Increasing dopamine levels in the brain improves feedback-based procedural learning in healthy participants: An artificial-grammar-learning experiment

The neuroanatomy of developmental language disorder: a systematic review and meta-analysis

Developmental language disorder (DLD) is a common neurodevelopmental disorder with adverse impacts that continue into adulthood. However, its neural bases remain unclear. Here we address this gap by systematically identifying and quantitatively synthesizing neuroanatomical studies of DLD using co-localization likelihood estimation, a recently developed neuroanatomical meta-analytic technique. Analyses of structural brain data (22 peer-reviewed papers, 577 participants) revealed highly consistent anomalies only in the basal ganglia (100% of participant groups in which this structure was examined, weighted by group sample sizes; 99.8% permutation-based likelihood the anomaly clustering was not due to chance). These anomalies were localized specifically to the anterior neostriatum (again 100% weighted proportion and 99.8% likelihood). As expected given the task dependence of activation, functional neuroimaging data (11 peer-reviewed papers, 414 participants) yielded less consistency, though anomalies again occurred primarily in the basal ganglia (79.0% and 95.1%). Multiple sensitivity analyses indicated that the patterns were robust. The meta-analyses elucidate the neuroanatomical signature of DLD, and implicate the basal ganglia in particular. The findings support the procedural circuit deficit hypothesis of DLD, have basic research and translational implications for the disorder, and advance our understanding of the neuroanatomy of language.

Atypical Reinforcement Learning in Developmental Dyslexia

OBJECTIVES

According to the Procedural Deficit Hypothesis, abnormalities in corticostriatal pathways could account for the language-related deficits observed in developmental dyslexia. The same neural network has also been implicated in the ability to learn contingencies based on trial and error (i.e., reinforcement learning [RL]). On this basis, the present study tested the assumption that dyslexic individuals would be impaired in RL compared with neurotypicals in two different tasks.

METHODS

In a probabilistic selection task, participants were required to learn reinforcement contingencies based on probabilistic feedback. In an implicit transitive inference task, participants were also required to base their decisions on reinforcement histories, but feedback was deterministic and stimulus pairs were partially overlapping, such that participants were required to learn hierarchical relations.

RESULTS

Across tasks, results revealed that although the ability to learn from positive/negative feedback did not differ between the two groups, the learning of reinforcement contingencies was poorer in the dyslexia group compared with the neurotypicals group. Furthermore, in novel test pairs where previously learned information was presented in new combinations, dyslexic individuals performed similarly to neurotypicals.

CONCLUSIONS

Taken together, these results suggest that learning of reinforcement contingencies occurs less robustly in individuals with developmental dyslexia. Inferences for the neuro-cognitive mechanisms of developmental dyslexia are discussed.

Dopamine modulations of reward-driven music memory consolidation

Music listening provides one of the most significant abstract rewards for humans because hearing music activates the dopaminergic mesolimbic system. Given the strong link between reward, dopamine, and memory, we aimed here to investigate the hypothesis that dopamine-dependent musical reward can drive memory improvements. Twenty-nine healthy participants of both sexes provided reward ratings of unfamiliar musical excerpts that had to be remembered following a consolidation period under three separate conditions: after the ingestion of a dopaminergic antagonist, a dopaminergic precursor, or a placebo. Linear mixed modeling of the intervention data showed that the effect of reward on memory-i.e., the greater the reward experienced while listening to the musical excerpts, the better the memory recollection performance-was modulated by both dopaminergic signaling and individual differences in reward processing. Greater pleasure was consistently associated with better memory outcomes in participants with high sensitivity to musical reward, but this effect was lost when dopaminergic signaling was disrupted in participants with average or low musical hedonia. Our work highlights the flexibility of the human dopaminergic system, which can enhance memory formation not only through explicit and/or primary reinforcers but also via abstract and aesthetic rewards such as music.

