Cortical and cognitive development in 4th, 8th and 12th grade students. The contribution of speed of processing and executive functioning to cognitive development

Developmental Changes in ANS Precision Across Grades 1-9: Different Patterns of Accuracy and Reaction Time

The main aim of this study was to analyze the patterns of changes in Approximate Number Sense (ANS) precision from grade 1 (mean age: 7.84 years) to grade 9 (mean age: 15.82 years) in a sample of Russian schoolchildren. To fulfill this aim, the data from a longitudinal study of two cohorts of children were used. The first cohort was assessed at grades 1-5 (elementary school education plus the first year of secondary education), and the second cohort was assessed at grades 5-9 (secondary school education). ANS precision was assessed by accuracy and reaction time (RT) in a non-symbolic comparison test ("blue-yellow dots" test). The patterns of change were estimated via mixed-effect growth models. The results revealed that in the first cohort, the average accuracy increased from grade 1 to grade 5 following a non-linear pattern and that the rate of growth slowed after grade 3 (7-9 years old). The non-linear pattern of changes in the second cohort indicated that accuracy started to increase from grade 7 to grade 9 (13-15 years old), while there were no changes from grade 5 to grade 7. However, the RT in the non-symbolic comparison test decreased evenly from grade 1 to grade 7 (7-13 years old), and the rate of processing non-symbolic information tended to stabilize from grade 7 to grade 9. Moreover, the changes in the rate of processing non-symbolic information were not explained by the changes in general processing speed. The results also demonstrated that accuracy and RT were positively correlated across all grades. These results indicate that accuracy and the rate of non-symbolic processing reflect two different processes, namely, the maturation and development of a non-symbolic representation system.

Spontaneous age-related changes of attention in unmedicated boys with attention deficit hyperactivity disorder

OBJECTIVE

Neuropsychological, neuroanatomical, and electrophysiological studies have reported a steady increase in the different attention types until the age of 10 years. Moreover, differences between healthy control (HC) boys and those with attention deficit hyperactivity disorder (ADHD) become nonsignificant in late childhood. This cross-sectional study aimed to perform a comparative analysis of attentional processing in boys with ADHD and HC in the 6:00-10:11 years age range. Methods: Age-related changes in attentional processing were compared between Caucasian Turkic boys (72-131 months of age) with ADHD (n = 144) and HC (n = 112). Selective, focused, and inhibitory attention were measured using the Stroop Test (5 scores); sustained attention was measured using the Cancellation Test (3 scores); and attention span was measured using the Visual Aural Digit Span Test-Revised (6 scores). Results: At the age of 6 years, the ADHD group had a significantly lower performance for all attention types. By the age of 10 years, there were no significant between-group differences. However, the component structure of the neuropsychological test scores in the ADHD group differed from that in the HC group and previous studies. Conclusions: Attentional processing in boys with ADHD changes within the age-range of 6:00-10:00 years where it finally becomes similar to that in HC boys. This delayed maturation is consistent with the maturational lag model of ADHD. However, there was a between-group difference in the component structure of attentional processing, which is consistent with the maturational deviance model of ADHD.

P300 development from infancy to adolescence

This article provides an overview of P300 research from infancy through adolescence. First, a brief historical overview is provided highlighting seminal studies that began exploration of the P300 component in developmental groups. Overall, these studies suggest that the P300 can be detected in children and appears to reflect similar cognitive processes to those in adults; however, it is significantly delayed in its latency to peak. Second, two striking findings from developmental research are the lack of a clear P300 component in infancy and differential electrophysiological responses to novel, unexpected stimuli in children, adolescents, and adults. Third, contemporary questions are described, which include P300-like components in infancy, alteration of P300 in atypically developing groups, relations between P300 and behavior, individual differences of P300, and neural substrates of P300 across development. Finally, we conclude with comments regarding the power of a developmental perspective and suggestions for important issues that should be addressed in the next 50 years of P300 research.

