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Corpus striatum and traumatic brain injury.

The possibility of a 'subcortical' syndrome differentially affecting memory in traumatic brain injury (TBI) subjects was examined. Magnetic resonance imaging scans of 46 traumatic brain injured male patients were compared with those of 34 male control subjects. Surface area measurements of the corpus striatum were calculated for both groups. Results demonstrated no significant differences in corpus striatum surface area measurements. Additionally, TBI patients were grouped according to severity of injury, as well as degree of corpus striatum atrophy, and neuropsychological outcome was examined. There were modest (r = 0.35) but significant correlations between corpus striatum degeneration and the delayed recall trial and total score of the Rey Auditory Verbal Learning Test, but no other correlations between neuropsychological and corpus striatal surface area were significant. Because subcortical pathology may have a differential effect on memory, recognition and recall memory were further analysed, but no significant differences were found. TBI subjects with the smallest corpus striatum values did not test significantly different from TBI patients with normal corpus striatum values or differences in cortical atrophy, as determined by a ventricle-to-brain ratio. These findings suggest that there is not a unique pattern of subcortical pathology involving the corpus striatum in TBI.

Adolescent↗

Dissociable lexical and phonological influences on serial recognition and serial recall.

The impact of the lexicality of memory items on memory performance was compared in two paradigms, serial recall and serial recognition. Experiments 1 to 3 tested 7- and 8-year-old children. Memory accuracy was only mildly impaired in lists containing nonwords compared with words in a serial recognition task involving judgments of whether the items in two sequences were in the same order (Experiment 1), although a substantial advantage for word over nonword items from the same stimulus pool was found in serial recall (Experiment 2). A stronger influence of lexicality on serial recall than serial recognition was further demonstrated in Experiments 3A and 3B, and in 4A and 4B using adult participants. These experiments also established comparable degrees of sensitivity to the phonological similarity of the memory sequences in the two paradigms. The phonological similarity effect in serial recall was found to arise from increased phoneme order errors, whereas the lexicality effect was due principally to the greater frequency of phoneme identity errors for nonwords. It is proposed that the lexicality effect originates in the redintegration of item information just prior to recall, and that this process is largely bypassed in serial recognition.

Adult↗

Processing and storage in working memory span.

Two experiments are reported that address theoretical assumptions as to the nature of working memory involved in working memory span tasks (Daneman & Carpenter, 1980). Experiment 1 used a version of the sentence span task, and Experiment 2 combined arithmetic verification with recall of presented words. In each experiment, working memory processing span was assessed independently of temporary storage span prior to their combination. Combined task performance under high demand for each component resulted in substantial residual performance for both task elements, particularly in Experiment 2. The results do not challenge the utility of the sentence span task as a measure of on-line cognition, but they raise concerns as to how resource might be allocated to processing and storage elements of the task within a single flexible resource pool, or between different resources of a multiple component working memory system. Although both models lack predictive power regarding resource allocation in these tasks, the multiple resource model appears to offer the better account.

Adult↗

Verbal and figural recognition memory: task development and age associations.

The goal of the present study was to develop and validate parallel tests of verbal and figural delayed-recognition memory with similar task demands and difficulty levels. Such tasks would allow examination of age differences and longitudinal age changes in visual recognition memory for two types of stimuli, activate divergent neural systems, and allow us to use the same procedures within the confines of functional neuroimaging as those we use in standard neuropsychological administration. The tasks introduced here include a delay between target presentation and test phase, are matched in difficulty, and yield moderate levels of performance. Individual and group differences in task performance were examined in 80 cognitively normal men and women in two older age groups: 60 to 69 and 70 to 85. Accuracy averaged 74% in both tasks, with lower performance in the oldest age group. Although accuracy was equivalent between tasks, subjects had a more liberal response bias in the figural than verbal task. Performance on the new recognition-memory tests was significantly related to Benton Visual Retention Test (BVRT; Benton [1963]. New York: The Psychological Corporation) and California Verbal Learning Test (CVLT; Delis, Kramer, Kaplan, & Ober [1987]. New York: The Psychological Corporation) performance measures. The absence of floor or ceiling effects, wide range of individual variability, and demonstrated concurrent validity of the present tasks suggest their potential utility in functional neuroimaging studies and in the early detection of cognitive decline.

Acoustic Stimulation↗

Fast improvement of verbal memory function after left temporal tumour resection.

