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Roor JJ, Dandachi-FitzGerald B, Peters MJV, Ponds RWHM. Providing a brief corrective statement does not improve test performance in patients invalidating testing: A multisite, single-blind randomized controlled trial. Clin Neuropsychol 2024:1-23. [PMID: 39056491 DOI: 10.1080/13854046.2024.2382340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024]
Abstract
Objective: Performance below the actual abilities of the examinee can be measured using performance validity tests (PVTs). PVT failure negatively impacts the quality of the neuropsychological assessment. In our study, we addressed this issue by providing a brief corrective statement regarding invalidity to improve test-taking behavior. Methods: This study is a multisite single-blind randomized controlled trial in a consecutive sample of clinically referred adult patients (N = 196) in a general hospital setting. Patients who failed a PVT (n = 71) were randomly allocated to a corrective statement approach (CS; n = 39), in which a brief verbal corrective statement was given by the technician, or received no corrective statement upon indications of invalid performance (NO-CS; n = 32). Both groups (CS and NO-CS) were provided with the same subsequently repeated and newly administered tests. Results: There were no group (CS vs. NO-CS) differences on both the repeated and single-administered PVTs and standard cognitive tests. Furthermore, invalid performing participants benefited significantly less from the repeated test administration compared to the valid performing group. Conclusions: Our study found that a brief corrective within-session statement, to address PVT failure and improve test-taking behavior, did not improve consequent test performance. These results suggest limited value of a brief verbal corrective statement to influence performance below best of capabilities. It highlights the need for more research to identify more effective approaches that can enhance patients test-taking behavior. Ultimately, such efforts are critical in ensuring accurate diagnosis and effective treatment recommendations for patients.
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Affiliation(s)
- Jeroen J Roor
- Department of Medical Psychology, VieCuri Medical Center, Venlo, the Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Brechje Dandachi-FitzGerald
- Faculty of Psychology, Open University Heerlen, Heerlen, the Netherlands
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Maarten J V Peters
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Rudolf W H M Ponds
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- Department of Medical Psychology, Amsterdam University Medical Centres, location VU, Amsterdam, the Netherlands
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2
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Pauls MMH, Fish J, Binnie LR, Benjamin P, Betteridge S, Clarke B, Dhillon MPK, Ghatala R, Hainsworth FAH, Howe FA, Khan U, Kruuse C, Madigan JB, Moynihan B, Patel B, Pereira AC, Rostrup E, Shtaya ABY, Spilling CA, Trippier S, Williams R, Young R, Barrick TR, Isaacs JD, Hainsworth AH. Testing the cognitive effects of tadalafil. Neuropsychological secondary outcomes from the PASTIS trial. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2023; 5:100187. [PMID: 37811523 PMCID: PMC10550803 DOI: 10.1016/j.cccb.2023.100187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 09/25/2023] [Accepted: 09/25/2023] [Indexed: 10/10/2023]
Abstract
Cerebral small vessel disease (SVD) is a major cause of cognitive impairment in older people. As secondary endpoints in a phase-2 randomised clinical trial, we tested the effects of single administration of a widely-used PDE5 inhibitor, tadalafil, on cognitive performance in older people with SVD. In a double-blinded, placebo-controlled, cross-over trial, participants received tadalafil (20 mg) and placebo on two visits ≥ 7 days apart (randomised to order of treatment). The Montreal Cognitive Assessment (MOCA) was administered at baseline, alongside a measure to estimate optimal intellectual ability (Test of Premorbid Function). Then, before and after treatment, a battery of neuropsychological tests was administered, assessing aspects of attention, information processing speed, working memory and executive function. Sixty-five participants were recruited and 55 completed the protocol (N = 55, age: 66.8 (8.6) years, range 52-87; 15/40 female/male). Median MOCA score was 26 (IQR: 23, 27], range 15-30). No significant treatment effects were seen in any of the neuropsychological tests. There was a trend towards improved performance on Digit Span Forward (treatment effect 0.37, C.I. 0.01, 0.72; P = 0.0521). We did not identify significant treatment effects of single-administration tadalafil on neuropsychological performance in older people with SVD. The trend observed on Digit Span Forward may help to inform future studies. Clinical trial registration http://www.clinicaltrials.gov. Unique identifier: NCT00123456, https://eudract.ema.europa.eu. Unique identifier: 2015-001,235-20NCT00123456.
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Affiliation(s)
- Mathilde MH Pauls
- Molecular & Clinical Sciences Research Institute, St George's University of London, UK
- Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Jessica Fish
- Neuropsychology, St George's University Hospitals NHS Foundation Trust, London, UK
- School of Health & Wellbeing, University of Glasgow, UK
| | - Lauren R Binnie
- Molecular & Clinical Sciences Research Institute, St George's University of London, UK
| | - Philip Benjamin
- Molecular & Clinical Sciences Research Institute, St George's University of London, UK
- Neuroradiology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Shai Betteridge
- Neuropsychology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Brian Clarke
- Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
| | | | - Rita Ghatala
- South London Stroke Research Network, London, UK
| | | | - Franklyn A Howe
- Molecular & Clinical Sciences Research Institute, St George's University of London, UK
| | - Usman Khan
- Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Christina Kruuse
- Department of Neurology and Neurovascular Research Unit, Herlev Gentofte Hospital, Denmark
| | - Jeremy B Madigan
- Neuroradiology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Barry Moynihan
- Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
- Department of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
| | - Bhavini Patel
- Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Anthony C Pereira
- Molecular & Clinical Sciences Research Institute, St George's University of London, UK
- Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Egill Rostrup
- Mental Health Centre, University of Copenhagen, Glostrup, Denmark
| | - Anan BY Shtaya
- Molecular & Clinical Sciences Research Institute, St George's University of London, UK
| | - Catherine A Spilling
- Molecular & Clinical Sciences Research Institute, St George's University of London, UK
| | | | | | - Robin Young
- Robertson Centre for Biostatistics, University of Glasgow, UK
| | - Thomas R Barrick
- Molecular & Clinical Sciences Research Institute, St George's University of London, UK
| | - Jeremy D Isaacs
- Molecular & Clinical Sciences Research Institute, St George's University of London, UK
- Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Atticus H Hainsworth
- Molecular & Clinical Sciences Research Institute, St George's University of London, UK
- Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
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3
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Denkinger S, Antoniou MP, Tarello D, Levi DM, Backus BT, Bavelier D, Chopin A. The eRDS v6 Stereotest and the Vivid Vision Stereo Test: Two New Tests of Stereoscopic Vision. Transl Vis Sci Technol 2023; 12:1. [PMID: 36857068 PMCID: PMC9987163 DOI: 10.1167/tvst.12.3.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
Purpose To describe two new stereoacuity tests: the eRDS v6 stereotest, a global dynamic random dot stereogram (dRDS) test, and the Vivid Vision Stereo Test version 2 (VV), a local or "contour" stereotest for virtual reality (VR) headsets; and to evaluate the tests' reliability, validity compared to a dRDS standard, and learning effects. Methods Sixty-four subjects passed a battery of stereotests, including perceiving depth from RDS. Validity was evaluated relative to a tablet-based dRDS reference test, ASTEROID. Reliability and learning effects were assessed over six sessions. Results eRDS v6 was effective at measuring small thresholds (<10 arcsec) and had a moderate correlation (0.48) with ASTEROID. Across the six sessions, test-retest reliability was good, varying from 0.84 to 0.91, but learning occurred across the first three sessions. VV did not measure stereoacuities below 15 arcsec. It had a weak correlation with ASTEROID (0.27), and test-retest reliability was poor to moderate, varying from 0.35 to 0.74; however, no learning occurred between sessions. Conclusions eRDS v6 is precise and reliable but shows learning effects. If repeated three times at baseline, this test is well suited as an outcome measure for testing interventions. VV is less precise, but it is easy and rapid and shows no learning. It may be useful for testing interventions in patients who have no global stereopsis. Translational Relevance eRDS v6 is well suited as an outcome measure to evaluate treatments that improve adult stereodepth perception. VV can be considered for screening patient with compromised stereovision.