Accelerated habitual learning resulting from L-dopa exposure in rats is prevented by N-acetylcysteine

Instrumental actions are initially goal-directed and driven by their associated outcome. However, with repeated experience habitual actions develop which are automated and efficient, as they are instead driven by antecedent stimuli. Dopamine is thought to facilitate the transition from goal-directed to habitual actions. This idea has been largely derived from evidence that psychostimulants accelerate the development of habitual actions. In the current study, we examined the impact of L-dopa (levodopa or L-dihydroxyphenylalanine), which also potentiates dopamine activity, on habitual learning. L-dopa was systemically administered prior to training rats to press a lever for a food outcome. When tested, L-dopa exposed animals were insensitive to changes in the value of the food outcome, and hence demonstrated accelerated habitual behavioral control compared to control animals that remained goal directed. We also showed that when N-acetylcysteine (NAC), an antioxidant and regulator of glutamate activity, was co-administered with L-dopa, it prevented the transition to habitual behavior; an effect demonstrated previously for cocaine. Therefore, this study establishes similarities between L-dopa and psychostimulants in both the development and prevention of habitual actions, and supports the notion that excess dopamine potentiates habitual learning. This finding extends the limited existing knowledge of the impact of L-dopa on learning and behavior, and has implications for neurological disorders where L-dopa is the primary treatment.

The Neurocognition of Developmental Disorders of Language

Developmental disorders of language include developmental language disorder, dyslexia, and motor-speech disorders such as articulation disorder and stuttering. These disorders have generally been explained by accounts that focus on their behavioral rather than neural characteristics; their processing rather than learning impairments; and each disorder separately rather than together, despite their commonalities and comorbidities. Here we update and review a unifying neurocognitive account—the Procedural circuit Deficit Hypothesis (PDH). The PDH posits that abnormalities of brain structures underlying procedural memory (learning and memory that rely on the basal ganglia and associated circuitry) can explain numerous brain and behavioral characteristics across learning and processing, in multiple disorders, including both commonalities and differences. We describe procedural memory, examine its role in various aspects of language, and then present the PDH and relevant evidence across language-related disorders. The PDH has substantial explanatory power, and both basic research and translational implications.

Dopamine modulates the reward experiences elicited by music

Understanding how the brain translates a structured sequence of sounds, such as music, into a pleasant and rewarding experience is a fascinating question which may be crucial to better understand the processing of abstract rewards in humans. Previous neuroimaging findings point to a challenging role of the dopaminergic system in music-evoked pleasure. However, there is a lack of direct evidence showing that dopamine function is causally related to the pleasure we experience from music. We addressed this problem through a double blind within-subject pharmacological design in which we directly manipulated dopaminergic synaptic availability while healthy participants (n = 27) were engaged in music listening. We orally administrated to each participant a dopamine precursor (levodopa), a dopamine antagonist (risperidone), and a placebo (lactose) in three different sessions. We demonstrate that levodopa and risperidone led to opposite effects in measures of musical pleasure and motivation: while the dopamine precursor levodopa, compared with placebo, increased the hedonic experience and music-related motivational responses, risperidone led to a reduction of both. This study shows a causal role of dopamine in musical pleasure and indicates that dopaminergic transmission might play different or additive roles than the ones postulated in affective processing so far, particularly in abstract cognitive activities.

Intrinsically regulated learning is modulated by synaptic dopamine signaling

We recently provided evidence that an intrinsic reward-related signal-triggered by successful learning in absence of any external feedback-modulated the entrance of new information into long-term memory via the activation of the dopaminergic midbrain, hippocampus, and ventral striatum (the SN/VTA-Hippocampal loop; Ripollés et al., 2016). Here, we used a double-blind, within-subject randomized pharmacological intervention to test whether this learning process is indeed dopamine-dependent. A group of healthy individuals completed three behavioral sessions of a language-learning task after the intake of different pharmacological treatments: a dopaminergic precursor, a dopamine receptor antagonist or a placebo. Results show that the pharmacological intervention modulated behavioral measures of both learning and pleasantness, inducing memory benefits after 24 hr only for those participants with a high sensitivity to reward. These results provide causal evidence for a dopamine-dependent mechanism instrumental in intrinsically regulated learning and further suggest that subject-specific reward sensitivity drastically alters learning success.

Pharmacological Dopamine Manipulation Does Not Alter Reward-Based Improvements in Memory Retention during a Visuomotor Adaptation Task

Motor adaptation tasks investigate our ability to adjust motor behaviors to an ever-changing and unpredictable world. Previous work has shown that punishment-based feedback delivered during a visuomotor adaptation task enhances error-reduction, whereas reward increases memory retention. While the neural underpinnings of the influence of punishment on the adaptation phase remain unclear, reward has been hypothesized to increase retention through dopaminergic mechanisms. We directly tested this hypothesis through pharmacological manipulation of the dopaminergic system. A total of 96 young healthy human participants were tested in a placebo-controlled double-blind between-subjects design in which they adapted to a 40° visuomotor rotation under reward or punishment conditions. We confirmed previous evidence that reward enhances retention, but the dopamine (DA) precursor levodopa (LD) or the DA antagonist haloperidol failed to influence performance. We reason that such a negative result could be due to experimental limitations or it may suggest that the effect of reward on motor memory retention is not driven by dopaminergic processes. This provides further insight regarding the role of motivational feedback in optimizing motor learning, and the basis for further decomposing the effect of reward on the subprocesses known to underlie motor adaptation paradigms.