CASE REPORT: A 7-y-old, right-handed girl presented at our clinic with complex partial seizures, behavioural problems and word-finding difficulties. Clinical examination was normal, but electroencephalogram revealed bilateral epileptic discharges in the temporal and paracentral leads. Magnetic resonance imaging showed an intracerebral mass in the left mesial temporal lobe in the areas of the gyrus temporooccipitalis medialis and gyrus parahippocampalis. Neuropsychological testing brought to light an above-average general intelligence, but the girl performed below average in verbal memory tests and average in figural memory tests. RESULTS: The tumour was completely removed by surgery. Neuropsychological testing 3 and 11 wk after tumour resection demonstrated above-average verbal learning and memory abilities and improved visual memory. The emotional disturbances, seizures and electroencephalogram abnormalities disappeared completely during the postoperative follow-up. CONCLUSION: After resection of a left temporal brain tumour, the patient was free of seizures, and neuropsychological functions recovered completely within weeks.

Brain Neoplasms↗

The relationship between neuropsychological functioning and instrumental activities of daily living following acquired brain injury.

The present study examined the ecological validity of neuropsychological tests relative to instrumental activities of daily living (IADLs) among 55 participants in a post-acute brain injury rehabilitation program. Stronger intellectual abilities, visual memory, delayed memory, verbal learning, and cognitive flexibility were significantly associated with success on the IADL tasks. However, each IADL task placed unique demands on cognitive abilities. Behavioral ratings of attention span and frustration tolerance also were positively related to task completion. Multiple aspects of patient functioning (neuropsychological abilities, self-regulatory behaviors), as well as task characteristics, must be considered to predict outcomes in everyday functioning.

Journal Article↗

Approaches to memory assessment in the chronic psychiatric elderly.

Approaches to memory assessment generally fall into two categories: a) Evaluation of the integrity of specific cognitive processes, and b) Quantitative measurement of performance levels on global dimensions of behavior. The California Verbal Learning Test (CVLT) is an exemplar of both the process and global approaches, while the Wechsler Memory Scale-Revised (WMS-R) represents the global approach. Despite the popularity of both instruments little extant research, examining their convergent/divergent properties or their compatibility, exists. In the present study we replicated, on a mixed sample of normal and psychiatric elderly, a previous study's pattern of CVLT/WMS-R convergent and divergent findings. In addition, we found that both instruments are similar in their discrimination between normal and psychiatric elderly subjects.

Journal Article↗

Relationship between cognitive function and regional cerebral blood flow in different types of dementia.

PURPOSE: We assessed relationships between cognitive impairment and regional cerebral blood flow (rCBF) in the different types of dementia. SUBJECTS AND METHODS: Subjects, who included 27 with Alzheimer's disease (AD), seven with frontotemporal dementia (FTD), six with vascular dementia (VaD), and 12 normal controls, were evaluated using the Mini-mental State (MMS), Kana-hiroi Test, an auditory verbal learning test (AVLT), a word fluency test (WFT) and Raven's Coloured Progressive Matrices (RCPM). The rCBF was measured using a three-dimensional stereotaxic ROI template method (3DSRT). RESULTS: In all dementia types, left superior frontal hypoperfusion was demonstrated. In AD and VaD significant CBF reduction also was seen in both angular, temporal, occipital, and precentral, both hippocampi, thalami, and pericallosal regions, and the left lenticular nucleus. MMS, Kana-hiroi Test, and AVLT scores correlated with CBF in all regions. WFT scores were correlated highly with CBF in the left side in frontal, temporal, and angular regions and right and left lenticular nuclei, thalami, and pericallosal regions. RCPM scores correlated with CBF in posterior regions. CONCLUSION: Close coupling was evident between reduced rCBF and cognitive dysfunction in patients with dementia. Use of neuropsychologic tests and rCBF determinations in combination should enhance diagnostic accuracy.

Aged↗

Cognitive functioning of adolescents and young adults with meningomyelocele and level of everyday physical activity.

PURPOSE: To explore whether cognitive functioning in patients with meningomyelocele (MMC) is related to level of everyday physical activity. METHOD: In a cross-sectional study in 14 patients with MMC (aged 14 - 26 years) a neuropsychological test battery was administered to each patient. Everyday physical activity of the patients was measured with an accelerometry-based Activity Monitor (AM), and compared to 14 healthy comparison subjects. RESULTS: Intellectual ability of 10 patients was in the normal range. For memory and verbal learning, executive functioning, divided attention and reaction speed subnormal scores were present in six or more patients. Time spent on dynamic activities was low in patients with MMC as compared to healthy subjects. After controlling for intellectual ability, we found that in patients with MMC (i) executive functioning was positively related, and (ii) word production was negatively related to everyday physical activity. CONCLUSION: We found some indication that specific impairments in executive functioning might be related to everyday physical activity of adolescents and young adults with MMC.

