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PubMed2006

Declarative and procedural learning in children and adolescents with posterior fossa tumours.

BACKGROUND: This quasi-experimental study was designed to assess two important learning types - procedural and declarative--in children and adolescents affected by posterior fossa tumours (astrocytoma vs. medulloblastoma), given that memory has an important impact on the child's academic achievement and personal development. METHODS: We had three groups: two clinical (eighteen subjects) and one control (twelve subjects). The learning types in these groups were assessed by two experimental tasks evaluating procedural-implicit and declarative memory. A Serial Reaction-Time Task was used to measure procedural sequence learning, and the Spanish version 1 of the California Verbal Learning Test-Children's Version- CVLT- 2 to measure declarative-explicit learning. The learning capacity was assessed considering only the blocks that represent learning, and were compared with MANOVA in clinical and normal subjects. The Raven, simple reaction-time, finger-tapping test, and grooved pegboard tests were used to assess the overall functioning of subjects. The results were compared with those from a control group of the same age, and with Spanish norm-referenced tools where available. RESULTS: The results indicate the absence of procedural-implicit learning in both clinical groups, whereas declarative-explicit learning is maintained in both groups. CONCLUSION: The clinical groups showed a conservation of declarative learning and a clear impairment of procedural learning. The results support the role of the cerebellum in the early phase of procedural learning.

Journal Article↗

PubMed1999

Memory assessment in studies of cognition-enhancing drugs for Alzheimer's disease.

There is an increasing number of cognition-enhancing drugs for Alzheimer's Disease (AD) and, consequently, drug trials represent a growing field of interest in research. As memory dysfunction is generally the first and most severe cognitive impairment in AD, the choice of memory testing to be used in these studies is of great importance. It should reflect an understanding of memory systems being assessed with neuropsychological tests and the fact that some tests can be more appropriate than others to show benefit with certain classes of cognition-enhancing drugs. Severe deterioration of episodic and semantic memory occurs very early in the AD process while working memory shows a gradual deterioration over time. Some aspects of working and implicit memory can be spared in the mild to moderate stages of AD. Tests of working, episodic, semantic and implicit memory are used as outcomes in trials with acetylcholinesterase inhibitors, drugs with other neurotransmitter strategies, metabolic enhancers and drugs which may impact upon a variety of CNS processes. The clinical scales and observational measures are largely used in trials of cognition-enhancing drugs for AD (46.66% of all the studies reviewed). The Digit Span test, the Rey Auditory Verbal Learning Test, the Buschke Selective Reminding Test and the verbal fluency tasks are the most sensitive memory tests, whereas the most sensitive scales are the Sandoz Clinical Assessment-Geriatric, the Gottfried-Bräne-Steel scale and the Blessed Dementia Scale. Finally, we suggest that future investigations should use sensitive memory tests, together with behavioural and psychiatric scales, rather than general observational evaluations.

Alzheimer Disease↗

PubMed1975

Verbal coding strategies used by hearing-impaired individuals.

A paired-associate verbal learning task was used to determine the type of perceptual coding strategies hearing-impaired persons use in auditory perceptual processing of language. Four lists of word pairs were devised, whereby the word pairs in each list were characterized as sharing either similar sign-similar meaning, dissimilar sign-similar meaning, similar sign-dissimilar meaning, or dissimilar sign-dissimilar meaning. Severely hearing-impaired subjects were required to replace the missing word associated with the word pairs. The results showed that, while the subjects were able to code the verbal material on both a sign basis and a semantic basis, the semantic coding strategy appeared to be more efficient than the sign coding strategy. The findings are related to earlier investigations and are explained according to a theoretical model of perception.

Adolescent↗

PubMed1989

Verbal recall and recognition abilities in patients with Wilson's disease.

Tests of memory and verbal fluency were administered to 19 neurologically impaired Wilson's patients, 12 non-neurologically impaired Wilson's patients and 15 normal control subjects. Wilson's patients with neurologic disease recalled significantly fewer words on the delayed recall version of the Rey Auditory Verbal Learning Test than control subjects (p less than .05) but they showed no impairment on the recognition version of this test. On a verbal fluency test (FAS) requiring the subject to retrieve items from different categories, Wilson's patients with neurologic disease generated significantly fewer words than control subjects (p less than .01). Results suggest that retrieval memory is mildly impaired in the neurologic WD group but rate of learning and rate of forgetting is normal.