Separating the effect of reward from corrective feedback during learning in patients with Parkinson's disease

Parkinson's disease (PD) is associated with procedural learning deficits. Nonetheless, studies have demonstrated that reward-related learning is comparable between patients with PD and controls (Bódi et al., Brain, 132(9), 2385-2395, 2009; Frank, Seeberger, & O'Reilly, Science, 306(5703), 1940-1943, 2004; Palminteri et al., Proceedings of the National Academy of Sciences of the United States of America, 106(45), 19179-19184, 2009). However, because these studies do not separate the effect of reward from the effect of practice, it is difficult to determine whether the effect of reward on learning is distinct from the effect of corrective feedback on learning. Thus, it is unknown whether these group differences in learning are due to reward processing or learning in general. Here, we compared the performance of medicated PD patients to demographically matched healthy controls (HCs) on a task where the effect of reward can be examined separately from the effect of practice. We found that patients with PD showed significantly less reward-related learning improvements compared to HCs. In addition, stronger learning of rewarded associations over unrewarded associations was significantly correlated with smaller skin-conductance responses for HCs but not PD patients. These results demonstrate that when separating the effect of reward from the effect of corrective feedback, PD patients do not benefit from reward.

White noise enhances new-word learning in healthy adults

Research suggests that listening to white noise may improve some aspects of cognitive performance in individuals with lower attention. This study investigated the impact of white noise on new word learning in healthy young adults, and whether this effect was mediated by executive attention skills. Eighty participants completed a single training session to learn the names of twenty novel objects. The session comprised 5 learning phases, each followed by a recall test. A final recognition test was also administered. Half the participants listened to white noise during the learning phases, and half completed the learning in silence. The noise group demonstrated superior recall accuracy over time, which was not impacted by participant attentional capacity. Recognition accuracy was near ceiling for both groups. These findings suggest that white noise has the capacity to enhance lexical acquisition.

Category learning in Alzheimer's disease and normal cognitive aging depends on initial experience of feature variability

Semantic category learning is dependent upon several factors, including the nature of the learning task, as well as individual differences in the quality and heterogeneity of exemplars that an individual encounters during learning. We trained healthy older adults (n=39) and individuals with a diagnosis of Alzheimer's disease or Mild Cognitive Impairment (n=44) to recognize instances of a fictitious animal, a "crutter". Each stimulus item contained 10 visual features (e.g., color, tail shape) which took one of two values for each feature (e.g., yellow/red, curly/straight tails). Participants were presented with a series of items (learning phase) and were either told the items belonged to a semantic category (explicit condition) or were told to think about the appearance of the items (implicit condition). Half of participants saw learning items with higher similarity to an unseen prototype (high typicality learning set), and thus lower between-item variability in their constituent features; the other half learned from items with lower typicality (low typicality learning set) and higher between-item feature variability. After the learning phase, participants were presented with test items one at a time that varied in the number of typical features from 0 (antitype) to 10 (prototype). We examined between-subjects factors of learning set (lower or higher typicality), instruction type (explicit or implicit), and group (patients vs. elderly control). Learning in controls was aided by higher learning set typicality: while controls in both learning set groups demonstrated significant learning, those exposed to a high-typicality learning set appeared to develop a prototype that helped guide their category membership judgments. Overall, patients demonstrated more difficulty with category learning than elderly controls. Patients exposed to the higher-typicality learning set were sensitive to the typical features of the category and discriminated between the most and least typical test items, although less reliably than controls. In contrast, patients exposed to the low-typicality learning set showed no evidence of learning. Analysis of structural imaging data indicated a positive association between left hippocampal grey matter density in elderly controls but a negative association in the patient group, suggesting differential reliance on hippocampal-mediated learning. Contrary to hypotheses, learning did not differ between explicit and implicit conditions for either group. Results demonstrate that category learning is improved when learning materials are highly similar to the prototype.