Adolescent↗

Investigating the mental abilities of rural Zulu primary school children in South Africa.

INTRODUCTION: Maximising the full potential of health and educational interventions in South African schools requires assessment of the current level of mental abilities of the school children as measured by cognitive and scholastic tests and the identification of any barriers to improved performance. OBJECTIVES: This study reports on the application and interpretation of a selected battery of mental ability tests among Zulu school children and the methodological and analytical issues that need to be addressed. DESIGN: The test scores of 806 primary school children from a rural community are presented, based on four tests: Raven's Coloured Progressive Matrices (CPM), an Auditory Verbal Learning Test (AVLT), the Symbol Digit Modalities Test (SDMT) and Young's Group Mathematics Test (GMT). RESULTS: Significant gender differences were found in the test scores, and the mean scores of Zulu children in this study were lower than those reported in other studies. The results of this selected test battery provide data for the further development of appropriate test instruments for South African conditions. CONCLUSION: These results can contribute towards the development of a test battery for South African children that can be used to assess and improve their school performance.

Child↗

Reproductive period and cognitive function in a representative sample of naturally postmenopausal women aged 60-64 years.

BACKGROUND: Greater lifetime estrogen exposure has been postulated to result in better cognition in later life, particularly in the area of verbal memory. In women, the highest levels of endogenous estrogen occur during their reproductive period, between menarche and menopause. OBJECTIVE: To investigate the association between reproductive period and cognition. METHODS: The sample consisted of 760 naturally postmenopausal women aged 60-64 years (mean age 62.5 +/- 1.5 years) participating in the PATH Through Life Study who were randomly drawn from the population of Canberra, Australia. Participants were administered a verbal learning test (immediate recall and 1-minute delay), the Mini-Mental State Examination (MMSE), digit span backwards, the Symbol-Digit Modalities Test and simple and choice reaction time tests. RESULTS: There were no significant associations detected between reproductive period and performance on any of the cognitive tests, either before or after controlling for potential confounding variables. CONCLUSIONS: Reproductive period, a surrogate measure of endogenous estrogen exposure, had no detectable effect on cognitive performance in this sample.

Australia↗

Neurocognitive performance in breast cancer survivors exposed to adjuvant chemotherapy and tamoxifen.

The primary aim of the current study was to examine whether neurocognitive functioning among breast cancer survivors (BCS) exposed to systemic adjuvant chemotherapy differs from that seen among BCS who did not receive chemotherapy. The performance of each of these BCS groups was compared to a demographically matched comparison group without history of breast cancer, a group not included in the majority of previous cognitive functioning studies. We also sought to explore whether usage of the anti-estrogen drug tamoxifen, a common component of breast cancer treatment, was related to neurocognitive functioning. Finally, we wished to examine the relationship between subjective report of cognitive functioning and objective performance on neurocognitive measures among BCS. Fifty-three survivors of breast cancer (all between 2-5 years after diagnosis and initial surgical removal of cancerous tissue) and 19 healthy non-BCS comparison subjects were administered a comprehensive neurocognitive battery, and measures of mood, energy level, and self-reported cognitive functioning. Those BCS who received adjuvant chemotherapy performed significantly worse in the domains of verbal learning, visuospatial functioning, and visual memory than BCS treated with surgery only. Those who received both chemotherapy and tamoxifen showed the greatest compromise. Although patients who received chemotherapy (with and without tamoxifen) performed worse than those treated with surgery only on several domains, neither group was significantly different from demographically matched comparison subjects without a history of breast cancer. Finally, we found no relationship between subjective cognitive complaints and objective performance, although cognitive complaints were associated with measures of psychological distress and fatigue. We highlight ways in which these data converge with other recent studies to suggest that systemic chemotherapy, especially in combination with tamoxifen, can have adverse yet subtle effects on cognitive functioning.

Adult↗

Implicit learning is intact in adult developmental dyslexic readers: evidence from the serial reaction time task and artificial grammar learning.

Previous research yielded equivocal results concerning implicit learning abilities of developmental dyslexic readers. These studies employed a sequence learning task that requires a motor response to each stimulus. However, implicit learning has been often studied using non-motor tasks. Thus, we investigated implicit learning capabilities of adult developmental dyslexic readers in two standard implicit learning paradigms differing in the involvement of the motor system, namely the serial response time task (SRTT) and artificial grammar learning (AGL).Twelve adult developmental dyslexic and twelve age- and sex- matched normal readers were tested. In the serial response time task (SRTT), participants are exposed to a structured display. Learning is measured by comparing response time (RT) to the structured sequence with RT to a random display. In the artificial grammar learning task (AGL), letter strings following a markovian finite state grammar are presented. In a subsequent test phase subjects have to judge new letter strings according to their grammaticality. Learning of the stimulus regularities was found in both tasks and for both groups of subjects. Furthermore, participants were unaware of the underlying stimulus construction principles. Dyslexic readers were unimpaired in SRTT as well as artificial grammar learning relative to normal readers. These findings show that implicit learning is intact in dyslexia. Intact implicit learning capabilities should be taken into account when designing training programs for developmental dyslexic readers.