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Affiliation(s)
- Sylvie Denkinger
- Psychology and Education Sciences, University of Geneva, Switzerland.,Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | - Maria-Paraskevi Antoniou
- Psychology and Education Sciences, University of Geneva, Switzerland.,Institute of Information Systems, University of Applied Sciences & Arts Western Switzerland (HES-SO) Valais-Wallis, Sierre, Switzerland
| | - Demetrio Tarello
- Psychology and Education Sciences, University of Geneva, Switzerland
| | - Dennis M Levi
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, CA, USA
| | | | - Daphné Bavelier
- Psychology and Education Sciences, University of Geneva, Switzerland.,Psychology and Education Sciences, University of Geneva & Campus Biotech, Switzerland
| | - Adrien Chopin
- Psychology and Education Sciences, University of Geneva, Switzerland.,Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
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4
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Hausman HK, Dai Y, O’Shea A, Dominguez V, Fillingim M, Calfee K, Carballo D, Hernandez C, Perryman S, Kraft JN, Evangelista ND, Van Etten EJ, Smith SG, Bharadwaj PK, Song H, Porges E, DeKosky ST, Hishaw GA, Marsiske M, Cohen R, Alexander GE, Wu SS, Woods AJ. The longitudinal impact of the COVID-19 pandemic on health behaviors, psychosocial factors, and cognitive functioning in older adults. Front Aging Neurosci 2022; 14:999107. [PMID: 36506467 PMCID: PMC9732386 DOI: 10.3389/fnagi.2022.999107] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 10/31/2022] [Indexed: 11/27/2022] Open
Abstract
Background: Older adults are at a greater risk for contracting and experiencing severe illness from COVID-19 and may be further affected by pandemic-related precautions (e.g., social distancing and isolation in quarantine). However, the longitudinal impact of the COVID-19 pandemic on older adults is unclear. The current study examines changes in health behaviors, psychosocial factors, and cognitive functioning in a large sample of older adults using a pre-pandemic baseline and longitudinal follow-up throughout 9 months of the COVID-19 pandemic. Methods: One hundred and eighty-nine older adults (ages 65-89) were recruited from a multisite clinical trial to complete additional virtual assessments during the COVID-19 pandemic. Mixed effects models evaluated changes in health behaviors, psychosocial factors, and cognitive functioning during the pandemic compared to a pre-pandemic baseline and over the course of the pandemic (i.e., comparing the first and last COVID-19 timepoints). Results: Compared to their pre-pandemic baseline, during the pandemic, older adults reported worsened sleep quality, perceived physical health and functioning, mental health, slight increases in depression and apathy symptoms, reduced social engagement/perceived social support, but demonstrated better performance on objective cognitive tasks of attention and working memory. Throughout the course of the pandemic, these older adults reported continued worsening of perceived physical health and function, fewer depression symptoms, and they demonstrated improved cognitive performance. It is important to note that changes on self-report mood measures and cognitive performance were relatively small regarding clinical significance. Education largely served as a protective factor, such that greater years of education was generally associated with better outcomes across domains. Conclusions: The present study provides insights into the longitudinal impact of the COVID-19 pandemic on health behaviors, psychosocial factors, and cognitive functioning in a population disproportionately affected by the virus. Replicating this study design in a demographically representative older adult sample is warranted to further inform intervention strategies targeting older adults negatively impacted by the COVID-19 pandemic.
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Affiliation(s)
- Hanna K. Hausman
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Yunfeng Dai
- Department of Biostatistics, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL,, United States
| | - Andrew O’Shea
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Vanessa Dominguez
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Matthew Fillingim
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Kristin Calfee
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Daniela Carballo
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Cindy Hernandez
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Sean Perryman
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Jessica N. Kraft
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Nicole D. Evangelista
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Emily J. Van Etten
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
| | - Samantha G. Smith
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
| | - Pradyumna K. Bharadwaj
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
| | - Hyun Song
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
| | - Eric Porges
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Steven T. DeKosky
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Neurology, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Georg A. Hishaw
- Department of Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, and BIO5 Institute, University of Arizona and Arizona Alzheimer’s Disease Consortium, Tucson, AZ, United States
| | - Michael Marsiske
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Ronald Cohen
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Gene E. Alexander
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States,Department of Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, and BIO5 Institute, University of Arizona and Arizona Alzheimer’s Disease Consortium, Tucson, AZ, United States
| | - Samuel S. Wu
- Department of Biostatistics, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL,, United States
| | - Adam J. Woods
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States,*Correspondence: Adam J. Woods
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5
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Bender AR, Ganguli A, Meiring M, Hampstead BM, Driver CC. Dynamic modeling of practice effects across the healthy aging-Alzheimer’s disease continuum. Front Aging Neurosci 2022; 14:911559. [PMID: 35966791 PMCID: PMC9366308 DOI: 10.3389/fnagi.2022.911559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
Standardized tests of learning and memory are sensitive to changes associated with both aging and superimposed neurodegenerative diseases. Unfortunately, repeated behavioral test administration can be confounded by practice effects (PE), which may obscure declines in level of abilities and contribute to misdiagnoses. Growing evidence, however, suggests PE over successive longitudinal measurements may differentially predict cognitive status and risk for progressive decline associated with aging, mild cognitive impairment (MCI), and dementia. Thus, when viewed as a reflection of neurocognitive plasticity, PE may reveal residual abilities that can add to our understanding of age- and disease-related changes in learning and memory. The present study sought to evaluate differences in PE and verbal recall in a clinically characterized aging cohort assessed on multiple occasions over 3 years. Participants included 256 older adults recently diagnosed as cognitively unimpaired (CU; n = 126), or with MCI of amnestic (n = 65) or non-amnestic MCI (n = 2085), and multi-domain amnestic dementia of the Alzheimer’s type (DAT; n = 45). We applied a continuous time structural equation modeling (ctsem) approach to verbal recall performance on the Hopkins Verbal Learning Test in order to distinguish PE from individual occasion performance, coupled random changes, age trends, and differing measurement quality. Diagnoses of MCI and dementia were associated with lower recall performance on all trials, reduced PE gain per occasion, and differences in non-linear dynamic parameters. Practice self-feedback is a dynamic measure of the decay or acceleration in PE process changes over longitudinal occasions. As with PE and mean recall, estimated practice self-feedback followed a gradient from positive in CU participants to null in participants with diagnosed MCI and negative for those with dementia diagnoses. Evaluation of sensitivity models showed this pattern of variation in PE was largely unmodified by differences in age, sex, or educational attainment. These results show dynamic modeling of PE from longitudinal performance on standardized learning and memory tests can capture multiple aspects of behavioral changes in MCI and dementia. The present study provides a new perspective for modeling longitudinal change in verbal learning in clinical and cognitive aging research.
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Affiliation(s)
- Andrew R. Bender
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, United States
- Graduate Program in Neuroscience, College of Natural Science, Michigan State University, East Lansing, MI, United States
- Michigan Alzheimer’s Disease Research Center, Ann Arbor, MI, United States
- *Correspondence: Andrew R. Bender,
| | - Arkaprabha Ganguli
- Department of Statistics and Probability, College of Natural Science, Michigan State University, East Lansing, MI, United States
| | - Melinda Meiring
- Graduate Program in Neuroscience, College of Natural Science, Michigan State University, East Lansing, MI, United States
| | - Benjamin M. Hampstead
- Michigan Alzheimer’s Disease Research Center, Ann Arbor, MI, United States
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, United States
- Research Program on Cognition and Neuromodulation Based Intervention, Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Charles C. Driver
- Institute of Education, University of Zurich, Zurich, Switzerland
- Institute for Educational Evaluation, Associated Institute at the University of Zurich, Zurich, Switzerland
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6
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Pai NN, Brown RC, Black KE. The development and validation of a questionnaire to assess relative energy deficiency in sport (RED-S) knowledge. J Sci Med Sport 2022; 25:794-799. [PMID: 35909054 DOI: 10.1016/j.jsams.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 07/07/2022] [Accepted: 07/09/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of this study was to develop and validate a questionnaire assessing knowledge of signs and symptoms of relative energy deficiency in sport among healthcareprofessionals and physically active individuals. DESIGN Cross-sectional study. METHODS The questionnaire was created in two phases: 1)Item development was established through a literature review, expert review (n = 4), and pre-testing among healthcare professionals, dietetic students, and the general population (n = 35). 2) Validity (item analysis, construct validity) and internal reliability were assessed by administrating the questionnaire to healthcare professionals (n = 97) and physically active individuals who engaged in moderate to intense physical activity (n=77). The questionnaire was re-administered in a subset of the same groups (n = 88) for test-retest reliability. RESULTS The expert responses showed >80% acceptability and pretesting through interviews indicated good content and face validity. Item response analysis resulted in removal of 6 items due to low discrimination ability. Significantly higher knowledge scores in health professionals compared with non-health professionals (mean difference (95% CI) = 2.8 (1.9, 3.7)) confirmed construct validity. Internal consistency, assessed using Cronbach's alpha (α = 0.79), and test-retest reliability using intra-class correlation coefficients (intra-class correlation coefficients = 0.80; Spearman's correlation = 0.84, p < 0.001) were good. The final questionnaire had 18 items assessing knowledge of signs and symptoms of Relative Energy Deficiency in Sport. CONCLUSIONS The questionnaire provides a valid and reliable tool to assess knowledge of signs and symptoms of Relative Energy Deficiency in Sport among health professionals and physically active individuals, which could guide future education requirements by assessing current knowledge.
