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PubMed1990

[Speech changes in dementia].

This review analyzes the spectrum of language deficits commonly encountered in dementia. A specific communication profile is found in dementia of the "cortical" type, such as Alzheimer's disease. With advancing disease lexical, comprehension and pragmatic functions deteriorate, whereas syntax and phonology tend to be preserved. This pattern bears some resemblance to aphasia types like transcortical and Wernicke's aphasia, however, a much broader range of communicative functions is impaired in Alzheimer's disease than in aphasia. Differentiation of dementia and aphasia, especially in elderly patients requires careful neuropsychological assessment of language, memory and other psychological functions. "Subcortical" dementia commonly presents with dysarthria as the leading symptom and linguistic impairment is rarely of crucial importance until late stages. Thus, the interetiologic dissociation of language and speech impairment can be used for dementia differentiation. Aphasia batteries are not sufficient to comprehend the range of language deficits in demented patients. Testing the communication impairment in dementia requires specific tasks for spontaneous speech, naming, comprehension, reading, writing, repetition and motor speech functions. Tasks for verbal learning and metalinguistic abilities should also be performed. Language deficits are frequent initial symptoms of dementia, thus language assessment may be of diagnostic relevance. Many data support the concept that the communication deficit in dementia results from a particular impairment of semantic memory.

Aged↗
PubMed1998

Language dysfunction in children with Rolandic epilepsy.

Rolandic epilepsy is regarded as the classic example of benign focal epilepsy. However, neuropsychological deficits have been noted in affected children. As Rolandic discharges are mainly distributed over the centrotemporal region, specific interference with language function might be suspected. Therefore, we conducted a standardized neuropsychological assessment in children with Rolandic epilepsy which covered all important aspects of language processing. We measured intelligence Quotient, verbal memory, auditory discrimination, vocabulary, grammar and literacy in 20 children with an active Rolandic focus. Information about performance at school was obtained from teachers by means of a questionnaire. Patients with Rolandic epilepsy failed five of the twelve standardized language tests significantly more often than the normative population and consequently showed impairment of the following functions: reading, spelling, auditory verbal learning, auditory discrimination with background noise and expressive grammar. Thirteen of the 20 children showed language dysfunction with difficulties in two or more of the twelve standardized language tests. In eight of these 13 children the Full Scale Intelligence Quotient was within average range, indicating a specific language deficit. Language dysfunction was closely associated with learning difficulties at school. This study documents a consistent pattern of language dysfunction in children with Rolandic epilepsy which suggests interictal dysfunction of perisylvian language areas.

Adolescent↗
PubMed2001

Neuropsychologic impairment after coronary bypass surgery: effect of gaseous microemboli during perfusionist interventions.

OBJECTIVE: Neuropsychologic impairment is a common complication of coronary bypass surgery. Cerebral microemboli during cardiopulmonary bypass are the principal cause of cognitive deficits after coronary bypass grafting. We have previously demonstrated that the majority of cerebral emboli occur during perfusionist interventions (ie, during the injection of air into the venous side of the cardiopulmonary bypass circuit). The purpose of this study was to determine whether an increase in perfusionist interventions is associated with an increased risk of postoperative cognitive impairment. METHODS: Patients undergoing elective coronary artery bypass grafting (n = 83) underwent a battery of neuropsychologic tests preoperatively and 3 months postoperatively. Patients were divided into 2 groups according to the median value of perfusionist interventions during cardiopulmonary bypass. Group 1 patients (n = 42) had fewer than 10 perfusionist interventions, and group 2 patients (n = 41) had 10 or more interventions. RESULTS: The 2 groups of patients were similar for all preoperative, intraoperative, and postoperative variables, with the exception of longer cardiopulmonary bypass times in group 2 patients (P <.001). Group 2 patients had lower mean scores on 9 of 10 neuropsychologic tests, with 3 (Rey Auditory Verbal Learning, Digit Span, and Visual Span) being statistically significant. Group 2 patients had worse cognitive test scores, even when controlling for increased bypass times. Group 2 patients had a nonsignificant trend toward an increased prevalence of neuropsychologic impairment 3 months postoperatively. CONCLUSIONS: Introduction of air into the cardiopulmonary bypass circuit by perfusionists, resulting in cerebral microembolization, may contribute to postoperative cognitive impairment.

Cardiopulmonary Bypass↗
PubMed2004

The depiction of car light beams in a child born completely blind.

A 12-year-old child (DI) who was completely blind from birth, made a series of tactual (raised-lines) drawings of cars. Among them, there was the depiction of a 'fast car at night' in which DI drew beams of light projecting out of the car. We analyse this drawing, and the preceding ones. We argue that the way in which cars and light beams were depicted by DI cannot be fully and solely explained by graphic imprecision, executive or motor deficiencies, or by rote or verbal learning. Instead, we propose that the most plausible explanation is that DI's depiction of light in a fast car at night reflects the child's naïve knowledge of light propagation, and that this knowledge was gained through perceiving light as radiant heat.

Automobiles↗
PubMed2001

A computer-assisted administration of the Continuous Visual Memory Test.