Levodopa impairs probabilistic reversal learning in healthy young adults

RATIONALE

Dopaminergic therapy improves some cognitive functions and worsens others in patients with Parkinson's disease (PD). These paradoxical effects are explained by the dopamine overdose hypothesis, which proposes that effects of dopaminergic therapy on a cognitive function is determined by the baseline dopamine levels in brain regions mediating that function.

OBJECTIVES

We directly tested this prevalent hypothesis, evaluating the effects of levodopa on stimulus-reward learning in healthy young adults, who presumably have optimal baseline dopamine levels and dopamine regulation.

METHODS

Twenty-six healthy, young adults completed a probabilistic reversal learning task in a randomized, double-blind, placebo-controlled, crossover design. Participants completed one session on levodopa 100 mg/carbidopa 25 mg and another session on placebo.

RESULTS

We found that levodopa impaired reversal learning relative to placebo. Further analyses revealed that levodopa impaired learning from both punishment and reward.

CONCLUSIONS

Exogenous dopamine impairs stimulus-reward learning, independent of PD pathology and prior to sensitization through repeated exposure, in healthy adults with normal cognition and baseline dopamine function. Our findings support the dopamine overdose hypothesis and caution clinicians about detrimental effects of levodopa in all clinical populations (e.g., early PD, restless leg syndrome) regardless of baseline cognitive and dopaminergic system function.

Examining Procedural Learning and Corticostriatal Pathways for Individual Differences in Language: Testing Endophenotypes of DRD2/ANKK1

The aim of the study was to explore whether genetic variation in the dopaminergic system is associated with procedural learning and the corticostriatal pathways in individuals with developmental language impairment (DLI). We viewed these two systems as endophenotypes and hypothesized that they would be more sensitive indicators of genetic effects than the language phenotype itself. Thus, we genotyped two SNPs in the DRD2/ANKK1 gene complex, and tested for their associations to the phenotype of DLI and the two endophenotypes. Results showed that individuals with DLI revealed poor procedural learning abilities and abnormal structures of the basal ganglia. Genetic variation in DRD2/ANKK1 was associated with procedural learning abilities and with microstructural differences of the caudate nucleus. The association of the language phenotype with these DRD2/ANKK1 polymorphisms was not significant, but the phenotype was significantly associated with the two endophenotypes. We suggest that procedural learning and the corticostriatal pathways could be used as effective endophenotypes to aid molecular genetic studies searching for genes predisposing to DLI.

Does complexity matter? Meta-analysis of learner performance in artificial grammar tasks

Complexity has been shown to affect performance on artificial grammar learning (AGL) tasks (categorization of test items as grammatical/ungrammatical according to the implicitly trained grammar rules). However, previously published AGL experiments did not utilize consistent measures to investigate the comprehensive effect of grammar complexity on task performance. The present study focused on computerizing Bollt and Jones's (2000) technique of calculating topological entropy (TE), a quantitative measure of AGL charts' complexity, with the aim of examining associations between grammar systems' TE and learners' AGL task performance. We surveyed the literature and identified 56 previous AGL experiments based on 10 different grammars that met the sampling criteria. Using the automated matrix-lift-action method, we assigned a TE value for each of these 10 previously used AGL systems and examined its correlation with learners' task performance. The meta-regression analysis showed a significant correlation, demonstrating that the complexity effect transcended the different settings and conditions in which the categorization task was performed. The results reinforced the importance of using this new automated tool to uniformly measure grammar systems' complexity when experimenting with and evaluating the findings of AGL studies.

Assaying the effect of levodopa on the evaluation of risk in healthy humans

In humans, dopamine is implicated in reward and risk-based decision-making. However, the specific effects of dopamine augmentation on risk evaluation are unclear. Here we sought to measure the effect of 100 mg oral levodopa, which enhances synaptic release of dopamine, on choice behaviour in healthy humans. We use a paradigm without feedback or learning, which solely isolates effects on risk evaluation. We present two studies (n = 20; n = 20) employing a randomised, placebo-controlled, within-subjects design. We manipulated different dimensions of risk in a controlled economic paradigm. We test effects on risk-reward tradeoffs, assaying both aversion to variance (the spread of possible outcomes) and preference for relative losses and gains (asymmetry of outcomes - skewness), dissociating this from potential non-specific effects on choice randomness using behavioural modelling. There were no systematic effects of levodopa on risk attitudes, either for variance or skewness. However, there was a drift towards more risk-averse behaviour over time, indicating that this paradigm was sensitive to detect changes in risk-preferences. These findings suggest that levodopa administration does not change the evaluation of risk. One possible reason is that dopaminergic influences on decision making may be due to changing the response to reward feedback.

