate whether or not there is an intrinsic relationship between PD-specific deviant learning characteristics and the severity of motor symptomatology. The results show, as expected, a significant correlation between the severity of bradykinetic/hypokinetic symptoms and the serial clustering gradient of the CVLT: the more bradykinetic PD patients (n = 48) were, the more they were dependent on the externally guided serial learning strategy. The findings are discussed in the context of our hypothesis that the actual deficit in patients with PD is a deficient processing of ambiguous internal cues.

Cluster Analysis↗

Effects of electroconvulsive therapy on neuropsychological function and circulating levels of ACTH, cortisol, prolactin, and TSH in patients with major depressive illness.

Thirteen patients with major depressive illness received unilateral electroconvulsive therapy (ECT). Memory and some other neuropsychological functions were studied concomitantly with changes in clinical symptoms. ACTH in plasma and cortisol, prolactin (PRL) and TSH in serum were measured 30 min before and 1, 5, 15, 30 and 60 min after treatment. Memory functions, impaired after the ECT series, were completely regained 1 month later. ACTH, cortisol, PRL and TSH were significantly increased by ECT. The maximum hormone level after ECT was lower at the last ECT in the series as compared with the first. After the last treatment, nonverbal memory performance was negatively associated with the maximum ACTH level after ECT and verbal learning was negatively correlated to the maximum cortisol level. The reason for these relationships is not known. Since both the ACTH secretion and memory function may be dependent upon the intracerebral catecholamines, the present findings may reflect variations in central monoaminergic receptor function.

Adolescent↗

Theoretically derived CVLT subtypes in HIV-1 infection: internal and external validation.

The present study sought to delineate empirically derived memory subtypes using the California Verbal Learning Test (CVLT; Delis et al., 1987) in a sample of adults with HIV-1 infection (N = 154). Confirmatory factor analysis was used to evaluate eight models of the CVLT structure suggested by Wiegner and Donders (1999). A four-factor model, consisting of Attention Span, Learning Efficiency, Delayed Recall, and Inaccurate Recall appeared to be the best fitting model. Variables with the highest factor loadings from the model were entered in a two-stage cluster analysis. Four reliable CVLT clusters or subtypes were identified: Normal, Atypical, Subsyndromal, and Frontal-striatal. Internal and external validation of subtypes demonstrated that clusters were stable and clinically interpretable. Subtypes were meaningfully related to neuropsychological functioning, and to some extent, depressive symptomatology. Subtypes did not differ significantly with respect to subjective neurocognitive complaints and markers of HIV-1 disease. The present findings highlight the heterogeneity of memory profiles in HIV-1 infection and support a frontal-striatal conceptualization of verbal memory performance. The identification of robust HIV-1 memory subtypes may have important implications for the clinical management of adults infected with HIV-1 infection.

Adult↗

Relationship between plasticity, mild cognitive impairment and cognitive decline.

A topic of great interest in gerontology research is the prediction of cognitive deterioration which marks the transition from mild cognitive impairment (MCI) to dementia. In this area the term plasticity is a construct of prime importance. Previous studies have demonstrated the existence of plasticity in healthy older persons, and it is thought that this is what discriminates between healthy individuals and those at risk for dementia. The aim of the present study is to demonstrate that plasticity exists in persons with MCI, and that a lack of plasticity may be one of the risk factors related to cognitive decline. An adapted version of the Auditory Verbal Learning Test-the AVLT of Learning Potential-was used to assess plasticity. Participants in the research were 203 older persons whose cognitive status had previously been determined using a cognitive screening test. The results show that plasticity exists in persons with MCI and that its presence is associated with less marked cognitive decline.

Aged↗

The effect of non-factual post-training negative comment on the recall of verbal information.

Healthy human volunteers were asked to study a 250-word account of the 1954 World Football Cup and submitted to a questionnaire on the verbally learned material 48 h later. The subjects were divided into 7 groups. One received no treatment between text and questionnaire. The others were shown either a brief laudatory or derogatory comment on the World Cup 0, 3, or 6 h after having read the text. The comment contained no facts relevant to the text. Subjects exposed to the derogatory comment 0 or 3 h after having studied the text performed much worse in the questionnaire than any of the other groups. Performance in another, unrelated, general knowledge memory test was not affected by reading the World Cup text or subsequent comments. Thus post-event non-factual information was able to affect recall of verbally acquired factual material even if presented 3 h later; the effect does not seem to be explicable by a general performance deficit, and may be due to integration of information acquired during and after the event into one single experience.

Adult↗

Equivalence of five forms of the Selective Reminding Test in young and elderly subjects.

This study evaluated the equivalence of five forms of the Selective Reminding Test, a widely used measure of verbal learning, 45 normal young and 45 normal elderly subjects were randomly administered three of the five test forms on three separate sessions. The five forms generally correlated well with one another and were of comparable difficulty, suggesting adequate test equivalence. Four of the five forms were particularly well matched.

Adolescent↗

Efficacy and tolerability of low-dose donepezil in schizophrenia.