The Continuous Visual Memory Test (CVMT) is a continuous design recognition test designed for the assessment of visual memory for clinical and research applications. Comparisons were made between the traditional and a computer-assisted format of the CVMT using 51 university students. Formats were compared on five CVMT dependent measures, concurrent validity, split-half reliability, and selected dependent measures from the California Verbal Learning Test (CVLT). Participants scored higher on the computer format dependent measures, with the exception of false alarms (new items incorrectly identified as old), which remained comparable between formats. Adequate concurrent validity (r =.70) and split-half reliability (rs =.61-.70) were demonstrated for CVMT Total Score. Restriction of range and ceiling effects precluded reliability and validity conclusions for CVMT Delay. The computer format showed a nonsignificant trend towards lower correlations with CVLT dependent measures.

Adolescent↗
PubMed2003

Specificity of malingering detection strategies in older adults using the CVLT and WCST.

Strategies for the detection of possible malingering have largely taken two forms. First is the development and validation of domain-specific measures of malingering designed specifically for the detection of malingering (e.g., Test Of Memory Malingering, Word Memory Test, and Word Completion Memory Test). The second has been the development and evaluation of performance patterns and cutoff scores applicable to commonly used neuropsychological instruments. Two such instruments that have been examined are the Wisconsin Card Sorting Test (WCST) and the California Verbal Learning Test (CVLT). While several studies propose possible cutoff scores and actuarial judgement strategies for these tests, the specificity of these strategies within older, nonimpaired adults has not been established. Without proper evaluation of potential age-related effects within these strategies, the actual utility of the strategies within suspected malingerers who are older adults is unknown. Therefore, the present study was conducted to evaluate the specificity of the proposed strategies for detecting possible malingering with the WCST and the CVLT in a sample of older, community-dwelling, nonimpaired adults. The results suggest that the currently existing WCST formulas may have limited utility for the detection of malingering with older adults while the CVLT strategies do appear to have potential clinical utility. The potential of these formulas for use with older adults is discussed.

Aged↗
PubMed1998

Quantitative evidence for neuroanatomic and neuropsychological markers in dementia of the Alzheimer's type.

Meta-analytic methods were used to determine the sensitivity of neuropsychological, structural, and physiological measures to temporal-hippocampal system function in dementia of the Alzheimer's type. Effect sizes are reported for the California Verbal Learning Test, the Wechsler Memory Scale-Revised, structural (i.e., magnetic resonance imaging [MRI]), and functional (i.e., positron emission tomography [PET], single photon emission computed tomography [SPECT]) neuroimaging methods. Overall, effect sizes from MRI studies are larger than those obtained from SPECT and PET, respectively, but not as large as those obtained from the neuropsychological measures. On the basis of this finding, the neuropsychological and gross pathologic similarities between Alzheimer's disease, other dementing conditions, and mixed dementias, warrants the coupling of neuropsychological evaluation for its sensitivity with neuroimaging visualization for its specificity in improving diagnostic and differential accuracy.

Aged↗
PubMed1999

Neuropsychological performance and cognitive olfactory event-related brain potentials in young and elderly adults.

The P3 event-related brain potential (ERP) reflects neuroelectric activity related to the speed of cognitive processing and allocation of attentional resources. The objective of the present study was to assess the relationship between the P3 and Slow Wave components of the olfactory event-related potential (OERP) with neuropsychological performance in young (n = 16) and elderly (n = 16) adults. OERPs were recorded monopolarly from midline electrode sites while subjects estimated the odor magnitude of each stimulus, eliciting highly reproducible P3s. Results showed that the late cognitive components (P3 amplitude, P3 latency and Slow Wave area) decline with age and that this decreased neuronal efficiency is associated with reductions in the neuropsychological performance indexed by the Trail Making Test and the California Verbal Learning Test.

Adult↗
PubMed1999

Neuropsychiatric correlates of memory-metamemory dissociations in HIV-infection.

Ninety-one adults with HIV-infection who varied in the concordance between their subjective memory complaints (or metamemory) on the Patient's Assessment of Own Functioning (Chelune, Heaton, & Lehman, 1986) and their memory performance on the California Verbal Learning Test (CVLT), were compared on the Beck Depression Inventory (BDI), and on neuropsychological (NP) tests of attention, language, psychomotor speed, and conceptual problem-solving. Subjects with low memory complaints and normal CVLT performance (n = 29) had low BDI scores and were normal in all other NP abilities. Subjects with high memory complaints and impaired CVLT performance (n = 20) had elevations on the BDI as well as NP impairments in psychomotor speed and category fluency. Subjects with low memory complaints but impaired CVLT performance (n = 16) had low BDI scores and were selectively impaired in conceptual problem-solving. Subjects with high memory complaints but normal CVLT performance (n = 26) had high BDI scores and normal NP functioning in all other abilities. These results suggest that there are at least two key determinants to metamemory inaccuracy in HIV-infection, namely, frontal executive impairments and mood disturbance.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Obsessive-compulsive disorder (OCD) patients are impaired in remembering temporal order and in judging their own performance.