MRI substrates of sustained attention system and cognitive impairment in pediatric MS patients

Objective:

To explore the structural and functional integrity of the sustained attention system in patients with pediatric multiple sclerosis (MS) and its effect on cognitive impairment.

Methods:

We enrolled 57 patients with pediatric MS and 14 age- and sex-matched healthy controls (HCs). Patients with >3 abnormal tests at neuropsychological evaluation were classified as cognitively impaired (CI). Sustained attention system activity was studied with fMRI during the Conners Continuous Performance Test (CCPT). Structural integrity of attention network connections was quantified with diffusion tensor (DT) MRI.

Results:

Within-group analysis showed similar patterns of recruitment of the attention network in HCs and patients with pediatric MS. Diffuse network DT MRI structural abnormalities were found in patients with MS. During CCPT, with increasing task demand, patients with pediatric MS showed increased activation of the left thalamus, anterior insula, and anterior cingulate cortex (ACC) and decreased recruitment of the right precuneus compared to HCs. Thirteen patients (23%) were classified as CI. Compared to cognitively preserved patients, CI patients with pediatric MS had decreased recruitment of several areas located mainly in parietal and occipital lobes and cerebellum and increased deactivation of the ACC, combined with more severe structural damage of white matter tracts connecting these regions.

Conclusions:

Our results suggest that the age-expected level of sustained attention system functional competence is achieved in patients with pediatric MS. Inefficient regulation of the functional interaction between different areas of this system, due to abnormal white matter integrity, may result in global cognitive impairment in these patients.

Can the Error-Monitoring System Differentiate ADHD From ADHD With Reading Disability? Reading and Executive Dysfunction as Reflected in Error Monitoring

OBJECTIVES

ADHD and reading disability (RD) are distinct disorders that often appear together. Individuals with both disorders are currently diagnosed based on questionnaires/behavioral performance. The present study aimed to determine whether ADHD alone differs from ADHD with RD in error monitoring, which is part of the executive system, as measured while reading.

METHOD

Event-related potentials were recorded during a lexical decision task performed by children with comorbid ADHD and RD and children with ADHD.

RESULTS

Lower executive function and reading abilities were accompanied by decreased event-related potential components in participants with ADHD and RD, compared with participants with ADHD.

CONCLUSION

Results suggest that the error monitoring activation can be used as a possible biomarker to objectively differentiate ADHD with RD from ADHD alone.

Do Action Potentials Regulate Myelination?

A variety of anatomical features suggest that functional activity in the nervous system can influence the process of myelination, yet direct evidence of this is lacking. Research by Zalc and colleagues shows that myelination of optic nerve is inhibited by a neurotoxin that blocks action potential activity and is stimulated by a toxin that increases impulse activity, suggesting that impulse activity is necessary for initiating myelination during development of the optic nerve. Research by Fields and colleagues, using electrical stimulation of axons, shows that low frequency impulse activity inhibits myelination of dorsal root ganglion neurons, but high frequency impulse activity has no effect. This results from reduced expression of a cell adhesion molecule on the stimulated axons that is critical for inducing myelination. Together these studies support the conclusion that impulse activity can influence the process of myelination, probably through more than one molecular mechanism operating during discrete steps in the myelination process.

Sustained attention and prediction: distinct brain maturation trajectories during adolescence