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Affiliation(s)
- Namratha N Pai
- Department of Human Nutrition, University of Otago, New Zealand; Department of Dietetics and Applied Nutrition, Welcomgroup Graduate School of Hotel Administration, Manipal Academy of Higher Education, India
| | - Rachel C Brown
- Department of Human Nutrition, University of Otago, New Zealand
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7
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Larson J, Roper J, Murrah W, Zabala M. Cognitive dual-task alters Local Dynamic Stability of lower extremity during common movements. J Biomech 2022; 137:111077. [DOI: 10.1016/j.jbiomech.2022.111077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 03/28/2022] [Accepted: 03/31/2022] [Indexed: 10/18/2022]
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8
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Boyle R, Jollans L, Rueda-Delgado LM, Rizzo R, Yener GG, McMorrow JP, Knight SP, Carey D, Robertson IH, Emek-Savaş DD, Stern Y, Kenny RA, Whelan R. Brain-predicted age difference score is related to specific cognitive functions: a multi-site replication analysis. Brain Imaging Behav 2021; 15:327-345. [PMID: 32141032 DOI: 10.1007/s11682-020-00260-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Brain-predicted age difference scores are calculated by subtracting chronological age from 'brain' age, which is estimated using neuroimaging data. Positive scores reflect accelerated ageing and are associated with increased mortality risk and poorer physical function. To date, however, the relationship between brain-predicted age difference scores and specific cognitive functions has not been systematically examined using appropriate statistical methods. First, applying machine learning to 1359 T1-weighted MRI scans, we predicted the relationship between chronological age and voxel-wise grey matter data. This model was then applied to MRI data from three independent datasets, significantly predicting chronological age in each dataset: Dokuz Eylül University (n = 175), the Cognitive Reserve/Reference Ability Neural Network study (n = 380), and The Irish Longitudinal Study on Ageing (n = 487). Each independent dataset had rich neuropsychological data. Brain-predicted age difference scores were significantly negatively correlated with performance on measures of general cognitive status (two datasets); processing speed, visual attention, and cognitive flexibility (three datasets); visual attention and cognitive flexibility (two datasets); and semantic verbal fluency (two datasets). As such, there is firm evidence of correlations between increased brain-predicted age differences and reduced cognitive function in some domains that are implicated in cognitive ageing.
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Affiliation(s)
- Rory Boyle
- Trinity College Institute of Neuroscience, Trinity College Dublin, Lloyd Building, Dublin 2, Ireland
| | - Lee Jollans
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, München, Germany
| | - Laura M Rueda-Delgado
- Trinity College Institute of Neuroscience, Trinity College Dublin, Lloyd Building, Dublin 2, Ireland
| | - Rossella Rizzo
- Physics Department, University of Calabria, Rende, CS, Italy
| | - Görsev G Yener
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University, İzmir, Turkey
- Department of Neurology, Dokuz Eylul University Medical School, İzmir, Turkey
- Brain Dynamics Multidisciplinary Research Center, Dokuz Eylul University, İzmir, Turkey
| | - Jason P McMorrow
- Centre for Advanced Medical Imaging, St. James's Hospital, Dublin 8, Ireland
- School of Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - Silvin P Knight
- School of Medicine, Trinity College Dublin, Dublin 2, Ireland
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin 2, Ireland
| | - Daniel Carey
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin 2, Ireland
- Department of Medical Gerontology, Trinity College Dublin, Dublin 2, Ireland
| | - Ian H Robertson
- Trinity College Institute of Neuroscience, Trinity College Dublin, Lloyd Building, Dublin 2, Ireland
- Global Brain Health Institute, Trinity College Dublin, Lloyd Building, Dublin 2, Ireland
| | - Derya D Emek-Savaş
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University, İzmir, Turkey
- Global Brain Health Institute, Trinity College Dublin, Lloyd Building, Dublin 2, Ireland
- Department of Psychology, Faculty of Letters, Dokuz Eylul University, İzmir, Turkey
| | - Yaakov Stern
- Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY, USA
| | - Rose Anne Kenny
- School of Medicine, Trinity College Dublin, Dublin 2, Ireland
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin 2, Ireland
- Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin 8, Ireland
| | - Robert Whelan
- Trinity College Institute of Neuroscience, Trinity College Dublin, Lloyd Building, Dublin 2, Ireland.
- Global Brain Health Institute, Trinity College Dublin, Lloyd Building, Dublin 2, Ireland.
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9
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Schultz R, Tate RL, Perdices M. Neuropsychological recovery during the first 12 months after severe traumatic brain injury: A longitudinal study with monthly assessments. Neuropsychol Rehabil 2021; 32:1291-1323. [PMID: 33685355 DOI: 10.1080/09602011.2021.1882507] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Neuropsychologists are commonly asked practical questions about cognitive recovery in the first year following moderate-to-severe traumatic brain injury (TBI), however guiding evidence to provide answers is limited. The design of this longitudinal study rectifies methodological problems in the literature by taking serial assessments on a monthly basis from 3- to 12-months post-trauma in a severe TBI sample (n = 23), and using four alternate forms of a brief yet sensitive cognitive assessment battery. Fifteen variables sampling seven cognitive domains were used: orientation, attention, processing speed, executive function, memory, language and visuospatial function. A matched control group (n = 23) was used to establish equivalence of the four alternate forms (no statistically significant differences), document practice effects (no statistically significant differences), and provide a comparison standard of cognitive functioning against which to interpret the TBI recovery curves. Twenty-one of 23 consenting TBI participants continued with the serial assessments. Hierarchical growth model analyses typically revealed linear recovery trajectories over the first 12 months. However, by 12-months post-trauma, a significant proportion (up to 36%) had residual mild to severe impairments in various cognitive domains. These results provide detailed information about patterns of cognitive recovery that also have direct clinical application.
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Affiliation(s)
- Regina Schultz
- Agency for Clinical Innovation, St Leonards, Sydney, Australia
| | - Robyn L Tate
- John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Sydney Medical School - Northern, The University of Sydney, Sydney, Australia
| | - Michael Perdices
- Department of Neurology, Royal North Shore Hospital, Sydney, Australia
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10
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Thangarajh M, Elfring GL, Trifillis P. Longitudinal Evaluation of Working Memory in Duchenne Muscular Dystrophy. J Clin Med 2020; 9:jcm9092940. [PMID: 32933029 PMCID: PMC7563441 DOI: 10.3390/jcm9092940] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/16/2020] [Accepted: 09/02/2020] [Indexed: 01/16/2023] Open
Abstract
Objective: The developmental maturation of forward and backward digit spans—indices of working memory—in boys with nonsense (nm) Duchenne muscular dystrophy (DMD) (nmDMD) was assessed using prospective, longitudinal data. Methods: Fifty-five boys of the 57 subjects with genetically confirmed nmDMD—who were from the placebo arm of a 48-week-long phase 2b clinical trial—were evaluated. Forward and backward digit spans were obtained every 12 weeks for a total of five assessments in all study subjects. Changes in forward and backward digit spans were evaluated based on age, corticosteroid treatment, and DMD mutation location. Results: Boys with nmDMD had lower mean scores on normalized forward digit span. Normalized forward digit spans were comparable between subjects stratified by age and between corticosteroid-naïve and corticosteroid-treated subjects. When stratified by DMD mutation location, normalized forward digit spans were lower in nmDMD subjects with mutations downstream of DMD exon 30, exon 45, and exon 63, both at baseline evaluation and at follow-up evaluation at 48 weeks. On average, normalized backward digit span scores were stable over 48 weeks in these subjects. Developmental growth modeling showed that subjects with nmDMD mutations upstream of DMD exon 30, upstream of DMD exon 45, and upstream of DMD exon 63 appeared to make better gains in working memory than subjects with mutations downstream of DMD exon 30, downstream of DMD exon 45, and downstream of DMD exon 63. Conclusion: Performance in working memory shows deficits in nmDMD and differed based on nmDMD location. Maturation in cognition was seen over a 48-week period. The developmental trajectory of working memory in this cohort was influenced by DMD mutation location.
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Affiliation(s)
- Mathula Thangarajh
- Department of Neurology, Virginia Commonwealth University, 1101 East Marshall Street, P.O. Box 980599, Richmond, VA 23298, USA
- Correspondence: ; Tel.: +1-804-628-0396
| | - Gary L. Elfring
- PTC Therapeutics Inc., South Plainfield, NJ 07080, USA; (G.L.E.); (P.T.)
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11
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Basner M, Hermosillo E, Nasrini J, Saxena S, Dinges DF, Moore TM, Gur RC. Cognition test battery: Adjusting for practice and stimulus set effects for varying administration intervals in high performing individuals. J Clin Exp Neuropsychol 2020; 42:516-529. [PMID: 32539487 DOI: 10.1080/13803395.2020.1773765] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Practice effects associated with the repeated administration of cognitive tests often confound true therapeutic or experimental effects. Alternate test forms help reduce practice effects, but generating stimulus sets with identical properties can be difficult. The main objective of this study was to disentangle practice and stimulus set effects for Cognition, a battery of 10 brief cognitive tests specifically designed for high-performing populations with 15 unique versions for repeated testing. A secondary objective was to investigate the effects of test-retest interval on practice effects. METHODS The 15 versions of Cognition were administered in three groups of 15-16 subjects (total N = 46, mean±SD age 32.5 ± 7.2 years, range 25-54 years, 23 male) in a randomized but balanced fashion with administration intervals of ≥10 days, ≤5 days, or 4 times per day. Mixed effect models were used to investigate linear and logarithmic trends across repeated administrations in key speed and accuracy outcomes, whether these trends differed significantly between administration interval groups, and whether stimulus sets differed significantly in difficulty. RESULTS Protracted, non-linear practice effects well beyond the second administration were observed for most of the 10 Cognition tests both in accuracy and speed, but test-retest administration interval significantly affected practice effects only for 3 out of the 10 tests and only in the speed domain. Stimulus set effects were observed for the 6 Cognition tests that use unique sets of stimuli. Factors were established that allow for correcting for both practice and stimulus set effects. CONCLUSIONS Practice effects are pronounced and probably under-appreciated in cognitive testing. The correction factors established in this study are a unique feature of the Cognition battery that can help avoid masking practice effects, address noise generated by differences in stimulus set difficulty, and facilitate interpretation of results from studies with repeated assessments.