Adolescent↗

PubMed2005

Cognitive findings after transient global amnesia: role of prefrontal cortex.

The aim of this study is to verify, after recovery, the presence of specific patterns of cognitive dysfunctions in Transient Global Amnesia (TGA). Fourteen patients with the diagnosis of TGA were submitted to a battery of neuropsychological tests and compared to a matched control group. We found significant qualitative and quantitative differences between TGA patients and controls in the California Verbal Learning Test (CLVT) and Rey-Osterrieth Complex Figure Test. Our data support the presence of selective cognitive dysfunctions after the clinical recovery. Moreover, for Verbal Fluency, Digit Span Backward, and Number of Clusters in the CVLT short-term memory test, the relation resulted as positively related with the temporal interval from the TGA episode. Reduction of categorical learning, attention, and qualitative alterations of spatial strategy seem to postulate a planning defect due to a prefrontal impairment.

Aged↗

PubMed1975

Effects of cigarette smoking on learning and retention.

Verbal rote learning was studied on 10 habitual smokers in a smoking and non-smoking session. Smoking induced a significant decrease in the number of correct responses on the learning task as compared to non-smoking values. The imparied learning coincided in time by an increased arousal as measured by heart rate. A test of recall 45 min after the end of the learning period, when the pre-smoking arousal level had been restored, showed that retention was better in the smoking condition than in the non-smoking condition. The results were interpreted in terms of Walker's theory (1958) postulating a relationship between arousal level and consolidation of memory.

Adult↗

PubMed1986

Effects of benzodiazepines on acquisition and performance: a critical assessment.

Evidence related to the effects of benzodiazepines on learning and memory is reviewed in the contexts of human verbal learning studies and animal studies using both aversive and non-aversive paradigms. While the impairment of acquisition by benzodiazepines appears to be a robust phenomenon generalizing across species and experimental conditions, the impairment in the performance of an already-learned task by such drugs appears to be more restrictive and highly dependent upon experimental contingencies. Thus far, performance impairment appears to be found mainly in animal studies using non-aversive, food-motivated tasks, with such tasks being particularly well suited for investigating such a phenomenon. At present, there is a noticeable lack of knowledge regarding the neurochemical substrates underlying BDZ-induced impairment. Finally, some issues that may contribute to the presence or absence of a BDZ-induced performance impairment in published studies are briefly considered.

Animals↗

PubMed1993

Learning and memory impairment in older, detoxified, benzodiazepine-dependent patients.

The effects of benzodiazepine dependence on the ability to learn and remember new material (determined with the Auditory-Verbal Learning Test) were studied in 20 detoxified, benzodiazepine-dependent patients who were 55 years of age or older and in a drug-dependence rehabilitation program. The patients were matched approximately for age, sex, and IQ with 20 detoxified, alcohol-dependent patients in the same rehabilitation program and 22 control subjects from a community sample. Neuropsychologic testing was performed a mean of 6 to 10 days after the patients had been completely detoxified from the addicting substance. The benzodiazepine-dependent patients had more difficulty with tests of learning and short-term and delayed recall than did the alcohol-dependent or control group. The difference between the benzodiazepine-dependent patients and the control group was statistically significant. The results suggest that benzodiazepine dependence in older people can cause memory impairment that persists into the early drug-free period.

Aged↗

PubMed2001

MRI atrophy parameters related to cognitive and motor impairment in Parkinson's disease.