There have been many advancements in the pharmacologic treatment of schizophrenia; however, negative symptoms and cognitive impairment remain an intractable part of this illness. Donepezil is an anticholinesterase inhibitor with cognitive enhancing effects approved for the treatment of Alzheimer disease that has shown some benefit in the treatment of schizophrenia. In this study, 15 inpatients at a state hospital with a history of schizophrenia were administered donepezil in a randomized, double-blind, crossover design. Neurocognitive testing and psychiatric ratings were completed at baseline and at regular intervals for 18 weeks. Results indicated that donepezil treatment was associated with modest improvements in psychiatric symptoms and improved verbal learning. These results suggest that donepezil may be helpful as adjunctive therapy for the treatment of psychiatric symptoms and cognitive impairment in a subgroup of schizophrenic patients.

Acetylcholine↗

Memory functioning during the first year after closed head injury in children and adolescents.

Effects of the severity of closed head injury (CHI) on verbal learning and memory and visual recognition memory were studied at base line and on a 1-year follow-up examination in 58 pediatric admissions sampled from three age ranges, 6-8, 9-12, and 13-15 years. Within each age range, recovery of memory was compared in patients with mild to moderate CHI and survivors of severe injury. Consistent with previous findings obtained in head-injured children sampled from a wide age range, the present study confirms that memory deficit persists at least 1 year after severe CHI. Impairment of visual recognition memory was directly related to severity of CHI in all three age ranges. The severity of CHI was directly related to initial and residual verbal memory deficit in adolescents, but this effect was inconsistent in children. We suggest that the cerebral substrate for visual recognition memory was well established in all three age ranges and thus was vulnerable to the effects of injury. In contrast, verbal memory skills were undergoing rapid development in the adolescents, but were still immature in children. Extended follow-up could conceivably demonstrate the late appearance of verbal memory deficit in the children who had apparent sparing of function.

Adolescent↗

Verbal memory in first-episode schizophrenia: heterogeneity in performance?

It is unclear if the commonly observed "subcortical" verbal memory profile in schizophrenic patients is present at the onset of the disease. Therefore, the performance of 43 first-episode patients with schizophrenia or schizophreniform disorder on the Dutch version of the California Verbal Learning Test (VLGT) was compared to that of 43 normal comparison participants. We hypothesized that the first-episode patients would exhibit a "subcortical" memory profile, that is, they would show a primary retrieval deficit. This hypothesis was not confirmed: the patients displayed a profile suggestive of a prominent storage deficit, that is, a "cortical" memory profile. Subsequently, patients' VLGT performance was cluster analyzed to determine whether subgroups could be identified exhibiting a cortical, subcortical, and normal profile, respectively. Two subgroups (N=22; N=13) exhibited memory impairments, while one subgroup (N=8) was unimpaired. The memory profiles of the two impaired subgroups differed both qualitatively and quantitatively, but did not conform neatly to a cortical and a subcortical profile. Demographic and verbal fluency data provided limited validation of the subgroup classification. Our results may suggest that combining the verbal memory performance of first-episode patients obscures meaningful heterogeneity. Alternatively, the cluster solution could merely reflect a continuum of severity.

Adolescent↗

Forgetting rate and interference effects on a verbal memory distractor task in patients with temporal lobe epilepsy.

To investigate interference effects in lateralized temporal lobe epilepsy (TLE), we compared 79 patients with left (n = 43) or right (n = 36) TLE and 33 healthy controls on a verbal memory distractor task (VMDT) structured according to the Brown-Peterson paradigm. The subjects were also administered a selective reminding procedure (SRP) for verbal learning, a word fluency test (WFT) and the Wisconsin Card Sorting test (WCST) for "frontal" functions. On the VMDT, left TLE patients were significantly impaired as compared to right TLE patients and controls. This impaired performance correlated with the severity of learning and short-term memory deficit but not with deficits on the WFT or the WCST. Our data suggest that lateralized epileptic discharges may affect the function played by the medial temporal lobe in inhibiting interference, thus contributing to the material-specific memory deficit of TLE patients.

Adult↗

Patterns of verbal memory performance in mild cognitive impairment, Alzheimer disease, and normal aging.

OBJECTIVE: Individuals with mild cognitive impairment (MCI) typically demonstrate memory loss that falls between normal aging (NA) and Alzheimer disease (AD), but little is known about the pattern of memory dysfunction in MCI. METHOD: To explore this issue, California Verbal Learning Test (CVLT) performance was examined across groups of MCI, AD, and NA. RESULTS: MCI subjects displayed a pattern of deficits closely resembling that of AD, characterized by reduced learning, rapid forgetting, increased recency recall, elevated intrusion errors, and poor recognition discriminability with increased false-positives. MCI performance was significantly worse than that of controls and better than that of AD patients across memory indices. Although qualitative analysis of CVLT profiles may be useful in individual cases, discriminant function analysis revealed that delayed recall and total learning were the best aspects of learning/memory on the CVLT in differentiating MCI, AD, and NA. CONCLUSIONS: These findings support the position that amnestic MCI represents an early point of decline on the continuum of AD that is different from normal aging.

Aged↗

Neurocognitive dimensions characterising patients with first-episode psychosis.