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Affiliation(s)
- Mathias Basner
- Unit for Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA, USA
| | - Emanuel Hermosillo
- Unit for Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA, USA
| | - Jad Nasrini
- Unit for Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA, USA
| | - Salil Saxena
- Unit for Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA, USA
| | - David F Dinges
- Unit for Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA, USA
| | - Tyler M Moore
- Brain Behavior Laboratory, Neuropsychiatry Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA, USA
| | - Ruben C Gur
- Brain Behavior Laboratory, Neuropsychiatry Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA, USA
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12
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Jendryczko D, Scharfen J, Holling H. The Impact of Situational Test Anxiety on Retest Effects in Cognitive Ability Testing: A Structural Equation Modeling Approach. J Intell 2019; 7:E22. [PMID: 31547510 PMCID: PMC6963292 DOI: 10.3390/jintelligence7040022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 08/17/2019] [Accepted: 09/16/2019] [Indexed: 11/23/2022] Open
Abstract
When a cognitive ability is assessed repeatedly, test scores and ability estimates are often observed to increase across test sessions. This phenomenon is known as the retest (or practice) effect. One explanation for retest effects is that situational test anxiety interferes with a testee's performance during earlier test sessions, thereby creating systematic measurement bias on the test items (interference hypothesis). Yet, the influence of anxiety diminishes with test repetitions. This explanation is controversial, since the presence of measurement bias during earlier measurement occasions cannot always be confirmed. It is argued that people from the lower end of the ability spectrum become aware of their deficits in test situations and therefore report higher anxiety (deficit hypothesis). In 2014, a structural equation model was proposed that specifically allows the comparison of these two hypotheses with regard to explanatory power for the negative anxiety-ability correlation found in cross-sectional assessments. We extended this model for usage in longitudinal studies to investigate the impact of test anxiety on test performance and on retest effects. A latent neighbor-change growth curve was implemented into the model that enables an estimation of retest effects between all pairs of successive test sessions. Systematic restrictions on model parameters allow testing the hypothetical reduction in anxiety interference over the test sessions, which can be compared to retest effect sizes. In an empirical study with seven measurement occasions, we found that a substantial reduction in interference upon the second test session was associated with the largest retest effect in a figural matrices test, which served as a proxy measure for general intelligence. However, smaller retest effects occurred up to the fourth test administration, whereas evidence for anxiety-induced measurement bias was only produced for the first two test sessions. Anxiety and ability were not negatively correlated at any time when the interference effects were controlled for. Implications, limitations, and suggestions for future research are discussed.
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Affiliation(s)
- David Jendryczko
- Institute of Psychology, Westfälische Wilhelms-Universität Münster, 48149 Münster, Germany.
| | - Jana Scharfen
- Institute of Psychology, Westfälische Wilhelms-Universität Münster, 48149 Münster, Germany.
| | - Heinz Holling
- Institute of Psychology, Westfälische Wilhelms-Universität Münster, 48149 Münster, Germany.
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13
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Paek EJ, Murray LL, Newman SD, Kim DJ. Test-retest reliability in an fMRI study of naming in dementia. BRAIN AND LANGUAGE 2019; 191:31-45. [PMID: 30807893 DOI: 10.1016/j.bandl.2019.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 12/18/2018] [Accepted: 02/12/2019] [Indexed: 06/09/2023]
Abstract
fMRI has been used as an outcome measure in dementia treatment studies, with many previous studies comparing only single pre- and post-treatment fMRI scans to determine treatment-induced neural changes, while utilizing single subject experimental designs. The purpose of the current study was to evaluate fMRI test-retest reliability in dementia patients and typical older adults using noun and verb confrontation naming to evaluate the validity of using a single pre/post-treatment scan comparison. Seven individuals with dementia and 9 control participants were tested three times over two months using the same fMRI procedures. Differences in individual and group level activation patterns were observed that varied across time. Additionally, the extent of variability fluctuated across individuals, groups, and the grammatical category of target words. Our findings suggested that one time fMRI scanning may inadequately represent an individual's typical brain activation pattern, particularly an individual with dementia. Thus, multiple imaging baselines are recommended.
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Affiliation(s)
- Eun Jin Paek
- Department of Audiology and Speech Pathology, University of Tennessee Health Science Center, Knoxville, TN 37996, United States.
| | - Laura L Murray
- School of Communication Sciences and Disorders, Western University, London, Ontario N6G 1H1, Canada.
| | - Sharlene D Newman
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN 47401, United States.
| | - Dae-Jin Kim
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN 47401, United States.
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14
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Martinec Nováková L, Havlíček J. Time, Age, Gender, and Test Practice Effects on Children’s Olfactory Performance: a Two-Year Longitudinal Study. CHEMOSENS PERCEPT 2019. [DOI: 10.1007/s12078-019-09260-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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15
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Weng PH, Chen JH, Chiou JM, Tu YK, Chen TF, Chiu MJ, Tang SC, Yeh SJ, Chen YC. The effect of lifestyle on late-life cognitive change under different socioeconomic status. PLoS One 2018; 13:e0197676. [PMID: 29897986 PMCID: PMC5999076 DOI: 10.1371/journal.pone.0197676] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 05/07/2018] [Indexed: 12/20/2022] Open
Abstract
This study aimed to identify lifestyle factors associated with cognitive change and to explore whether the effect of lifestyle varies by socioeconomic status (SES). Participants aged 65 years and older were recruited from elderly health checkup programs from 2011 to 2013 in Taiwan. Neuropsychological tests, including tests of global cognition, logical memory, executive function, verbal fluency and attention, were administered at baseline (N = 603) and 2 years later (N = 509). After literature review, 9 lifestyle factors and 3 SES indicators were chosen and their effects on cognitive change were evaluated using linear regression adjusting for age, sex, education, APOE ε4 status, and baseline cognitive score. Five lifestyle factors (high vegetable and fish intake, regular exercise, not smoking, and light to moderate alcohol consumption) and 3 SES indicators [annual household income (> 33,333 USD vs. less), occupational complexity (high vs. low mental demanding job), and years of education (> 12 years vs. less)] were found to be protective against cognitive decline (P < 0.1 in any cognitive domains, ß ranging from 0.06 to 0.38). After further adjusting for all the lifestyle and SES factors, fish intake, higher income and occupational complexity remained protective. Significant interactions were found between a healthful lifestyle (defined as having ≥ 3 healthful lifestyle factors) and income on changes of global cognition and verbal fluency (Pinteraction = 0.02 and 0.04). The protective effect of a healthful lifestyle was observed only among participants with lower income in global cognition and logical memory [ß = 0.17, 95% confidence interval (CI) = 0.07–0.26; ß = 0.30, 95% CI = 0.14–0.46]. To the best of our knowledge, this study for the first time explored how the interactions of lifestyle and SES affect cognitive change. Our findings will aid in developing dementia prevention programs and reduce health inequalities.
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Affiliation(s)
- Pei-Hsuan Weng
- Department of Family Medicine, Taiwan Adventist Hospital, Taipei, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Jen-Hau Chen
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan
| | - Jeng-Min Chiou
- Institute of Statistical Science, Academia Sinica, Taipei, Taiwan
| | - Yu-Kang Tu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ta-Fu Chen
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Jang Chiu
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Sung-Chun Tang
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Shin-Joe Yeh
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yen-Ching Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
- Research Center for Genes, Environment and Human Health, College of Public Health, National Taiwan University, Taipei, Taiwan
- * E-mail:
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16
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Huebner DM, McGarrity LA, Smith TW, Perry NS, Suchy Y. Changes in Executive Function Following a Stressful Interpersonal Task Are Associated With Condomless Anal Intercourse Among Men Who Have Sex With Men. Ann Behav Med 2018; 52:406-411. [PMID: 29684134 DOI: 10.1093/abm/kax020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Executive functioning (EF) describes a set of neurocognitive processes critical to enacting complex health behaviors. However, theoretical frameworks for understanding sexual risk behavior have generally neglected neurocognitive constructs, and beyond a few studies of individuals selected for high substance use, the literature contains virtually no research on this topic with other adults at risk for HIV infection, such as men who have sex with men (MSM). Purpose This study tested whether EF was associated with condomless anal intercourse (CAI) among MSM. Methods Seventy MSM completed cognitive tests assessing EF at two time points-baseline, and approximately 30 min later after engaging in a stressful interpersonal task. Men also reported their sexual behaviors over the past 3 months, including the frequency of CAI. Results Baseline EF was unrelated to CAI. However, CAI was associated with the degree to which performance improved from baseline to post-stressor administration. Compared with norms for practice effects, men who reported CAI improved less than expected from baseline to post-stressor EF performance, whereas men who reported no CAI exhibited a more normative practice effect. Conclusions MSM with histories of greater sexual risk improved less than anticipated from baseline to post-stressor on tests of EF, suggesting that they might be more cognitively depleted by the stressful interpersonal task they engaged in between administrations. It is possible that certain individuals struggle to maintain executive control in stressful interpersonal situations, a finding that could contribute to the difficulty some individuals face executing precautionary behaviors during a sexual encounter.
