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Zhou A, Britt C, Woods RL, Orchard SG, Murray AM, Shah RC, Rajan R, McNeil JJ, Chong TTJ, Storey E, Ryan J. Normative Data for Single-Letter Controlled Oral Word Association Test in Older White Australians and Americans, African-Americans, and Hispanic/Latinos. J Alzheimers Dis Rep 2023; 7:1033-1043. [PMID: 37849629 PMCID: PMC10578329 DOI: 10.3233/adr-230089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 08/24/2023] [Indexed: 10/19/2023] Open
Abstract
Background The Controlled Oral Word Association Test (COWAT) is a commonly used measure of verbal fluency. While a normal decline in verbal fluency occurs in late adulthood, significant impairments may indicate brain injury or diseases such as Alzheimer's disease. Normative data is essential to identify when test performance falls below expected levels based on age, gender, and education level. Objective This study aimed to establish normative performance data on single-letter COWAT for older community-dwelling adults. Methods Over 19,000 healthy men and women, without a diagnosis of dementia or a Modified Mini-Mental State Examination score below 77/100, were recruited for the ASPREE trial. Neuropsychological assessments, including the COWAT with letter F, were administered at study entry. Results Median participant age was 75 years (range 65-98), with 56.5% being women. The majority of participants had 9-11 years of education in Australia and over 12 years in the U.S. The COWAT performance varied across ethno-racial groups and normative data were thus presented separately for 16,335 white Australians, 1,084 white Americans, 896 African-Americans, and 316 Hispanic/Latinos. Women generally outperformed men in the COWAT, except for Hispanic/Latinos. Higher education levels consistently correlated with better COWAT performance across all groups, while the negative association with age was weaker. Conclusions This study provides comprehensive normative data for the COWAT stratified by ethno-racial groups in Australia and the U.S., considering age, gender, and education level. These norms can serve as reference standards for screening cognitive impairments in older adults in both clinical and research settings.
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Affiliation(s)
- Aoshuang Zhou
- Division of Epidemiology, Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Carlene Britt
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Robyn L. Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Suzanne G. Orchard
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Anne M. Murray
- Division of Geriatric and Palliative Medicine, Department of Medicine, Hennepin Healthcare, Minneapolis, MN, USA
- Berman Center for Outcomes and Clinical Research, Minneapolis, MN, USA
| | - Raj C. Shah
- Department of Family and Preventive Medicine and the Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Ramesh Rajan
- Biomedicine Discovery Institute, Monash University, Clayton, VIC, Australia
| | - John J. McNeil
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Trevor T.-J. Chong
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
- Department of Neurology, Alfred Health, Melbourne, VIC, Australia
- Department of Clinical Neurosciences, St Vincent’s Hospital, Melbourne, VIC, Australia
| | - Elsdon Storey
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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2
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Gabrić P, Vandek M. Semantic fluency reveals reduced functional connectivity between subcategorical co-hyponyms in recent-onset inpatients with first-episode psychosis. CLINICAL LINGUISTICS & PHONETICS 2022; 36:870-886. [PMID: 34355620 DOI: 10.1080/02699206.2021.1961019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/31/2021] [Accepted: 07/22/2021] [Indexed: 06/13/2023]
Abstract
Data on clustering and switching during semantic fluency (SF) in patients with first-episode psychosis (PwFEP) are scant. We aimed to investigate (1) clustering and switching on SF in PwFEP using more detailed clustering analyses and (2) the possibility of disproportionate clustering deficits across different SF tasks in PwFEP and healthy subjects (HS), with the latter being suggested by the current literature on patients with schizophrenia. We recruited 22 Croatian-speaking PwFEP with schizophrenia features or symptoms and 22 HS matched in age, sex distribution, and handedness. All patients were medicated and had a mean illness duration of 1 month. The categories animals, trees, vegetables, fruits, and musical instruments were administered for SF. PwFEP produced significantly fewer correct words in the aggregate score, as well as across all categories. The switching rate was significantly higher in PwFEP, but no post hoc comparisons were significant. PwFEP also produced significantly smaller clusters, yet the post hoc comparisons for the tree and fruit task were not significant. A higher switching rate and smaller clusters indicate less efficient functional connectivity within subcategories of the given categories, but not necessarily between the subcategories. Although both less likely to produce a cluster once a switch has been uttered and less likely to produce clusters larger than two words compared to HS, the latter deficit was more pronounced. Our results further suggest that PwFEP might show normal clustering performance on some SF tasks. We discuss the results in the context of the hypothesis of semantic hyperactivation in psychoses.