BACKGROUND: Patients with Parkinson's disease (PD) show specific neuropsychological deficits in attention, memory, visuospatial or frontal lobe functions, which can arise from degeneration of different cerebral structures. OBJECTIVE: The aim of the present study was to analyze the role of focal degeneration (basal ganglia and substantia nigra) and diffuse cerebral atrophy (ventricular enlargement) in motor/cognitive impairment in PD. PATIENTS AND METHODS: We administered to 14 patients with advanced PD the following tests: Purdue Pegboard, Rey's Auditory-Verbal Learning test (RAVLT), Benton's Line Orientation, Trail Making, phonemic verbal fluency and Stroop test. Ventricular system, caudate and putamen nuclei and pars compacta of the substantia nigra were quantitatively measured by magnetic resonance imaging. Correlation analyses were carried out. RESULTS: The results showed that ventricular enlargement is negatively correlated with the performance on RAVLT and Stroop test. No relationship was found between caudate atrophy and cognitive deficits. Degeneration of putamen nucleus was found to be associated with motor deficits. CONCLUSION: Memory and frontal impairment are related to diffuse cerebral degeneration and the motor deficit is related to degeneration of the putamen nucleus.

Aged↗

PubMed1992

Memory and learning performances in POW survivors with history of malnutrition and combat veteran controls.

Former prisoners of war (POWs) with histories of malnutrition and body wasting were compared on standardized measures of memory and learning with POW survivors who sustained less confinement body weight loss and combat veterans of similar ages and military assignments. Results showed that POWs who sustained the greatest degree of trauma-induced weight loss, or that exceeding 35% of their precaptivity body weights, performed significantly worse on four of the five Wechsler Memory Scale /3-Revised (WMS-R) indices, showed more rapid rates of forgetting on the Visual Reproduction test, and exhibited slower acquisition rates and less sophisticated mastery of the learning materials on a modified version of the Rey Auditory Verbal Learning Test (AVLT). Given their relatively intact performances on measures of general intelligence and attention-concentration, the POWs with a history of severe malnutrition appeared to evidence a pattern of cognitive limitations qualitatively similar to that associated with alcoholic Korsakoff's syndrome.

Journal Article↗

PubMed1998

Prediction of verbal memory loss in individuals after anterior temporal lobectomy.

PURPOSE: Decreased memory function represents the area of greatest neuropsychological morbidity after anterior temporal lobectomy (ATL), particularly for left ATL candidates. We wished to identify easily derived demographic and neuropsychological predictors of risk of pre- to postoperative memory decline using only information available preoperatively. METHODS: We assessed decline in memory as measured by the California Verbal Learning Test (CVLT) by deriving multiple regression equations using the following measures as independent variables: age at onset, chronological age at time of surgery, sex, Full Scale IQ (FSIQ), level of education, and preoperative memory scores. In all, 203 patients (93 males, 110 females), undergoing ATL (107 left, 96 right) with preoperative and 6-month postoperative testing, were examined. RESULTS: The combination of age, FSIQ, sex, side of surgery and preoperative score was highly predictive (p-values < 0.0001) of postoperative memory scores. Higher postoperative scores were associated with higher preoperative score, younger chronological age, higher FSIQ, female sex, and right side of resection. Reliable change index (RCI) values were used to estimate meaningful decline on the total score across five trials. Logistic regression analysis showed preoperative score and age to be predictors of RCI decline for left-sided resections. Sensitivity of decline (> or =90th centile RCI) prediction was 56%, and specificity was 95%. Validation in 30 patients from a separate population of patients undergoing left ATL produced similar figures. CONCLUSIONS: The derived regression equations can accurately predict verbal memory decline on a list-learning task in approximately 50% of individual patients undergoing ATL, and false-positive prediction errors are very rare.

Age Factors↗

PubMed1988

Verbal memory and learning in unilateral posterior cerebral infarction. A report on 30 cases.