Catechol-O-Methyltransferase Polymorphism Influences Outcome After Ischemic Stroke

Background. To explore whether a polymorphism in dopamine metabolism influences the effectiveness of neurological rehabilitation and the outcome after ischemic stroke. Methods. The Barthel Index (BI) and the Rivermead Motor Assessment (RMA) were assessed in 78 moderately affected stroke patients (1) after they had entered a neurological inpatient rehabilitation, (2) after 4 weeks of rehabilitation therapy, and (3) 6 months later. Polymorphisms of the gene encoding catechol- O-methyltransferase (COMT) were determined. BI and RMA results were analyzed with respect to the genetic profiles of COMT. Results. Carriers of COMT Val/Val alleles showed better results in BI and RMA than COMT Met/Met carriers at all 3 time points. Val/Met carriers exhibited results in between the homozygotes, suggesting a gene–dose relationship. Altogether, BI and RMA results were highly correlated. Conclusion. Stroke patients with COMT Val/Val alleles had higher motor functions and abilities of activities of daily living even at the beginning of the rehabilitation period. All patient groups improved during the rehabilitation period to a similar degree, suggesting that physical therapy is comparably effective in all polymorphism subtypes.

Dissociating the cognitive effects of levodopa versus dopamine agonists in a neurocomputational model of learning in Parkinson's disease

BACKGROUND/AIMS

Levodopa and dopamine agonists have different effects on the motor, cognitive, and psychiatric aspects of Parkinson's disease (PD).

METHODS

Using a computational model of basal ganglia (BG) and prefrontal cortex (PFC) dopamine, we provide a theoretical synthesis of the dissociable effects of these dopaminergic medications on brain and cognition. Our model incorporates the findings that levodopa is converted by dopamine cells into dopamine, and thus activates prefrontal and striatal D(1) and D(2) dopamine receptors, whereas antiparkinsonian dopamine agonists directly stimulate D(2) receptors in the BG and PFC (although some have weak affinity to D(1) receptors).

RESULTS

In agreement with prior neuropsychological studies, our model explains how levodopa enhances, but dopamine agonists impair or have no effect on, stimulus-response learning and working memory.

CONCLUSION

Our model explains how levodopa and dopamine agonists have differential effects on motor and cognitive processes in PD.

Parkinson's disease progression: implicit acquisition, cognitive and motor impairments, and medication effects

Parkinson's disease (PD) symptoms have been collectively ascribed to malfunctioning of dopamine-related nigro-striatal and cortico-striatal loops. However, some doubts about this proposition are raised by controversies about the temporal progression of the impairments, and whether they are concomitant or not. The present study consists of a systematic revision of literature data on both functional PD impairments and dopaminergic medication effects in order to draw a coherent picture about the disease progression. It was done in terms of an explanatory model for the disruption of implicit knowledge acquisition, motor and cognitive impairments, and the effects of dopaminergic medication on these functions. Cognitive impairments arise at early stages of PD and stabilizes while disruption of implicit knowledge acquisition and motor impairments, are still in progression; additionally, dopaminergic medication reduces motor impairments and increases disruption of implicit knowledge acquisition. Since this model revealed consistency and plausibility when confronted with data of others studies not included in model's formulation, it may turn out to be a useful tool for understanding the multifaceted characteristics of PD.

Linking neurogenetics and individual differences in language learning: the dopamine hypothesis

Fundamental advances in neuroscience have come from investigations into neuroplasticity and learning. These investigations often focus on identifying universal principles across different individuals of the same species. Increasingly, individual differences in learning success have also been observed, such that any seemingly universal principle might only be applicable to a certain extent within a particular learner. One potential source of this variation is individuals' genetic differences. Adult language learning provides a unique opportunity for understanding individual differences and genetic bases of neuroplasticity because of the large individual differences in learning success that have already been documented, and because of the body of empirical work connecting language learning and neurocognition. In this article, we review the literature on the genetic bases of neurocognition, especially studies examining polymorphisms of dopamine (DA)-related genes and procedural learning. This review leads us to hypothesize that there may be an association between DA-related genetic variation and language learning differences. If this hypothesis is supported by future empirical findings we suggest that it may point to neurogenetic markers that allow for language learning to be personalized.