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Affiliation(s)
- Petar Gabrić
- Department of Linguistics, University of Zagreb, Zagreb, Croatia
- Institute for German Linguistics, Philipps University of Marburg, Marburg, Germany
| | - Mija Vandek
- Department of Linguistics, University of Zagreb, Zagreb, Croatia
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3
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Tung H, Lin WH, Hsieh PF, Lan TH, Chiang MC, Lin YY, Peng SJ. Left Frontotemporal Region Plays a Key Role in Letter Fluency Task-Evoked Activation and Functional Connectivity in Normal Subjects: A Functional Near-Infrared Spectroscopy Study. Front Psychiatry 2022; 13:810685. [PMID: 35722586 PMCID: PMC9205401 DOI: 10.3389/fpsyt.2022.810685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 02/24/2022] [Indexed: 11/13/2022] Open
Abstract
Letter fluency task (LFT) is a tool that measures memory, executive function, and language function but lacks a definite cutoff value to define abnormalities. We used the optical signals of functional near-infrared spectroscopy (fNIRS) to study the differences in power and connectivity between the high-functioning and low-functioning participants while performing three successive LFTs, as well as the relationships between the brain network/power and LFT performance. We found that the most differentiating factor between these two groups was network topology rather than activation power. The high-functional group (7 men and 10 women) displayed higher left intra-hemispheric global efficiency, nodal strength, and shorter characteristic path length in the first section. They then demonstrated a higher power over the left Broca's area than the right corresponding area in the latter two sections. The low-LFT group (9 men and 11 women) displayed less left-lateralized connectivity and activation power. LFT performance was only related to the network topology rather than the power values, which was only presented in the low-functioning group in the second section. The direct correlation between power and connectivity primarily existed in the inter-hemispheric network, with the timing relationship also seeming to be present. In conclusion, the high-functioning group presented more prominent left-lateralized intra-hemispheric network connectivity and power activation, particularly in the Broca's area. The low-functioning group seemed to prefer using other networks, like the inter-hemispheric, rather than having a single focus on left intra-hemispheric connectivity. The network topology seemed to better reflect the LFT performance than did the power values.
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Affiliation(s)
- Hsin Tung
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Center of Faculty Development, Taichung Veterans General Hospital, Taichung, Taiwan.,Division of Epilepsy, Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan.,College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Wei-Hao Lin
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan.,Department of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Peiyuan F Hsieh
- Division of Epilepsy, Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan.,College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Tsuo-Hung Lan
- Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan.,Department of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli, Taiwan
| | - Ming-Chang Chiang
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yung-Yang Lin
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Syu-Jyun Peng
- Professional Master Program in Artificial Intelligence in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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Pagliarin KC, Fernandes EG, Muller MD, Portalete CR, Fonseca RP, Altmann RF. Clustering and switching in verbal fluency: a comparison between control and individuals with brain damage. Codas 2021; 34:e20200365. [PMID: 34816946 PMCID: PMC9769432 DOI: 10.1590/2317-1782/20212020365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 07/02/2021] [Indexed: 02/03/2023] Open
Abstract
PURPOSE The aim of this study is to analyze and compare the performance and strategies used by control subjects and patients with unilateral brain damage on phonemic and semantic Verbal Fluency tasks. METHODS The sample consisted of 104 participants divided into four groups (26 with left hemisphere damage and aphasia- LHDa, 28 with left hemisphere damage and no aphasia- LHDna, 25 with right hemisphere damage- RHD and 25 neurologically healthy control subjects). All participants were administered the phonemic ("M" letter-based) and semantic (animals) verbal fluency tasks from the Montreal-Toulouse Language Assessment Battery (MTL-BR). RESULTS Patients in the LHDa group showed the worst performance (fewer words produced, fewer clusters and switches) in both types of fluency task. RHD group showed fewer switching productions when compared with controls and LHDna had fewer words productions than controls in the first 30 seconds block. CONCLUSION Our findings suggest that the LHDa group obtained lower scores in most measures of SVF and PVF when compared to the other groups.