Adolescence is a key period for frontal cortex maturation necessary for the development of cognitive ability. Sustained attention and prediction are cognitive functions critical for optimizing sensory processing, and essential to efficiently adapt behaviors in an ever-changing world. The aim of the current study was to investigate the brain developmental trajectories of attentive and predictive processing through adolescence. We recorded EEG in 36 participants from the age of 12-24 years (three age groups: 12-14, 14-17, 18-24 years) to target development during early and late adolescence, and early adulthood. We chose a visual target detection task which loaded upon sustained attention, and we manipulated target predictability. Continued maturation of sustained attention after age 12 was evidenced by improved performance (hits, false alarms (FAs) and sensitivity) in a detection task, associated with a frontal shift in the scalp topographies of the Contingent Negative Variation (CNV) and P3 responses, with increasing age. No effect of age was observed on predictive processing, with all ages showing similar benefits in reaction time, increases in P3 amplitude (indexing predictive value encoding and memorization), increases in CNV amplitude (corresponding to prediction implementation) and reduction in target-P3 latency (reflecting successful prediction building and use), with increased predictive content. This suggests that adolescents extracted and used predictive information to generate predictions as well as adults. The present results show that predictive and attentive processing follow distinct brain developmental trajectories: prediction abilities seem mature by the age of 12 and sustained attention continues to improve after 12-years of age and is associated with maturational changes in the frontal cortices.

Less efficient and costly processes of frontal cortex in childhood chronic fatigue syndrome

The ability to divide one's attention deteriorates in patients with childhood chronic fatigue syndrome (CCFS). We conducted a study using a dual verbal task to assess allocation of attentional resources to two simultaneous activities (picking out vowels and reading for story comprehension) and functional magnetic resonance imaging. Patients exhibited a much larger area of activation, recruiting additional frontal areas. The right middle frontal gyrus (MFG), which is included in the dorsolateral prefrontal cortex, of CCFS patients was specifically activated in both the single and dual tasks; this activation level was positively correlated with motivation scores for the tasks and accuracy of story comprehension. In addition, in patients, the dorsal anterior cingulate gyrus (dACC) and left MFG were activated only in the dual task, and activation levels of the dACC and left MFG were positively associated with the motivation and fatigue scores, respectively. Patients with CCFS exhibited a wider area of activated frontal regions related to attentional resources in order to increase their poorer task performance with massive mental effort. This is likely to be less efficient and costly in terms of energy requirements. It seems to be related to the pathophysiology of patients with CCFS and to cause a vicious cycle of further increases in fatigue.

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Decrease in divided attention was related to fatigue in childhood and adolescence.

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Left frontal cortex of healthy students activated in verbal divided attention task

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Right MFG and ACG were additionally activated in CCFS patients.

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CCFS is characterized as an energy-inefficient process in frontal cortex.

Developmental trends in the facilitation of multisensory objects with distractors

Sensory integration and the ability to discriminate target objects from distractors are critical to survival, yet the developmental trajectories of these abilities are unknown. This study investigated developmental changes in 9- (n = 18) and 11-year-old (n = 20) children, adolescents (n = 19) and adults (n = 22) using an audiovisual object discrimination task with uni- and multisensory distractors. Reaction times (RTs) were slower with visual/audiovisual distractors, and although all groups demonstrated facilitation of multisensory RTs in these conditions, children's and adolescents' responses corresponded to fewer race model violations than adults', suggesting protracted maturation of multisensory processes. Multisensory facilitation could not be explained by changes in RT variability, suggesting that tests of race model violations may still have theoretical value at least for familiar multisensory stimuli.

Neuropsychological performance of youth with secondary attention-deficit/hyperactivity disorder 6- and 12-months after traumatic brain injury