Obsessive-compulsive disorder (OCD) has been related to frontostriatal dysfunction, but some inconsistencies between studies and a relative paucity of neuropsychological research still characterizes the study of OCD. We compared 28 patients with OCD and matched healthy controls on two neuropsychological tests sensitive to frontal dysfunction: temporal ordering and a "feeling-of-doing" (FOD) judgment about ordering. The OCD group performed significantly worse than controls in the temporal ordering task despite showing normal recognition memory. Patients were also impaired in "feeling-of-doing" judgments suggesting they have a lack of self-awareness of their performance. Thus, the results of the current study reinforces previous research that indicates that OCD patients fail on tasks that require adequate functioning of the frontal-striatal pathways.

Adolescent↗
PubMed2003

Fatigue in HIV/AIDS is associated with depression and subjective neurocognitive complaints but not neuropsychological functioning.

Fatigue and depressive symptoms are common in HIV-infection. The relationship between these symptoms and neuropsychological functioning is poorly understood, particularly in symptomatic infection/AIDS. This study examined the associations among fatigue, depressive symptoms, subjective neurocognitive complaints, and objective neuropsychological performance in HIV/AIDS. Sixty-eight men with HIV-infection (27 adults with HIV-infection but not AIDS and 41 with AIDS diagnosis) completed a neuropsychological test battery and self-report measures of fatigue (Fatigue Severity Scale), depressive symptoms (Beck Depression Inventory), and subjective neurocognitive complaints (Patient's Assessment of Own Functioning). High levels of fatigue were endorsed by participants. Fatigue severity was related to depressive symptoms but not to AIDS diagnosis or medication status. Verbal learning and motor function was worse in participants with AIDS, but neuropsychological functioning was not significantly correlated with fatigue or depressive symptoms. Subjective neurocognitive complaints were predicted by both depressive symptoms and fatigue. Our results suggest that adults with fatigue and HIV-infection (with or without AIDS) should be screened for depression. Neither fatigue nor depressive symptoms appear to affect neuropsychological functioning in HIV/AIDS. Future research is needed to develop and evaluate instruments and methods to differentiate depression-related fatigue from fatigue that may reflect underlying medical disease. Such research will further the development of effective treatments for fatigue associated with HIV-infection.

Acquired Immunodeficiency Syndrome↗
PubMed2001

The nature of declarative and nondeclarative knowledge for implicit and explicit learning.

Using traditional implicit and explicit artificial-grammar learning tasks, the author investigated the similarities and differences between the acquisition of declarative knowledge under implicit and explicit learning conditions and the functions of the declarative knowledge during testing. Results suggested that declarative knowledge was not predictive of or required for implicit learning but was related to consistency in implicit learning performance. In contrast, declarative knowledge was predictive of and required for explicit learning and was related to consistency in performance. For explicit learning, the declarative knowledge functioned as a guide for other behavior. In contrast, for implicit learning, the declarative knowledge did not serve as a guide for behavior but was instead a post hoc description of the most commonly seen stimuli.

Adult↗
PubMed1982

The relationship between learning disability, intelligence, and paired-associate learning.

Learning disabled (N = 45) and non-learning disabled (N = 39) third and fourth grade boys and girls were compared in four paired-associate situations. The situations respectively measured learning, memory, exemplar learning, and transfer. Intelligence was measured with the WISC-R. The data were nonnormal in distribution, and the results were thus analyzed parametrically for intelligence and group. What appears to be an interaction occurred. Intelligence facilitated performance for normals on the memory task but had a deleterious effect for the learning disabled Ss. The learning disabled high intelligence group, however, performed significantly better than the other groups on the exemplar and transfer tasks. These findings are discussed in terms of conceptualizations of learning disability and the nature of intervention strategies. In addition, concern is raised for the validity for research with these children where the IQ factor is ignored or covaried and not directly investigated.

Child↗
PubMed1981

Developmental differences in children's labeling of movement.

Children's encoding of information, specifically, the correct use and application of labels, is one factor frequently used to account for developmental differences in verbal learning. Labels may also be used in connection with remembering positional movements. The purpose of this study was to evaluate developmental differences in the effects of labels upon remembering movements. In addition, the study evaluated whether better or poorer labeling strategies would increase or decrease performance in the age groups studied. Subjects consisted of kindergarten children (N=27), fifth grade children (N=27), and adults (N=27) randomly assigned within each age level to one of three groups: subjective label, irrelevant label, and relevant label. Subjects were tested on a two-dimensional positioning task allowing estimates of radial, location, and distance errors. Results indicated that relevant labels (clock face) improved performance for remembering positions within all age conditions. Of major interest was the finding that relevant labels increased performance of the kindergarten children to the approximate level of the irrelevant label (animals) group for fifth graders. The same finding was evident for the fifth graders with the relevant label group approximating performance of adults forced to use a less sophisticated strategy (irrelevant label, i.e., animals). This finding suggests that a significant portion of the differences between younger and older children and adult performance is due to the processing deficit of poor encoding strategies used by children.

Journal Article↗