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Affiliation(s)
- David M Huebner
- Department of Prevention and Community Health, George Washington University, Washington, DC
| | | | - Timothy W Smith
- Department of Psychology, University of Utah, Salt Lake City, UT
| | - Nicholas S Perry
- Department of Psychology, University of Utah, Salt Lake City, UT
| | - Yana Suchy
- Department of Psychology, University of Utah, Salt Lake City, UT
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Steel J, Ferguson A, Spencer E, Togher L. Language and cognitive communication disorder during post-traumatic amnesia: Profiles of recovery after TBI from three cases. Brain Inj 2017; 31:1889-1902. [DOI: 10.1080/02699052.2017.1373200] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Joanne Steel
- Speech Pathology, The University of Newcastle, Newcastle, Australia
- NHMRC Centre of Research Excellence in Brain Recovery, Moving Ahead, Sydney, Australia
| | - Alison Ferguson
- Speech Pathology, The University of Newcastle, Newcastle, Australia
- NHMRC Centre of Research Excellence in Brain Recovery, Moving Ahead, Sydney, Australia
| | | | - Leanne Togher
- Speech Pathology, The University of Sydney, Sydney, Australia
- NHMRC Centre of Research Excellence in Brain Recovery, Moving Ahead, Sydney, Australia
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18
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Samuel RD, Zavdy O, Levav M, Reuveny R, Katz U, Dubnov-Raz G. The Effects of Maximal Intensity Exercise on Cognitive Performance in Children. J Hum Kinet 2017; 57:85-96. [PMID: 28713461 PMCID: PMC5504581 DOI: 10.1515/hukin-2017-0050] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
High intensity physical exercise has previously been found to lead to a decline in cognitive performance of adults. The aim of this study was to determine the effects of maximal intensity exercise on cognitive performance of children. Using a repeated-measures design, 20 children and adolescents aged 8-17 years completed a battery of tests measuring memory and attention. Forward and Backward Digit Span tests, the Rey Auditory-Verbal Learning Test (RAVLT) and the Digit Symbol Substitution Test (DSST) were performed at baseline, immediately after, and one hour after a maximal cardiopulmonary exercise test. Forward and Backward Digit Span scores significantly improved post-recovery compared with baseline measurements. There was a significant decrease in RAVLT scores post-exercise, which returned to baseline values after recovery. The DSST test scores were mildly elevated from post-exercise to after recovery. Maximal intensity exercise in children and adolescents may result in both beneficial and detrimental cognitive effects, including transient impairment in verbal learning. Cognitive functions applying short term memory improve following a recovery period. Parents, educators and coaches should consider these changes in memory and attention following high-intensity exercise activities in children.
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Affiliation(s)
- Roy David Samuel
- Department of Physical Education and Movement, Kibbutzim College of Education Technology and the Arts, Tel Aviv, Israel, and Department of Sport Management, Florida State University, FL, Florida, USA
| | - Ofir Zavdy
- Hebrew University-Hadassah Medical School, Jerusalem, Israel
| | - Miriam Levav
- Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel
| | - Ronen Reuveny
- Edmond J. Safra International Congenital Heart Center, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel
| | - Uriel Katz
- Edmond J. Safra International Congenital Heart Center, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel
| | - Gal Dubnov-Raz
- Exercise, Nutrition and Lifestyle Clinic, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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19
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Arendasy ME, Sommer M. Reducing the effect size of the retest effect: Examining different approaches. INTELLIGENCE 2017. [DOI: 10.1016/j.intell.2017.03.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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20
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Zhou FC, Wang CY, Ungvari GS, Ng CH, Zhou Y, Zhang L, Zhou J, Shum DHK, Man D, Liu DT, Li J, Xiang YT. Longitudinal changes in prospective memory and their clinical correlates at 1-year follow-up in first-episode schizophrenia. PLoS One 2017; 12:e0172114. [PMID: 28245266 PMCID: PMC5330457 DOI: 10.1371/journal.pone.0172114] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Accepted: 01/31/2017] [Indexed: 11/25/2022] Open
Abstract
This study aimed to investigate prospective memory (PM) and the association with clinical factors at 1-year follow-up in first-episode schizophrenia (FES). Thirty-two FES patients recruited from a university-affiliated psychiatric hospital in Beijing and 17 healthy community controls (HCs) were included. Time- and event-based PM (TBPM and EBPM) performances were measured with the Chinese version of the Cambridge Prospective Memory Test (C-CAMPROMPT) at baseline and at one-year follow-up. A number of other neurocognitive tests were also administered. Remission was determined at the endpoint according to the PANSS score ≤ 3 for selected items. Repeated measures analysis of variance revealed a significant interaction between time (baseline vs. endpoint) and group (FES vs. HCs) for EBPM (F(1, 44) = 8.8, p = 0.005) and for all neurocognitive components. Paired samples t-tests showed significant improvement in EBPM in FES (13.1±3.7 vs. 10.3±4.8; t = 3.065, p = 0.004), compared to HCs (15.7±3.6 vs. 16.5±2.3; t = -1.248, p = 0.230). A remission rate of 59.4% was found in the FES group. Analysis of covariance revealed that remitters performed significantly better on EBPM (14.9±2.6 vs. 10.4±3.6; F(1, 25) = 12.2, p = 0.002) than non-remitters at study endpoint. The association between EBPM and 12-month clinical improvement in FES suggests that EBPM may be a potential neurocognitive marker for the effectiveness of standard pharmacotherapy. Furthermore, the findings also imply that PM may not be strictly a trait-related endophenotype as indicated in previous studies.
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Affiliation(s)
- Fu-Chun Zhou
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Chuan-Yue Wang
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Gabor S. Ungvari
- The University of Notre Dame Australia / Marian Centre, Perth, Australia
- School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Chee H. Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Yan Zhou
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Liang Zhang
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Jingjing Zhou
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - David H. K. Shum
- Menzies Health Institute Queensland and School of Applied Psychology, Griffith University, Gold Coast, Queensland, Australia
| | - David Man
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Deng-Tang Liu
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing, China
- IDG/McGovern Institute for Brain Research, Beijing, China
- Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal University, Beijing, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
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21
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Arrieux JP, Cole WR, Ahrens AP. A review of the validity of computerized neurocognitive assessment tools in mild traumatic brain injury assessment. Concussion 2017; 2:CNC31. [PMID: 30202572 PMCID: PMC6093758 DOI: 10.2217/cnc-2016-0021] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 12/19/2016] [Indexed: 11/21/2022] Open
Abstract
Computerized neurocognitive assessment tools (NCATs) offer potential advantages over traditional neuropsychological tests in postconcussion assessments. However, their psychometric properties and clinical utility are still questionable. The body of research regarding the validity and clinical utility of NCATs suggests some support for aspects of validity (e.g., convergent validity) and some ability to distinguish between concussed individuals and controls, though there are still questions regarding the validity of these tests and their clinical utility, especially outside of the acute injury timeframe. In this paper, we provide a comprehensive summary of the existing validity literature for four commonly used and studied NCATs (automated neuropsychological assessment metrics, CNS vital signs, cogstate and immediate post-concussion and cognitive testing) and lay the groundwork for future investigations.
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Affiliation(s)
- Jacques P Arrieux
- Womack Army Medical Center, Fort Bragg, NC, USA.,Defense & Veterans Brain Injury Center (DVBIC), Fort Bragg, NC, USA.,Womack Army Medical Center, Fort Bragg, NC, USA.,Defense & Veterans Brain Injury Center (DVBIC), Fort Bragg, NC, USA
| | - Wesley R Cole
- Womack Army Medical Center, Fort Bragg, NC, USA.,Defense & Veterans Brain Injury Center (DVBIC), Fort Bragg, NC, USA.,Womack Army Medical Center, Fort Bragg, NC, USA.,Defense & Veterans Brain Injury Center (DVBIC), Fort Bragg, NC, USA
| | - Angelica P Ahrens
- Womack Army Medical Center, Fort Bragg, NC, USA.,Defense & Veterans Brain Injury Center (DVBIC), Fort Bragg, NC, USA.,Womack Army Medical Center, Fort Bragg, NC, USA.,Defense & Veterans Brain Injury Center (DVBIC), Fort Bragg, NC, USA
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22
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Gavett BE, Gurnani AS, Saurman JL, Chapman KR, Steinberg EG, Martin B, Chaisson CE, Mez J, Tripodis Y, Stern RA. Practice Effects on Story Memory and List Learning Tests in the Neuropsychological Assessment of Older Adults. PLoS One 2016; 11:e0164492. [PMID: 27711147 PMCID: PMC5053775 DOI: 10.1371/journal.pone.0164492] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 09/26/2016] [Indexed: 11/18/2022] Open
Abstract
Two of the most commonly used methods to assess memory functioning in studies of cognitive aging and dementia are story memory and list learning tests. We hypothesized that the most commonly used story memory test, Wechsler's Logical Memory, would generate more pronounced practice effects than a well validated but less common list learning test, the Neuropsychological Assessment Battery (NAB) List Learning test. Two hundred eighty-seven older adults, ages 51 to 100 at baseline, completed both tests as part of a larger neuropsychological test battery on an annual basis. Up to five years of recall scores from participants who were diagnosed as cognitively normal (n = 96) or with mild cognitive impairment (MCI; n = 72) or Alzheimer's disease (AD; n = 121) at their most recent visit were analyzed with linear mixed effects regression to examine the interaction between the type of test and the number of times exposed to the test. Other variables, including age at baseline, sex, education, race, time (years) since baseline, and clinical diagnosis were also entered as fixed effects predictor variables. The results indicated that both tests produced significant practice effects in controls and MCI participants; in contrast, participants with AD declined or remained stable. However, for the delayed-but not the immediate-recall condition, Logical Memory generated more pronounced practice effects than NAB List Learning (b = 0.16, p < .01 for controls). These differential practice effects were moderated by clinical diagnosis, such that controls and MCI participants-but not participants with AD-improved more on Logical Memory delayed recall than on delayed NAB List Learning delayed recall over five annual assessments. Because the Logical Memory test is ubiquitous in cognitive aging and neurodegenerative disease research, its tendency to produce marked practice effects-especially on the delayed recall condition-suggests a threat to its validity as a measure of new learning, an essential construct for dementia diagnosis.