Adult↗

Initial validation of a screening battery for the detection of HIV-associated cognitive impairment.

This study sought to develop and validate a screening battery for detecting HIV-related neuropsychological (NP) impairment. Six NP measures representing the ability areas most likely affected by HIV infection were paired in 14 combinations and their diagnostic accuracy rates compared. The measures were selected from a larger NP battery administered to 190 HIV-seropositive (HIV+) participants. Screening battery performance was classified as NP impaired if demographically corrected T-scores fell below 40 on both tests, or below 35 on one test. Using blind clinical ratings of NP test results from the larger battery as the "gold standard" for global NP status (impaired or unimpaired), we found that several test combinations demonstrated adequate diagnostic accuracy in detecting NP impairment. The most sensitive test combinations were the Hopkins Verbal Learning Test-Revised (HVLT-R; Total Recall) and the Grooved Pegboard Test nondominant hand (PND) pair and the HVLT-R and WAIS-III Digit Symbol (DS) subtest pair (sensitivity = 78% and 75%, respectively). Both test combinations (HVLT-R/PND, HVLT-R/DS) were more accurate than the HIV Dementia Scale (HDS) in classifying HIV+ participants as NP impaired or unimpaired. Results suggest that demographically corrected T-scores from pairs of common NP measures may serve as valid screening instruments to identify subjects with HIV-related neurocognitive impairment who could benefit from more extensive NP examination.

Adult↗

Significant discrepancies between immediate and delayed WMS-III indices are rare in temporal lobe epilepsy patients.

Initial factor analysis of Wechsler Memory Scale-Third Edition (WMS-III) standardization data resulted in a five-factor model that included separate immediate (IMM) and delayed (DEL) memory factors for auditory (AUD) and visual (VIS) memory. However, recent factor analyses that revealed three factors--AUD, VIS, and working memory--were discovered to be more accurate. Continued use of separate WMS-III IMM and DEL indices has been recommended because future studies with clinical groups might support this distinction. Data from this investigation of 88 temporal lobe epilepsy (TLE) patients suggested separate IMM and DEL WMS-III indices are not necessary in this population. Results were as follows: 1) There was no significant difference between the IMM and DEL indices for AUD or VIS memory. 2) The percentage of individuals with a significant difference between the IMM and DEL indices (IMM minus DEL >11 or <-12) was similar for our TLE group and the standardization sample. 3) The mean percent retention standard score (SS) was at the average level for the four memory subtests, and for each subtest only about 10% of the TLE patients had impaired scores. 4) Hippocampal volumes correlated significantly with both IMM and DEL indices. These data suggest that combining the appropriate WMS-III IMM and DEL memory subtest scores to form AUD and VIS memory indices is appropriate for TLE patients.

Adult↗

Neuropsychological differentiation of dementia with Lewy bodies from normal aging and Alzheimer's disease.

We examined the diagnostic utility of selected neuropsychological measures in the differentiation of dementia with Lewy bodies (DLB) from normal aging and Alzheimer's disease (AD). Patients with DLB (n = 87), AD (n = 138), and a group of normal controls (n = 103) were recruited from the Mayo Alzheimer's disease patient registry and Alzheimer's Disease Research Center. Neuropsychological measures shown to have utility in previous studies were included in the analysis. The final multivariate logistic regression model distinguishing DLB from normal controls included Auditory Verbal Learning Test (AVLT) percent retention, Block Design, Trail Making Test-Part A, and Benton Visual Form Discrimination. This model has a sensitivity of 88.6% and specificity of 96.1%. The final multivariate logistic model distinguishing DLB from AD included Trail Making Part A, Boston Naming Test (BNT), AVLT percent retention, and copy of the Rey-Osterrieth Complex Figure. This model had a sensitivity of 83.3% and a specificity of 91.4%. AVLT and BNT had negative coefficients, indicating that lower scores decreased the likelihood of DLB relative to AD. These finding extend prior research suggesting a cognitive profile that can aid in the clinical diagnosis of DLB. Early attention and visual perceptual disturbance suggests DLB, while early impairment in memory and naming suggests AD.

Aged↗