The present study compared executive dysfunction among children with attention-deficit/hyperactivity disorder (ADHD) after traumatic brain injury (TBI), also called secondary ADHD (S-ADHD), pre-injury ADHD and children with TBI only (i.e., no ADHD). Youth aged 6-16 years admitted for TBI to five trauma centers were enrolled (n=177) and evaluated with a semi-structured psychiatric interview scheduled on three occasions (within 2 weeks of TBI, i.e., baseline assessment for pre-injury status; 6-months and 12-months post-TBI). This permitted the determination of 6- and 12-month post-injury classifications of membership in three mutually exclusive groups (S-ADHD; pre-injury ADHD; TBI-only). Several executive control measures were administered. Unremitted S-ADHD was present in 17/141 (12%) children at the 6-month assessment, and in 14/125 (11%) children at 12-months post-injury. The study found that children with S-ADHD exhibited deficient working memory, attention, and psychomotor speed as compared to children with pre-injury ADHD. Furthermore, the children with S-ADHD and the children with TBI-only were impaired compared to the children with pre-injury ADHD with regard to planning. No group differences related to response inhibition emerged. Age, but not injury severity, gender, or adaptive functioning was related to executive function outcome. Neuropsychological sequelae distinguish among children who develop S-ADHD following TBI and those with TBI only. Moreover, there appears to be a different pattern of executive control performance in those who develop S-ADHD than in children with pre-injury ADHD suggesting that differences exist in the underlying neural mechanisms that define each disorder, underscoring the need to identify targeted treatment interventions.

The interactive effects of physical fitness and acute aerobic exercise on electrophysiological coherence and cognitive performance in adolescents

The current study examined the effects of physical fitness and aerobic exercise on cognitive functioning and coherence of the electroencephalogram in 30 adolescents between the ages of 13 and 14 years. Participants were first classified as fit or unfit and then performed a modified Eriksen flanker task after a bout of acute exercise and after a period of relaxation. Analysis of behavioural differences between the fit and unfit groups revealed an interaction between fitness levels and acute physical exercise. Specifically, fit participants had significantly faster reaction times in the exercise condition in comparison with the rest condition; unfit, but not fit, participants had higher error rates for NoGo relative to Go trials in the rest condition. Furthermore, unfit participants had higher levels of lower alpha, upper alpha, and beta coherence in the resting condition for NoGo trials, possibly indicating a greater allocation of cognitive resources to the task demands. The higher levels of alpha coherence are of particular interest in light of its reported role in inhibition and effortful attention. The results suggest that physical fitness and acute exercise may enhance cognition by increasing the efficacy of the attentional system.

Speed isn't everything: complex processing speed measures mask individual differences and developmental changes in executive control

The rate at which people process information appears to influence many aspects of cognition across the lifespan. However, many commonly accepted measures of 'processing speed' may require goal maintenance, manipulation of information in working memory, and decision-making, blurring the distinction between processing speed and executive control and resulting in overestimation of processing speed contributions to cognition. This concern may apply particularly to studies of developmental change, as even seemingly simple processing speed measures may require executive processes to keep children and older adults on task. We report two new studies and a re-analysis of a published study, testing predictions about how different processing speed measures influence conclusions about executive control across the lifespan. We find that the choice of processing speed measure affects the relationship observed between processing speed and executive control, in a manner that changes with age, and that choice of processing speed measure affects conclusions about development and the relationship among executive control measures. Implications for understanding processing speed, executive control, and their development are discussed.

A review of the relation of aerobic fitness and physical activity to brain structure and function in children

A growing number of schools have increasingly de-emphasized the importance of providing physical activity opportunities during the school day, despite emerging research that illustrates the deleterious relationship between low levels of aerobic fitness and neurocognition in children. Accordingly, a brief review of studies that link fitness-related differences in brain structure and brain function to cognitive abilities is provided herein. Overall, the extant literature suggests that childhood aerobic fitness is associated with higher levels of cognition and differences in regional brain structure and function. Indeed, it has recently been found that aerobic fitness level even predicts cognition over time. Given the paucity of work in this area, several avenues for future investigations are also highlighted.

Development of Inattention, Impulsivity, and Processing Speed as Measured by the d2 Test: Results of a Large Cross-sectional Study in Children Aged 7–13

The development of three aspects of selective attention was studied in 451 Dutch schoolchildren attending second to sixth grade. Selective attention was measured with the d2 Test of attention. The largest age differences were found for processing speed that continued to improve until the sixth grade. Impulsivity, as measured by the percentage of errors of commission, decreased until the fourth grade. Inattention, measured by the percentage of errors of omission, was stable in all grades. Processing speed and impulsivity were correlated with the score on the Attention Problems subscale of the Child Behavior Checklist. These results imply that selective attention continues to develop, at least, until the end of elementary school. The findings are support for a step-wise model of cognitive development (P. Anderson, 2002).