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Affiliation(s)
- Brandon E. Gavett
- Department of Psychology, University of Colorado Colorado Springs, Colorado Springs, Colorado, United States of America
| | - Ashita S. Gurnani
- Department of Psychology, University of Colorado Colorado Springs, Colorado Springs, Colorado, United States of America
| | - Jessica L. Saurman
- Department of Psychology, University of Colorado Colorado Springs, Colorado Springs, Colorado, United States of America
| | - Kimberly R. Chapman
- Alzheimer's Disease Center, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Eric G. Steinberg
- Alzheimer's Disease Center, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Brett Martin
- Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Christine E. Chaisson
- Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Jesse Mez
- Alzheimer's Disease Center, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Yorghos Tripodis
- Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Robert A. Stern
- Alzheimer's Disease Center, Boston University School of Medicine, Boston, Massachusetts, United States of America
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Cole WR, Arrieux JP, Dennison EM, Ivins BJ. The impact of administration order in studies of computerized neurocognitive assessment tools (NCATs). J Clin Exp Neuropsychol 2016; 39:35-45. [DOI: 10.1080/13803395.2016.1198470] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Sterling NW, Lichtenstein M, Lee EY, Lewis MM, Evans A, Eslinger PJ, Du G, Gao X, Chen H, Kong L, Huang X. Higher Plasma LDL-Cholesterol is Associated with Preserved Executive and Fine Motor Functions in Parkinson's Disease. Aging Dis 2016; 7:237-45. [PMID: 27330838 PMCID: PMC4898920 DOI: 10.14336/ad.2015.1030] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Accepted: 10/30/2015] [Indexed: 11/26/2022] Open
Abstract
Plasma low density lipoprotein (LDL) cholesterol has been associated both with risk of Parkinson's disease (PD) and with age-related changes in cognitive function. This prospective study examined the relationship between baseline plasma LDL-cholesterol and cognitive changes in PD and matched Controls. Fasting plasma LDL-cholesterol levels were obtained at baseline from 64 non-demented PD subjects (62.7 ± 7.9 y) and 64 Controls (61.3 ± 6.8 y). Subjects underwent comprehensive neuropsychological testing at baseline, 18-, and 36-months. Linear mixed-effects modeling was used to assess the relationships between baseline LDL-cholesterol levels and longitudinal cognitive changes. At baseline, PD patients had lower scores of fine motor (p<0.0001), executive set shifting (p=0.018), and mental processing speed (p=0.049) compared to Controls. Longitudinally, Controls demonstrated improved fine motor and memory test scores (p=0.044, and p=0.003), whereas PD patients demonstrated significantly accelerated loss in fine motor skill (p=0.002) compared to Controls. Within the PD group, however, higher LDL-cholesterol levels were associated with improved executive set shifting (β=0.003, p<0.001) and fine motor scores (β=0.002, p=0.030) over time. These associations were absent in Controls (p>0.7). The cholesterol - executive set shifting association differed significantly between PDs and Controls (interaction p=0.005), whereas the cholesterol - fine motor association difference did not reach significance (interaction, p=0.104). In summary, higher plasma LDL-cholesterol levels were associated with better executive function and fine motor performance over time in PD, both of which may reflect an effect on nigrostriatal mediation. Confirmation of these results and elucidation of involved mechanisms are warranted, and might lead to feasible therapeutic strategies.
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Affiliation(s)
- Nicholas W. Sterling
- Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.
| | - Maya Lichtenstein
- Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.
| | - Eun-Young Lee
- Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.
| | - Mechelle M. Lewis
- Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.
- Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.
| | - Alicia Evans
- Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.
| | - Paul J. Eslinger
- Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.
- Public Health Sciences, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.
- Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.
| | - Guangwei Du
- Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.
| | - Xiang Gao
- Department of Nutritional Sciences, the Pennsylvania State University, University Park, PA 16802, USA.
| | - Honglei Chen
- Epidemiology Branch/Aging & Neuroepidemiology Group, National Institute of Environmental Health Sciences, Research Triangle Park, NC 27709, USA
| | - Lan Kong
- Public Health Sciences, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.
| | - Xuemei Huang
- Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.
- Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.
- Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.
- Neurosurgery, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.
- Kinesiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.
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Neuropsychological Practice Effects in the Context of Cognitive Decline: Contributions from Learning and Task Novelty. J Int Neuropsychol Soc 2016; 22:453-66. [PMID: 26790693 DOI: 10.1017/s1355617715001332] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Although cognitive decline is typically associated with decreasing practice effects (PEs) (presumably due to declining memory), some studies show increased PEs with declines in cognition. One explanation for these inconsistencies is that PEs reflect not only memory, but also rebounds from adapting to task novelty (i.e., novelty effect), leading to increased PEs. We examined a theoretical model of relationships among novelty effects, memory, cognitive decline, and within-session PEs. Sixty-six older adults ranging from normal to severely impaired completed measures of memory, novelty effects, and two trials each of Wechsler Adult Intelligence Scale, 4 th Edition Symbol Search and Coding. Interrelationships among variables were examined using regression analyses. PEs for Symbol Search and Coding (a) were related to different proposed PE components (i.e., memory and novelty effects), such that novelty effect predicted Symbol Search PE (R2 =.239, p<.001) and memory predicted Coding PE (R2 =.089, p=.015), and (b) showed different patterns across stages of cognitive decline, such that the greatest cognitive decline was associated with smallest Coding PE (R2 =.125, p=.004), whereas intermediate cognitive decline was associated with the greatest Symbol Search PE (R2 =.097, p=.040). The relationship between cognitive decline and PE for Symbol Search was partially mediated by novelty effect among older adults with abnormal cognitive decline (model R2 =.286, p<.001). These findings (a) suggest that PE is not a unitary construct, (b) offer an explanation for contradictory findings in the literature, and (c) highlight the need for a better understanding of component processes of PE across different neuropsychological measures.
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Examining the feasibility and tolerability of a clinically informed multisite, repetitive transcranial magnetic stimulation protocol. J Neurosci Methods 2016; 258:24-7. [PMID: 26545442 DOI: 10.1016/j.jneumeth.2015.10.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 10/06/2015] [Accepted: 10/27/2015] [Indexed: 11/20/2022]
Abstract
BACKGROUND Multi-site repetitive transcranial magnetic stimulation (rTMS) has been applied experimentally in the treatment of obsessive compulsive disorder (OCD). NEW METHOD This study was conducted to systematically evaluate the safety, tolerability and neurocognitive effects of rTMS applied to three cortical regions over a period of three months. NEW METHOD Twenty healthy participants aged 22-33 years were randomly allocated to receive one session of active or sham stimulation of low and high frequency rTMS applied sequentially to the pre-supplementary motor area, right-dorsolateral prefrontal cortex and left-orbitofrontal cortex totalling 9 min. Tolerability and safety was evaluated using a standardised safety questionnaire. Neurocognitive functioning was examined using the Cambridge Neuropsychological Test Automated Battery and measures of verbal fluency from the Delis-Kaplan Executive Functioning Test™ at five time points over three months. RESULTS The protocol was safe and tolerable. Frequencies of minor adverse effects were higher in active (17 endorsements) than sham (1 endorsement) conditions. No between group differences in neurocognitive functioning were identified over three months. COMPARISON WITH EXISTING METHOD This study is the first to evaluate the feasibility of low and high frequency parameters applied sequentially in a single session to the three selected cortical regions whilst providing neurocognitive data. CONCLUSIONS rTMS applied sequentially over three cortical regions was found to be safe and tolerable in healthy individuals with no major neurocognitive effects over three months. Such findings can be used to inform the development of rTMS protocols involving multi-site stimulation for OCD.