BACKGROUND: Assessment of neurocognitive dysfunction in schizophrenia is hampered by the multitude of tests used in the literature. AIMS: We aimed to identify the main dimensions of an assessment battery for patients with first-episode psychosis and to estimate the relationship between dimension scores and gender, age, education, diagnosis and symptoms. METHOD: Eight frequently used neuropsychological tests were used. We tested 219 patients 3 months after start of therapy or at remission, whichever occurred first. RESULTS: We identified five dimensions: working memory (WM); verbal learning (VL); executive function (EF); impulsivity (im); and motor speed (MS). Significant findings were that the MS score was higher for men, and the WM and VL scores were correlated with years of education. CONCLUSIONS: Neurocognitive function in first-episode psychosis is described by at least five independent dimensions.

Adult↗

Mineralocorticoid and glucocorticoid receptors and their differential effects on memory performance in people with Addison's disease.

The effects of corticosteroids on memory performance have been the subject of some controversy. Whilst many studies have shown that high levels of corticosteroids can impair memory performance, others have shown they can facilitate it. One explanation for these discrepant effects arises from the differential activation of the two types of corticosteroid receptor--the mineralocorticoid receptor (MRs) and the glucocorticoid receptor (GRs), and the function each subserves during memory formation. Studies in rats and chickens suggest that activation of the MRs is essential during sensory storage (i.e. encoding), whereas normal levels of activation of the GRs (in addition to the already activated MRs) is essential during memory consolidation and retrieval. By using a repeated measures design with nine people with Addison's disease (mean age, 37.9 years), the effects following activation of the MRs only, GRs only, and a combination of MRs/GRs, on working memory and the episodic and semantic components of declarative memory were investigated. MRs and GRs were activated using either MR specific (9 alpha fluorohydrocortisone) or GR specific (dexamethasone) exogenous steroids, respectively. The results showed that participants performed better in the Digits Backward task when both receptors were activated compared to when GRs only were activated (P<0.01). They also performed better in recall in the Hopkins Verbal Learning Test when both receptors were activated compared to when MRs only were activated (P<0.05) and GRs only were activated (P<0.01). Whilst significant effects were not consistent across memory tasks, these results lend further support to the view that balanced activation of MRs and GRs is necessary for optimal memory function in humans.

Addison Disease↗

Adult attention deficit hyperactivity disorder identified by neuropsychological testing.

The authors used neuropsychological tests to assess and classify adult patients with attention deficit hyperactivity disorder (ADHD) and controls. Four memory tests correctly classified 81% of subjects. The memory tests were: the auditory Consonant trigram test, the Benton Visual Retention test, the Rey Auditory Verbal Learning test, and the modified Diagnosticum für Cerebralschädigung. The patients scored lower than controls also in other tests sensitive to frontal lobe dysfunction. The results underpin the importance of neuropsychological testing in adult ADD, but also support notions of a working-memory deficit linked to a dysfunction in the prefrontal cortex in these patients.

Adolescent↗

Mayo's Older Americans Normative Studies: expanded AVLT Recognition Trial norms for ages 57 to 98.

This paper expands upon previously published Mayo's Older Americans Normative Studies (MOANS) Auditory Verbal Learning Test (AVLT) norms by presenting age and gender specific data for Recognition Trial accuracy (recognition 'hits' corrected for false positive errors) in a total of 836 subjects (the original sample, augmented by an additional 311 subjects). Observations are offered concerning clinical implications of AVLT Recognition Trial performance. Gender differences in recognition memory are discussed.

Aged↗

Mapping cerebellar vermal morphology and cognitive correlates in prenatal alcohol exposure.

Prenatal exposure to alcohol can result in neuroanatomical and neurocognitive deficits. High-resolution magnetic resonance imaging, surface-based image analytic methods, and neuropsychological measures were used to characterize the cerebellar vermis and to evaluate potential cognitive correlates of vermal morphology in 21 children and adolescents with prenatal alcohol exposure and 21 normally developing individuals. Alcohol-exposed individuals showed statistically significant reductions in the midline sagittal areas of the anterior vermis and posterior-inferior vermis, and significant displacement of the anterior and posterior-inferior vermal regions. Anterior vermal dysmorphology was negatively correlated with verbal learning and memory performance within the alcohol-exposed group. These observations expand on previous reports of cerebellar abnormalities in prenatal alcohol exposure, in that they localize the specific pattern of cerebellar vermal dysmorphology.

Adolescent↗

Age and sex differences in neurobehavioral performance: a study of Portuguese elementary school children.

In this study normative data were obtained on measures of IQ, visual/motor, motor and memory functions among Portuguese elementary school children. Subjects were 228 females and 275 males, 8.0 to 11.9 years of age, in grades 2 through 4, who participated in a dental study. Performance on all tests improved with increasing age. Females performed better in rote verbal learning, psychomotor speed, and speed of information processing. Males had higher scores on tests of visual learning, visual memory, and fine motor speed and coordination. Nonverbal IQ had a significant impact on all tests except motor speed and coordination. Results represent an initial attempt to evaluate Portuguese children in educational and medical settings.

Age Factors↗