Medial prefrontal theta bursts precede rapid motor responses during visual selective attention

After visual target stimuli presented infrequently at a covertly attended location, quicker speeded button presses immediately followed a larger positive (P3f) ramp in averaged electroencephalographic (EEG) recordings from the forehead. We show this peak in the mean response time locked to the button press to be principally composed of triphasic, primarily low-theta band (4.5 Hz) complexes preceding but only partially phase-locked to the button press, with larger complexes preceding quicker motor responses. For 10 of 15 subjects, independent component analysis of the unaveraged 31-channel data identified a temporally independent medial frontal EEG process contributing to these phenomena. Low-resolution tomographic modeling localized related components of two 253-channel data sets to medial frontal polar cortex (BA32/10). The far-frontal low-theta complexes and concomitant mean P3f positivity may index cortical activity induced by paralimbic processes involved in disinhibiting impulsive motor responses to rewarding or goal-fulfilling stimuli or events.

The development of stop-signal and Go/Nogo response inhibition in children aged 7–12 years: Performance and event-related potential indices

The present study examined the development of response inhibition during the Stop-signal and Go/Nogo tasks in children using performance and ERP measures. Twenty-four children aged 7 to 12 years completed both tasks, each with an auditory Nogo/Stop-signal presented on 30% of trials. On average, response inhibition was more difficult in the Stop-signal than Go/Nogo task. Response inhibition performance did not develop significantly across the age range, while response execution varied significantly in a task dependent manner (Go/Nogo: increasing accuracy and reducing response variability with age; Stop-signal: reducing Go mean reaction time and response variability with age). The N1, P2, N2 and P3 components showed different scalp distributions, with N1 and P2 peaking earlier, and P3 later, in Nogo compared to Stop stimuli. N2 and P3 amplitude were positively correlated with successful inhibition probability in the Go/Nogo task only. N2 amplitude and latency to both Nogo and successful Stop stimuli decreased linearly with age, but not in the frontal regions. N1 and P3 amplitude in the parietal region increased with age for Stop-signals. An age-related reduction in P3 latency to Nogo stimuli correlated significantly with reduced RT and variability in Go responding, indicating a relationship between efficient Nogo and Go processing. Together the behavioural and ERP results suggest little development of the response inhibition process as measured via the Stop-signal and Go/Nogo tasks across the 7 to 12 year age range, while response execution processes develop substantially.

P300 development during adolescence: Effects of DRD2 genotype

OBJECTIVE

Young boys at high risk for alcoholism by having a family history of alcoholism (FH+) have lower amplitude of the visual P300 event-related scalp potential. They have also been reported to have a slowing in the rate of P300 amplitude change during adolescence. The present study examined whether the change in P300 amplitude during adolescence in sons of alcoholics and nonalcoholics is affected by D2 dopamine receptor (DRD2) polymorphism.

METHODS

P300 was elicited with a visual discrimination task from 71 adolescent sons of alcoholics and social drinkers (Time 1, T1). The task was readministered 2 years later (Time 2, T2). Comparisons were made between boys who had the DRD2 A1 allele (A1+) and boys who did not (A1-), and between boys with one or both parents being alcoholic (FH+) and boys having no alcoholic parents (FH-).

RESULTS

Discrimination task accuracy was lowest in the highest risk group (A1+, FH+) at T1, and highest in the lowest risk group (A1-, FH-) at T2, producing a significant interaction of allelic group x family history group x session. Reaction time was faster at T2 than T1, and this effect was larger in FH-boys (125 ms) than FH+boys (40 ms). Overall, the behavioral results suggest mild performance deficits on the discrimination task are associated with higher risk for alcoholism. In both testing sessions, P300 attained larger amplitudes in sons of nonalcoholics than sons of alcoholics. At T2 compared to T1, both the latency and amplitude of the P300 were decreased. However, while the developmental P300 latency effect was equivalent in both the A1+ and A1- allelic groups, the P300 amplitude reduction during adolescence, measured both in response to targets and in target minus non-target subtraction waveforms, was only found in boys with the A1- allele.