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Magne Bjølseth T, Engedal K, Šaltytė Benth J, Bergsholm P, Strømnes Dybedal G, Lødøen Gaarden T, Tanum L. Speed of recovery from disorientation may predict the treatment outcome of electroconvulsive therapy (ECT) in elderly patients with major depression. J Affect Disord 2016; 190:178-186. [PMID: 26519638 DOI: 10.1016/j.jad.2015.10.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 09/17/2015] [Accepted: 10/10/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND No study has previously investigated whether the speed of recovery from disorientation in the post-ictal period may predict the short-term treatment outcome of electroconvulsive therapy (ECT). METHODS This longitudinal cohort study included 57 elderly patients with unipolar or bipolar major depression, aged 60-85 years, treated with formula-based ECT. Treatment outcome was assessed weekly during the ECT course using the 17-item Hamilton Rating Scale for Depression (HRSD17). The post-ictal reorientation time (PRT) was assessed at the first and third treatments. RESULTS Longer PRTs at the first and third treatments predicted a more rapid decline and a lower end-point in continuous HRSD17 scores (p=0.002 and 0.019, respectively). None of the patients who recovered from disorientation in less than 5 min met the remission criterion, defined as an HRSD17 score of 7 or less. A greater increment in stimulus dosage from the first to the third ECT session rendered a smaller relative decline in PRT (p<0.001). LIMITATIONS The limited number of subjects may reduce the generalizability of the findings. CONCLUSIONS The speed of recovery from disorientation at the first and third sessions seems to be a predictor of the treatment outcome of formula-based ECT, at least in elderly patients with major depression. It remains to be clarified how the PRT may be utilized to guide stimulus dosing.
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Affiliation(s)
- Tor Magne Bjølseth
- Department of Geriatric Psychiatry, Diakonhjemmet Hospital, Oslo, Norway.
| | - Knut Engedal
- Norwegian Centre for Aging and Health, Vestfold Health Trust, Tønsberg, Norway
| | - Jūratė Šaltytė Benth
- Institute of Clinical Medicine, Campus Ahus, University of Oslo, Norway; HØKH, Research Centre, Akershus University Hospital, Norway
| | - Per Bergsholm
- Department of Emergency Mental Health Services, Oslo University Hospital, Ullevål, Norway
| | | | | | - Lars Tanum
- Department of Research and Development in Mental Health, Akershus University Hospital, Norway
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Preece D, Allan A, Becerra R. A case study of the neuropsychological outcomes following microsurgery, conventional radiotherapy and stereotactic radiotherapy for an adult's recurrent craniopharyngioma. Brain Inj 2016; 30:104-11. [PMID: 26736032 DOI: 10.3109/02699052.2015.1104552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To examine the neuropsychological outcomes for an adult patient, 2 years after receiving microsurgery and conventional radiotherapy for a recurrent craniopharyngioma; and the impact of a further intervention, stereotactic radiotherapy, on this level of neuropsychological functioning. PARTICIPANT JD, a 30 year old male whose recurrent craniopharyngioma had 2 years earlier been treated with two operations and conventional radiotherapy. DESIGN JD was assessed (using standardized clinical tests) before and after a course of stereotactic radiotherapy. RESULTS Prior to stereotactic radiotherapy (and 2 years after microsurgery and conventional radiotherapy) JD's IQ was intact, but considerable impairments were present in executive functioning, memory, theory of mind and processing speed. Fifteen months after stereotactic radiotherapy, all neuropsychological domains remained largely static or improved, supporting the utility of this treatment option in the neuropsychological domain. However, deficits in executive functioning, memory and processing speed remained. CONCLUSION These findings suggest that, even after multiple treatments, substantial cognitive impairments can be present in an adult patient with a recurrent craniopharyngioma. This profile of deficits underlines the inadequacy of relying purely on IQ as a marker for cognitive health in this population and emphasizes the need to include neuropsychological impairments as a focus of rehabilitation with these patients.
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Affiliation(s)
- David Preece
- a School of Psychology and Social Science, Edith Cowan University , Perth WA , Australia
| | - Alfred Allan
- a School of Psychology and Social Science, Edith Cowan University , Perth WA , Australia
| | - Rodrigo Becerra
- a School of Psychology and Social Science, Edith Cowan University , Perth WA , Australia
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Burke T, Wynne B, O'Brien C, Elamin M, Bede P, Hardiman O, Pender N. Retrospective investigations of practice effects on repeated neuropsychological measures of executive functioning. ACTA ACUST UNITED AC 2015. [DOI: 10.1080/03033910.2015.1044554] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ibrahim I, Tobar S, Elassy M, Mansour H, Chen K, Wood J, Gur RC, Gur RE, El Bahaei W, Nimgaonkar V. Practice effects distort translational validity estimates for a Neurocognitive Battery. J Clin Exp Neuropsychol 2015; 37:530-7. [PMID: 26054545 DOI: 10.1080/13803395.2015.1037253] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION With the globalization of biomedical research and the advent of "precision medicine," there is increased need for translation of neuropsychological tests, such as computerized batteries that can be incorporated in large-scale genomic studies. Estimates of translational validity are obtained by administering the test in the original and the translated versions to bilingual individuals. We investigated the translation of a neuropsychological battery from English to Arabic and how practice effects influence translational validity estimates. METHODS The Penn computerized neurocognitive battery (Penn CNB) includes tests that were validated with functional neuroimaging and provides measures of accuracy and speed of performance in several cognitive domains. To develop an Arabic version of the CNB, the English version was translated into Arabic, then back translated and revised. The Arabic and the original English versions were administered in a randomized crossover design to bilingual participants (N = 22). RESULTS Performance varied by cognitive domain, but generally improved at the second session regardless of the language of the initial test. When performance on the English and Arabic version was compared, significant positive correlations were detected for accuracy in 8/13 cognitive domains and for speed in 4/13 domains (r = .02 to .97). When the practice estimates using linear models were incorporated, the translational validity estimates improved substantially (accuracy, r = .50-.96, speed, r = .63-.92, all correlations, p = .05 or better). CONCLUSION While crossover designs control for order effects on average performance, practice effects, regardless of language, still need to be removed to obtain estimates of translational validity. When practice effect is controlled for, the Arabic and English versions of the Penn-CNB are well correlated, and the Arabic version is suitable for use in research.
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Affiliation(s)
- Ibtihal Ibrahim
- a Department of Psychiatry , University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic , Pittsburgh , PA , USA
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Pereira DR, Costa P, Cerqueira JJ. Repeated Assessment and Practice Effects of the Written Symbol Digit Modalities Test Using a Short Inter-Test Interval. Arch Clin Neuropsychol 2015; 30:424-34. [DOI: 10.1093/arclin/acv028] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2015] [Indexed: 11/13/2022] Open
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Kayser S, Bewernick BH, Matusch A, Hurlemann R, Soehle M, Schlaepfer TE. Magnetic seizure therapy in treatment-resistant depression: clinical, neuropsychological and metabolic effects. Psychol Med 2015; 45:1073-1092. [PMID: 25420474 DOI: 10.1017/s0033291714002244] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Magnetic seizure therapy (MST), despite being in an early phase of clinical research, has been demonstrated to be associated with antidepressant efficacy. However, safety, tolerability and efficacy data in connection with functional brain activity from larger samples are lacking. The aim of this study was to determine clinical and cognitive effects of MST and the influence of MST on regional brain glucose metabolism. METHOD Twenty-six patients suffering from treatment-resistant depression (TRD) underwent MST. Ten patients underwent a randomized trial and 16 patients an open-label study design. The primary outcome criterion was the severity of depressive symptoms assessed with the Hamilton Depression Rating Scale (HAMD). Depressive symptoms, tolerability and cognitive safety, along with social functioning and quality of life parameters, were assessed using various rating scales. A clinical follow-up visit 6 months following the completion of a course of MST and [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) scans of 12 patients were analysed. RESULTS A significant response to MST was demonstrated by 69% of the patient sample, with 46% meeting remission criteria. Anxiety ratings were significantly reduced in responders and their quality of life was improved. Half of the responders relapsed within 6 months. No cognitive side-effects were observed. FDG-PET scans showed a metabolic increase in the frontal cortex bilaterally and a decrease in the left striatum. CONCLUSIONS Robust antidepressant and anti-anxiety efficacy of MST was demonstrated, and found to be associated with localized metabolic changes in brain areas that are strongly implicated in depression. Thus, MST presents an effective, well-tolerated and safe treatment option for patients unable to respond to other forms of therapy for depression.