Unilateral posterior cerebral infarction, sparing memory-related structures in the diencephalon, may represent a means of investigating the role of hippocampal afferents and the parahippocampal areas in memory processing. Among 30 patients with unilateral posterior cerebral infarction a group of 12 subjects with left-sided lesions suffered from marked verbal memory and learning dysfunction, whereas the remaining subjects with left or right-sided lesions showed no obvious memory deficit. The impairment was most prominent for verbal learning tasks, while recall of isolated and complex verbal information appeared to be less affected. In some cases the memory disturbance could be detected up to one year after the causative event. Analysis by CT scanning revealed a coincidence of mnestic disturbances with lesions around the left collateral sulcus affecting the posterior parahippocampal gyrus and the collateral isthmus. The latter term refers to the fibre stem of the medial temporal lobe limited by the floor of the lateral ventricle and the depth of the collateral sulcus. Through this bottle-neck, bidirectional fibres run between the posterior parahippocampal gyrus and different sensory-specific and multimodal association areas. A lesion within the collateral isthmus or, more particularly, a combined lesion of the collateral isthmus and the posterior parahippocampal gyrus, deprives the hippocampus itself of its main afferent projection source and, on the other hand, prevents dissemination of the hippocampal output to widespread neocortical areas. It cannot be excluded, at least in some cases, that small lesions in the fimbria-fornix route, in the retrosplenial cortex or in the hippocampal formation itself also contribute to the memory and learning dysfunction. However, these small lesions, so far as they could be detected by CT scanning, were present in patients with and without memory disturbances.

Adult↗

PubMed2006

The effects of concurrent cannabis use among ecstasy users: neuroprotective or neurotoxic?

The research evidence regarding the potential effects of ecstasy suggests that it may be neurotoxic and that its use is associated with cognitive impairment. In recent years evidence has emerged suggesting that cannabinoids, the active ingredients in cannabis, can be neuroprotective under certain conditions. Given that many ecstasy users also consume cannabis at the same time, the possibility emerges that these individuals might be less susceptible to ecstasy-related impairment. The present paper reanalyses the data from a number of previous studies, contrasting the performance of those individuals who generally consume cannabis and ecstasy at the same time with those who generally consume ecstasy on its own. The two ecstasy-using groups are compared with non-ecstasy users on a range of measures including processing speed, random letter generation, verbal and visuo-spatial working memory span, reasoning and associative learning. The two ecstasy user groups did not differ significantly from each other on any of the measures. Both user groups were significantly worse than non-ecstasy users on measures of associative learning, verbal and visuo-spatial working memory and reasoning. The results suggest that consuming cannabis at the same time as ecstasy does not reduce the likelihood of cognitive impairment.

Age Factors↗

PubMed2005

Sources of declarative memory impairment in bipolar disorder: mnemonic processes and clinical features.

BACKGROUND: There is mounting evidence that declarative memory processes are impaired in patients with bipolar disorder. However, predictors of the observed impairment are not well understood. This study seeks to: (i) better characterize the nature of declarative memory impairment in bipolar disorder, and (ii) determine the relationship between clinical variables and memory function in bipolar disorder. METHODS: 49 adult patients with bipolar disorder in varying mood states and 38 demographically matched healthy participants completed a comprehensive neurocognitive battery assessing general cognitive functioning, processing speed, and declarative memory. The California verbal learning test was used to characterize learning and memory functions. RESULTS: Although patients with bipolar disorder utilized a similar semantic clustering strategy to healthy controls, they recalled and recognized significantly fewer words than controls, suggesting impaired encoding of verbal information. In contrast, lack of rapid forgetting suggests relative absence of a storage deficit in bipolar patients. While severity of mood symptomatology and illness duration were not associated with task performance, gender and family history significantly affected memory function. CONCLUSIONS: Results suggest that declarative memory impairments in bipolar patients: (1) are consistent with deficits in learning, but do not appear to be related to different organizational strategies during learning, and (2) do not appear to be secondary to clinical state, but rather may be associated with the underlying pathophysiology of the illness.

Adult↗

PubMed1994

Verbal memory performance of patients with human immunodeficiency virus infection: evidence of subcortical dysfunction. The HNRC Group.