CONCLUSION

Differences in the developmental course of P300 amplitude over the course of adolescence are dependent on DRD2 polymorphism.

SIGNIFICANCE

These results suggest the importance of genetic determinants of the dopaminergic system in understanding the P300 as a risk marker for substance abuse using an integrative developmental perspective.

Aerobic Fitness and Neurocognitive Function in Healthy Preadolescent Children

PURPOSE

We investigated the relationship between age, aerobic fitness, and cognitive function by comparing high- and low-fit preadolescent children and adults.

METHOD

Twenty-four children (mean age = 9.6 yr) and 27 adults (mean age = 19.3 yr) were grouped according to their fitness (high, low) such that four approximately equal groups were compared. Fitness was assessed using the Fitnessgram test, and cognitive function was measured by neuroelectric and behavioral responses to a stimulus discrimination task.

RESULTS

Adults exhibited greater P3 amplitude at Cz and Pz sites, and decreased amplitude at the Oz site compared with children. High-fit children had greater P3 amplitude compared with low-fit children and high- and low-fit adults. Further, adults had faster P3 latency compared with children, and high-fit participants had faster P3 latency compared with low-fit participants at the Oz site. Adults exhibited faster reaction time than children; however, fitness interacted with age such that high-fit children had faster reaction time than low-fit children.

CONCLUSION

These findings suggest that fitness was positively associated with neuroelectric indices of attention and working memory, and response speed in children. Fitness was also associated with cognitive processing speed, but these findings were not age-specific. These data indicate that fitness may be related to better cognitive functioning in preadolescents and have implications for increasing cognitive health in children and adults.

Development of "hot" executive function: the children's gambling task

Development of affective decision-making was studied in 48 children at two ages (3 and 4 years) using a simplified version of the Iowa Gambling Task (). On each of 50 trials, children chose from 1 of 2 decks of cards that, when turned, displayed happy and sad faces, corresponding to rewards (candies) won and lost, respectively. Cards in 1 deck offered more rewards per trial, but were disadvantageous across trials due to occasional large losses; cards in the other deck offered fewer rewards per trial, but were advantageous overall. On later trials, 4-year-olds made more advantageous choices than 3-year-olds, and 4-year-olds made more advantageous choices than would be expected by chance, whereas 3-year-olds made more disadvantageous choices than would be expected by chance. These findings, which were especially pronounced for girls, indicate that affective decision-making develops rapidly during the preschool period, possibly reflecting the growth of neural systems involving orbitofrontal cortex.

Development of orbitofrontal function: current themes and future directions

In recent years, an exciting thrust in the developmental research literature has been the focus on "executive" functions (EF). However, the emphasis has been on the more purely cognitive aspects of EF operative in abstract reasoning and problem solving-aspects associated mainly with dorsolateral frontal regions. Although the literature on adult neuropsychology has seen an emerging and growing interest in the study of processes more related to orbitofrontal cortex (OFC), including emotion and personality, research on the development of EF has lagged behind. This special issue of Brain and Cognition is intended to redress this imbalance by bringing together researchers who are studying the nature and development of orbitofrontal function from a wide variety of perspectives.