Implicit memory in music and language

Research on music and language in recent decades has focused on their overlapping neurophysiological, perceptual, and cognitive underpinnings, ranging from the mechanism for encoding basic auditory cues to the mechanism for detecting violations in phrase structure. These overlaps have most often been identified in musicians with musical knowledge that was acquired explicitly, through formal training. In this paper, we review independent bodies of work in music and language that suggest an important role for implicitly acquired knowledge, implicit memory, and their associated neural structures in the acquisition of linguistic or musical grammar. These findings motivate potential new work that examines music and language comparatively in the context of the implicit memory system.

FOXP2 and the role of cortico-basal ganglia circuits in speech and language evolution

PURPOSE OF THE REVIEW

A reduced dosage of the transcription factor FOXP2 leads to speech and language impairments probably owing to deficits in cortical and subcortical neural circuits. Based on evolutionary sequence analysis it has been proposed that the two amino acid substitutions that occurred on the human lineage have been positively selected. Here I review recent studies investigating the functional consequences of these two substitutions and discuss how these first endeavors to study human brain evolution can be interpreted in the context of speech and language evolution.

RECENT FINDINGS

Mice carrying the two substitutions in their endogenous Foxp2 gene show specific alterations in dopamine levels, striatal synaptic plasticity and neuronal morphology. Mice carrying only one functional Foxp2, show additional and partly opposite effects suggesting that FOXP2 has contributed to tuning cortico-basal ganglia circuits during human evolution. Evidence from human and songbird studies suggest that this could have been relevant during language acquisition or vocal learning, respectively.

SUMMARY

FOXP2 could have contributed to the evolution of human speech and language by adapting cortico-basal ganglia circuits. More generally the recent studies allow careful optimism that aspects of human brain evolution can be investigated in model systems such as the mouse.

White matter integrity in right hemisphere predicts pitch-related grammar learning

White matter plays an important role in various domains of cognitive function. While disruptions in white matter are known to affect many domains of behavior and cognition, the ability to acquire grammatical regularities has been mostly linked to the left hemisphere, perhaps due to its dependence on linguistic stimuli. The role of white matter in the right hemisphere in grammar acquisition is yet unknown. Here we show for the first time that in the domain of pitch, intact white matter connectivity in right-hemisphere analogs of language areas is important for grammar learning. A pitch-based artificial grammar learning task was conducted on subjects who also underwent diffusion tensor imaging. Probabilistic tractography using seed regions of interest in the right inferior frontal gyrus and right middle temporal gyrus showed positive correlations between tract volume and learning performance. Furthermore, significant correlations were observed between learning performance and FA in white matter underlying the supramarginal gyrus, corresponding to the right temporal-parietal junction of the arcuate fasciculus. The control task of recognition did not correlate with tract volume or FA, and control tracts in the left hemisphere did not correlate with behavioral performance. Results show that the right ventral arcuate fasciculus is important in pitch-based artificial grammar learning, and that brain structures subserving learning may be tied to the hemisphere that processes the stimulus more generally.

Amphetamine-related improvement in executive function in patients with chronic schizophrenia is modulated by practice effects

BACKGROUND

Amelioration of cognitive impairment is an important treatment goal for a broad range of neuropsychiatric disorders, including schizophrenia. One critical issue in clinical trial design is the extent to which repeated exposure to cognitive tests (i.e., practice effects) may lead to improvement in performance on the cognitive tests in the absence of any true treatment effect. The current study examined the extent to which practice effects on a measure of executive function may influence the sensitivity of that task to detecting the cognitive-enhancing effects of a single acute dose of d-amphetamine in individuals with chronic schizophrenia.

METHODS

Twenty-four men with chronic schizophrenia were randomized to receive a constant or random/matched alternate form version of a hidden maze learning measure of executive function (Groton Maze Learning Test; GMLT) on four separate occasions in one month. They also completed a measure of psychomotor speed. Using a double-blind, placebo-controlled, parallel groups design, cognitive function following administration of a single dose of d-amphetamine (20mg p.o) or placebo was then assessed.

RESULTS

The group who received the constant-pathway version of the GMLT showed a large practice effect (d = 2.05) over four practice sessions. Consequently, they did not evidence any improvement on the GMLT following d-amphetamine administration. In contrast, the group who received the random/matched alternate version of the GMLT showed a statistically significant and large effect size (d = .84) improvement on this measure. Both groups showed d-amphetamine-related improvement on a measure of psychomotor speed.

CONCLUSIONS

Results of this study suggest that practice effects associated with repeated exposure to a cognitive test could obscure the sensitivity of the test to detecting true treatment-related cognitive improvement.