In the present study, the California Verbal Learning Test (CVLT) was administered to symptomatic HIV+ (n = 31), asymptomatic HIV+ (n = 94), and HIV-normal control (HIV-NC) (n = 40) subjects to assess the prevalence and nature of their verbal memory deficits. Symptomatic HIV+ subjects were significantly impaired relative to HIV-control subjects on CVLT measures of acquisition and retention, and were significantly less likely than control subjects to use a semantic clustering strategy to support recall. The performance of the asymptomatic HIV+ subjects fell between those of the symptomatic HIV+ subjects and HIV-controls on almost every CVLT measure. A linear discriminant function analysis (DFA) was used to compare the performances of these three groups to Alzheimer's disease (AD). Huntington's disease (HD), and normal control (NC) subjects on three CVLT measures, including total recall over five learning trials, intrusion errors, and a derived score of delayed recognition discriminability minus the final learning trial. Significant differences were found between the number of symptomatic HIV+ subjects classified as HD (32%), AD (3%), and normal (65%), the number of asymptomatic HIV+ subjects classified as HD (16%), AD (1%), and normal (83%), and the number of HIV-NC subjects classified as HD (2%), AD (0%), and normal (98%). The profile of verbal memory deficits exhibited by the subgroup of impaired HIV+ subjects was similar to that of patients with HD, a prototypical subcortical dementia, and different from that of patients with AD, a prototypical cortical dementia. This finding is consistent with reports of the predominance of subcortical neuropathological changes associated with HIV infection.

AIDS Dementia Complex↗

PubMed2001

An evaluation of a case of agenesis of the corpus callosum with Rourke's nonverbal learning disorder model.

This article evaluates the case of an 11-year-old male with congenital agenesis of the corpus callosum, against Rourke's NLD models. A comprehensive neuropsychological assessment was completed, and impairments with attention, movement, fine motor and sensory perception, visuo-spatial organization, and verbal memory were identified. Additionally, a volumetric analysis of the magnetic resonance image (MRI) was completed. Although no gross structural abnormalities, beyond agenesis, were present, the possibility of unobservable abnormalities was considered. Many predicted NLD deficits were clearly evidenced in this case, including associated behavioral problems. This study concludes that although Rourke's NLD model is descriptive of many aspects of white matter impairments, it may not account for the full range or severity of deficits that may be observed. In callosal agenesis, children may exhibit verbal learning, auditory attentional, and verbal expressive difficulties.

Clinical Conference↗

PubMed2005

Impaired recruitment of the dorsolateral prefrontal cortex and hippocampus during encoding in bipolar disorder.

BACKGROUND: The aim of the present study was to examine the functional neuroanatomy of episodic memory impairment in euthymic subjects with bipolar I disorder. There is evidence that individuals with bipolar disorder have cognitive impairments not only during mood episodes but also when they are euthymic. The most consistently reported cognitive difficulty in euthymic subjects with bipolar disorder is impairment in verbal episodic memory (i.e., the ability to learn new verbal information). METHODS: The current study examined verbal learning in eight euthymic, remitted subjects with bipolar I disorder (BP-I; seven nonmedicated) and eight control subjects matched for age, gender, education, and intelligence. Subjects underwent (15)O-CO(2) positron emission tomography scanning while completing a verbal learning paradigm that consisted of encoding (learning) several lists of words. RESULTS: The BP-I subjects had more difficulties learning the lists of words compared with the control subjects. Compared with control subjects, BP-I subjects exhibited blunted regional cerebral blood flow (rCBF) increases in the left dorsolateral prefrontal cortex (Brodmann's area 9/46) during encoding. CONCLUSIONS: Consistent with previous studies, subjects with BP-I were impaired in learning new verbal information. This was associated with rCBF abnormalities in brain regions involved in learning and episodic memory.

Adult↗

PubMed1976

Overselectivity, developmental level, and overtraining in autistic and normal children.

Thirteen autistic children were compared to 13 normal children matched to them in mental age, on performance of a visual discrimination task. Form, color, and size were relevant and redundant cues. The groups did not differ significantly in mean trials to reach criterion or in breadth of learning, and both groups increased their breadth of learning after 50 trials of overtraining. Form was preferred to color and size by both autistic and normal children. Within each group, rank on mental age was highly correlated with rank in breadth of learning. Verbal and nonverbal autistic children did not differ in breadth of learning or in dimensional preference. Even nonverbal autistics equaled the performance of their normal controls. Our results suggest that overselective attention is better understood as part of a general developmental lag in cognition in autistic children than as a specific deficit underlying psychotic behavior.

Attention↗