Time course and nature of stimulus evaluation in category induction as revealed by visual event-related potentials

Category induction involves abstraction of features common to two or more stimuli. We predicted that category induction affects processing of each stimulus, before completion of perceptual analysis. Event-related potentials (ERPs) were recorded from ten 11-13-year olds while they were performing visual category-induction tasks. Subjects viewed a series of two geometric shapes belonging to the same perceptual category (size, color, or shape), defined by one or two shared features, and decided if a probe stimulus shared membership in that category. Large frontal N120, frontal-central N300 and smallest P450 were elicited by the first stimulus; number of shared features affected P150, N170, and P450 amplitudes to the second stimulus. Principal Component Analysis (PCA) indicated networks of frontal, parietal and occipital activity, different to each stimulus. Results suggest that in young adolescents category induction affects early stages of stimulus processing. Processing is based on selective analysis of stimuli for shared features, not exhaustive examination of all features of all stimuli.

Event-related potential and behavioral measures of attention in 5-, 7-, and 9-year-olds

In 2 experiments, the development of auditory selective attention in children was assessed. The participants, aged 5, 7, and 9 years, responded to target stimuli in the left ear for 1 series (ignoring the standard stimuli) and in the right ear for the other series. In Experiment 1, event-related potentials (ERPs) evoked by the auditory stimuli were recorded from frontal, central, and parietal sites. The 9-year-olds showed a greater processing negativity (Nd) to the attended channel compared with the 5-year-olds. Both 7- and 9-year-olds showed significantly larger amplitudes for the P3 component of ERPs in the attended vs. ignored condition. Behaviorally, the 5-year-olds made fewer hits and more false alarms than did older children, and the 9-year-olds made significantly more false alarms than did the 7-year-olds. The results of Experiment 2 showed that the detriment in the performance of the 9-year-olds was a result of task parameters. The inability of 5-year-olds to attend selectively appears to involve problems with the inhibition of the processing of irrelevant information and with selection of the correct response.

Animal models of periadolescent substance abuse

Use of addictive substances by human juveniles and adolescents is common, including use to intoxication and progression from one drug to other drugs. Until quite recently, animal studies have not addressed the periadolescent period as a time of special vulnerability to substance abuse. For ethanol (EtOH), the most studied drug in periadolescent animals, it has become clear that effects of alcohol are similar in some ways, but different in others, compared to the effects seen in adult animals. Sparse data suggest that this conclusion may apply to other drugs as well. Recent work in rats indicates that periadolescent substance use may disrupt normal pubertal development, and may induce stronger effects on systems subserving plasticity and cognition than in adults. Animal data also indicate that some drugs may produce altered subsequent sensitivity to the same or a different drug, changes in adult cognitive capabilities, and even CNS damage. It is now clear that there can be no presumption that all studies of abusable substances carried out in adult animals will generalize readily to periadolescents. Some data suggest that continuing developmental changes in receptor expression may underlie age-related changes in drug effects. However, the biological characteristics of periadolescence which predispose toward consumption to intoxication, and the mechanisms underlying drug progression and persisting drug effects, still remain to be well defined.

Why is learning and memory dysfunction in Type 2 diabetes limited to older adults?

Review of the literature on the cognitive correlates and consequences of Type 2 diabetes reveals two very intriguing findings. Not only are verbal learning and memory skills most likely to be disrupted as compared to other cognitive skills (e.g. attention, executive function; psychomotor efficiency), but these mnestic deficits appear to be restricted to individuals with diabetes who are older than 60-65 years of age. Middle-aged adults with either Type 2 or Type 1 diabetes are apparently protected insofar as researchers have only infrequently reported learning and memory impairments in that age group. Why do older adults have such an increased risk of diabetes-associated memory dysfunction? In our view, this phenomenon is a consequence of a synergistic interaction between diabetes-related metabolic derangements and the structural and functional changes occurring in the central nervous system (CNS) that are part of the normal ageing process. To critically evaluate that possibility, we summarise what is known about learning and memory dysfunction in the adult with diabetes, examine the extent to which chronic hyperglycaemia may adversely affect the integrity of the CNS, and selectively review the literature on age-associated changes in brain morphology and cognitive function, paying special attention to the threshold theory of cognitive impairment.