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Affiliation(s)
- Karina Carlesso Pagliarin
- Programa de Pós-Graduação em Distúrbios da Comunicação Humana, Universidade Federal de Santa Maria – UFSM, Santa Maria (RS), Brasil.
| | - Eduarda Giovelli Fernandes
- Programa de Pós-Graduação em Distúrbios da Comunicação Humana, Universidade Federal de Santa Maria – UFSM, Santa Maria (RS), Brasil.
| | - Maryndia Diehl Muller
- Programa de Pós-Graduação em Distúrbios da Comunicação Humana, Universidade Federal de Santa Maria – UFSM, Santa Maria (RS), Brasil.
| | - Caroline Rodrigues Portalete
- Programa de Pós-Graduação em Distúrbios da Comunicação Humana, Universidade Federal de Santa Maria – UFSM, Santa Maria (RS), Brasil.
| | - Rochele Paz Fonseca
- Programa de Pós-Graduação em Psicologia, Pontifícia Universidade Católica do Rio Grande do Sul – PUCRS, Porto Alegre (RS), Brasil.
| | - Raira Fernanda Altmann
- Programa de Pós-Graduação em Distúrbios da Comunicação Humana, Universidade Federal de Santa Maria – UFSM, Santa Maria (RS), Brasil.
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Siddi S, Petretto DR, Burrai C, Scanu R, Baita A, Trincas P, Trogu E, Campus L, Contu A, Preti A. The role of set-shifting in auditory verbal hallucinations. Compr Psychiatry 2017; 74:162-172. [PMID: 28167329 DOI: 10.1016/j.comppsych.2017.01.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 12/05/2016] [Accepted: 01/16/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Auditory verbal hallucinations (AVHs) are a cardinal characteristic of psychosis. Recent research on the neuropsychological mechanism of AVHs has focused on source monitoring failure, but a few studies have suggested the involvement of attention, working memory, processing speed, verbal learning, memory, and executive functions. In this study we examined the neuropsychological profile of patients with AVHs, assuming that the mechanism underlying this symptom could be a dysfunction of specific cognitive domains. METHODS A large neuropsychological battery including set-shifting, working memory, processing speed, attention, fluency, verbal learning and memory, and executive functions was administered to 90 patients with psychotic disorders and 44 healthy controls. The group of patients was divided into two groups: 46 patients with AVHs in the current episode and 44 who denied auditory hallucinations or other modalities in the current episode. AVHs were assessed with the Psychotic Symptom Rating Scales (PSYRATS); the Launay-Slade Hallucination Scale was used to measure long-term propensity to auditory verbal hallucination-like experiences (HLEs) in the sample. RESULTS Patients showed poorer performances on all neuropsychological measures compared to the healthy controls' group. In the original dataset without missing data (n=58), patients with AVHs (n=29) presented poorer set shifting and verbal learning, higher levels of visual attention, and marginally significant poorer semantic fluency compared to patients without AVHs (n=29). In the logistic model on the multiple imputed dataset (n=90, 100 imputed datasets), lower capacity of set shifting and semantic fluency distinguished patients with AVHs from those without them. CONCLUSIONS Patients experiencing persistent AVHs might fail to shift their attention away from the voices; poorer semantic fluency could be a secondary deficit of set-shifting failure.
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Affiliation(s)
- Sara Siddi
- Section of Clinical Psychology, Department of Education, Psychology, and Philosophy, University of Cagliari, Italy; Research and Development Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Faculty of Medicine, University of Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
| | - Donatella Rita Petretto
- Section of Clinical Psychology, Department of Education, Psychology, and Philosophy, University of Cagliari, Italy
| | - Caterina Burrai
- Psychiatric Diagnosis and Treatment Service I, Department of Mental Health, ASL Cagliari, Cagliari, Italy
| | - Rosanna Scanu
- Section of Clinical Psychology, Department of Education, Psychology, and Philosophy, University of Cagliari, Italy
| | - Antonella Baita
- Psychiatric Diagnosis and Treatment Service I, Department of Mental Health, ASL Cagliari, Cagliari, Italy
| | - Pierfranco Trincas
- Psychiatric Diagnosis and Treatment Service II, Department of Mental Health, ASL Cagliari, Cagliary, Italy
| | - Emanuela Trogu
- Psychiatric Diagnosis and Treatment Service II, Department of Mental Health, ASL Cagliari, Cagliary, Italy
| | - Liliana Campus
- Psychiatric Diagnosis and Treatment Service I, Department of Mental Health, ASL Cagliari, Cagliari, Italy
| | - Augusto Contu
- Head, Department of Mental Health, ASL Cagliari, Cagliari, Italy
| | - Antonio Preti
- Section of Clinical Psychology, Department of Education, Psychology, and Philosophy, University of Cagliari, Italy; Genneruxi Medical Center, Cagliari, Italy
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Batty RA, Francis A, Thomas N, Hopwood M, Ponsford J, Rossell SL. Predicting co-morbid traumatic brain injury and psychosis from neuropsychological profile. Schizophr Res 2016; 172:143-4. [PMID: 26908278 DOI: 10.1016/j.schres.2016.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 02/08/2016] [Accepted: 02/11/2016] [Indexed: 10/22/2022]
Affiliation(s)
- Rachel A Batty
- Brain and Psychological Sciences Research Centre (BPsyC), Swinburne University of Technology, Melbourne, Victoria, Australia; Monash-Alfred Psychiatry Research Centre (MAPrc), Melbourne, Victoria, Australia; RMIT University, Bundoora, Victoria, Australia.
| | | | - Neil Thomas
- Brain and Psychological Sciences Research Centre (BPsyC), Swinburne University of Technology, Melbourne, Victoria, Australia; Monash-Alfred Psychiatry Research Centre (MAPrc), Melbourne, Victoria, Australia
| | - Malcolm Hopwood
- University of Melbourne Department of Psychiatry, Albert Road Clinic, Melbourne, Victoria, Australia
| | - Jennie Ponsford
- Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Richmond, Victoria, Australia
| | - Susan L Rossell
- Brain and Psychological Sciences Research Centre (BPsyC), Swinburne University of Technology, Melbourne, Victoria, Australia; Monash-Alfred Psychiatry Research Centre (MAPrc), Melbourne, Victoria, Australia
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7
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Batty RA, Francis A, Thomas N, Hopwood M, Ponsford J, Rossell SL. A brief neurocognitive assessment of patients with psychosis following traumatic brain injury (PFTBI): Use of the Repeatable battery for the Assessment of Neuropsychological Status (RBANS). Psychiatry Res 2016; 237:27-36. [PMID: 26921048 DOI: 10.1016/j.psychres.2016.01.062] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Revised: 11/02/2015] [Accepted: 01/27/2016] [Indexed: 11/25/2022]
Abstract
Patients who develop psychosis following a traumatic brain injury (PFTBI) show impaired neurocognition; however, the degree of impairment has not been empirically investigated using a standardised battery. We administered the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) to patients with PFTBI (n=10), and to three groups of controls: traumatic brain injury (TBI) (n=10), schizophrenia (n=23), and nonclinical controls (n=23). The results confirmed that the cognitive neuropsychological profile of dually-diagnosed patients with PFTBI is significantly and substantially impaired. Seventy per cent of patients with PFTBI received a neuropsychological classification between the "extremely low" and "low average" ranges. Group-wise analyses on the RBANS indices indicated that patients with PFTBI had the lowest (Immediate Memory, Attention, Delayed Memory, Total Score), or equal lowest (visuospatial, equivalent with schizophrenia patients) scores, with the exception of the Language Index where no group differences were shown (however, the mean PFTBI score on the Language Index was two standard deviations below the RBANS normative score). These findings provide novel evidence of impaired cognitive neuropsychological processing in patients with PFTBI using a standardised and replicable battery.
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Affiliation(s)
- Rachel A Batty
- Brain and Psychological Sciences Research Centre (BPsyC), Swinburne University of Technology, Melbourne, Victoria, Australia; Monash-Alfred Psychiatry Research Centre (MAPrc), Melbourne, Victoria, Australia; RMIT University, Bundoora, Victoria, Australia.
| | | | - Neil Thomas
- Brain and Psychological Sciences Research Centre (BPsyC), Swinburne University of Technology, Melbourne, Victoria, Australia; Monash-Alfred Psychiatry Research Centre (MAPrc), Melbourne, Victoria, Australia
| | - Malcolm Hopwood
- University of Melbourne, Department of Psychiatry, Albert Road Clinic, Melbourne, Victoria, Australia
| | - Jennie Ponsford
- Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Richmond, Victoria, Australia
| | - Susan L Rossell
- Brain and Psychological Sciences Research Centre (BPsyC), Swinburne University of Technology, Melbourne, Victoria, Australia; Monash-Alfred Psychiatry Research Centre (MAPrc), Melbourne, Victoria, Australia
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