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Affiliation(s)
- S Kayser
- Department of Psychiatry and Psychotherapy,University of Bonn,Germany
| | - B H Bewernick
- Department of Psychiatry and Psychotherapy,University of Bonn,Germany
| | - A Matusch
- Institute of Neurosciences and Medicine (INM-2),Forschungszentrum Jülich,Germany
| | - R Hurlemann
- Department of Psychiatry and Psychotherapy,University of Bonn,Germany
| | - M Soehle
- Department of Anaesthesiology and Intensive Care Medicine,University of Bonn,Germany
| | - T E Schlaepfer
- Department of Psychiatry and Psychotherapy,University of Bonn,Germany
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Zaninotto AL, de Paula Guirado VM, Baldivia B, Núñes MD, Amorim RLO, Teixeira MJ, de Lucia MCS, de Andrade AF, Paiva WS. Improvement of verbal fluency in patients with diffuse brain injury over time. Neuropsychiatr Dis Treat 2014; 10:1155-60. [PMID: 25028551 PMCID: PMC4077785 DOI: 10.2147/ndt.s62728] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Diffuse axonal injury (DAI), a common cause of neurological sequelae in patients with traumatic brain injury (TBI), is considered one of the most prevalent forms of primary neuronal injury in patients with severe TBI. Cognitive deficits induced by DAI can persist over time, especially following moderate or severe injuries. The aim of the present study was to compare verbal fluency (VF) performance at 6 and 12 months after the trauma in a same group of patients with DAI. METHODS Eighteen patients with moderate to severe DAI and 17 healthy volunteers were enrolled. All DAI participants had sustained a TBI at least 6 months prior to the start of the study, were between 18 and 50 years of age, and had at least 4 years of education. The VF test was administered within an extensive neuropsychological test battery. We evaluated the same patients at 6 months (DAI1 group) and 12 months (DAI2 group) and compared the results of neuropsychological tests with a control group of healthy volunteers who were matched to patients for sex, age, and educational level. RESULTS In comparison to controls, the DAI1 group produced significantly fewer words. The DAI2 group produced significantly more semantic words than DAI1 (P<0.05) and demonstrated a trend towards the production of more clusters for letter A (P=0.09) and total words generated in a phonemic test (P=0.09). No significant differences were observed between DAI2 and the control group in the total number of words generated in phonetic FAS or semantic fluency scores. CONCLUSION The present findings may be useful in the construction of a management plan for long-term TBI rehabilitation that considers the trauma of each patient. Further, our results suggest the VF test is a suitable instrument for the assessment of cognitive difficulties following TBI.
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Affiliation(s)
- Ana Luiza Zaninotto
- Division of Psychology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
| | | | - Beatriz Baldivia
- Division of Psychology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
| | - Monica Domiano Núñes
- Division of Psychology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
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Cavaco S, Gonçalves A, Pinto C, Almeida E, Gomes F, Moreira I, Fernandes J, Teixeira-Pinto A. Semantic Fluency and Phonemic Fluency: Regression-based Norms for the Portuguese Population. Arch Clin Neuropsychol 2013; 28:262-71. [DOI: 10.1093/arclin/act001] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Lee KS, Jeon MJ, Hwang TY, Kim CY, Sakong J. Evaluation of reliability of computerized neurobehavioral tests in Korean children. Neurotoxicology 2012; 33:1362-7. [PMID: 22981304 DOI: 10.1016/j.neuro.2012.08.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Revised: 08/28/2012] [Accepted: 08/28/2012] [Indexed: 11/25/2022]
Abstract
Neurobehavioral tests are among the most efficient methods of identifying the adverse health effects of neurotoxicants. The reliability of neurobehavioral tests may be affected by racial or cultural backgrounds, but the widely used computerized neurobehavioral tests have been developed and standardized for Western children. It is thus necessary to assess the reliability of the existing computerized neurobehavioral tests for Korean children. For this reason, 254 healthy 7- to 8-year-old Korean children completed a neurobehavioral test-retest, with the test and retest held two months apart. Six neurobehavioral test items adapted from Korean Computerized Neurobehavioral Tests (KCNT) and modified to match the children's ability levels: Simple Reaction Time, Choice Reaction Time, Color Word Vigilance, Addition, Symbol Digit, and Finger Tapping Speed. The test reliability was assessed using the Pearson product-moment correlation coefficient (r) and the intraclass correlation coefficient (ICC). The ICCs ranged from 0.46 to 0.84 and were very similar to the Pearson coefficients. High reliability was detected in Symbol Digit (r=0.84, ICC=0.83), followed by the Finger Tapping Speed of the dominant hand (r=0.67, ICC=0.67) and of the non-dominant hand (r=0.65, ICC=0.65). The study findings suggest that the reliability of most computerized neurobehavioral tests is appropriate for epidemiological researches on Korean children, and that Symbol Digit and Finger Tapping Speed are more satisfactory bases for the periodic examination of neurobehavioral performance. These findings can also be useful in the future assembly of a neurobehavioral test battery, by providing more stable neurobehavioral test items for Korean children.
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Affiliation(s)
- Kyeong-Soo Lee
- Department of Preventive Medicine and Public Health, College of Medicine, Yeungnam University, 317-1 Daemyung-dong, Nam-gu, Daegu 705-717, Republic of Korea
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Calamia M, Markon K, Tranel D. Scoring Higher the Second Time Around: Meta-Analyses of Practice Effects in Neuropsychological Assessment. Clin Neuropsychol 2012; 26:543-70. [DOI: 10.1080/13854046.2012.680913] [Citation(s) in RCA: 248] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Woods DL, Herron TJ, Yund EW, Hink RF, Kishiyama MM, Reed B. Computerized analysis of error patterns in digit span recall. J Clin Exp Neuropsychol 2012; 33:721-34. [PMID: 21957866 DOI: 10.1080/13803395.2010.550602] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
We analyzed error patterns during digit span (DS) testing in four experiments. In Experiment 1, error patterns analyzed from a community sample of 427 subjects revealed strong primacy and recency effects. Subjects with shorter DSs showed an increased incidence of transposition errors in comparison with other error types and a greater incidence of multiple errors on incorrect trials. Experiment 2 investigated 46 young subjects in three test sessions. The results replicated those of Experiment 1 and demonstrated that error patterns of individual subjects were consistent across repeated test administrations. Experiment 3 investigated 40 subjects from Experiment 2 who feigned symptoms of traumatic brain injury (TBI) with 80% of malingering subjects producing digit spans in the abnormal range. A digit span malingering index (DSMI) was developed to detect atypical error patterns in malingering subjects. Overall, 59% of malingering subjects with abnormal digit spans showed DSMIs in the abnormal range and DSMI values correlated significantly with the magnitude of malingering. Experiment 4 compared 29 patients with TBI with a new group of 38 control subjects. The TBI group showed significant reductions in digit span. Overall, 32% of the TBI patients showed DS abnormalities and 11% showed abnormal DSMIs. Computerized error-pattern analysis improves the sensitivity of DS assessment and can assist in the detection of malingering.
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Affiliation(s)
- David L Woods
- Human Cognitive Neurophysiology Laboratory, Veterans Affairs Northern California Health Care System, Martinez, CA, USA.
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Langner R, Eickhoff SB, Steinborn MB. Mental fatigue modulates dynamic adaptation to perceptual demand in speeded detection. PLoS One 2011; 6:e28399. [PMID: 22145041 PMCID: PMC3228758 DOI: 10.1371/journal.pone.0028399] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Accepted: 11/07/2011] [Indexed: 01/07/2023] Open
Abstract
When stimulus intensity in simple reaction-time tasks randomly varies across trials, detection speed usually improves after a low-intensity trial. With auditory stimuli, this improvement was often found to be asymmetric, being greater on current low-intensity trials. Our study investigated (1) whether asymmetric sequential intensity adaptation also occurs with visual stimuli; (2) whether these adjustments reflect decision-criterion shifts or, rather, a modulation of perceptual sensitivity; and (3) how sequential intensity adaptation and its underlying mechanisms are affected by mental fatigue induced through prolonged performance. In a continuous speeded detection task with randomly alternating high- and low-intensity visual stimuli, the reaction-time benefit after low-intensity trials was greater on subsequent low- than high-intensity trials. This asymmetry, however, only developed with time on task (TOT). Signal-detection analyses showed that the decision criterion transiently became more liberal after a low-intensity trial, whereas observer sensitivity increased when the preceding and current stimulus were of equal intensity. TOT-induced mental fatigue only affected sensitivity, which dropped more on low- than on high-intensity trials. This differential fatigue-related sensitivity decrease selectively enhanced the impact of criterion down-shifts on low-intensity trials, revealing how the interplay of two perceptual mechanisms and their modulation by fatigue combine to produce the observed overall pattern of asymmetric performance adjustments to varying visual intensity in continuous speeded detection. Our results have implications for similar patterns of sequential demand adaptation in other cognitive domains as well as for real-world prolonged detection performance.
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Affiliation(s)
- Robert Langner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany.
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Abstract
Neuropsychological assessments are increasingly in demand for a wide range of patients. This paper offers a survey of the basic aspects of neuropsychological assessment that are of greatest importance for professionals (e.g., psychologists, psychiatrists, social workers, and lawyers) who are not trained in neuropsychological testing, but who refer clients for neuropsychological assessment. This survey could also serve neuropsychologists in their early stages of training, by addressing some of the major issues related to the assessment process. The range of goals that neuropsychological assessment may attain is first outlined. Next, a model is presented that explains the rationale enabling generalization from assessment to real-world functions that are the focus of interest and the target of prediction. Issues that need to be considered before deciding to conduct a neuropsychological evaluation are then introduced, and sources of information available to the assessor are described. A description is provided of what a neuropsychological assessment includes, with an emphasis on its cognitive aspects. Finally, mention is made of some of the difficulties and challenges that must be confronted in the course of a neuropsychological assessment.
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Affiliation(s)
- Eli Vakil
- Department of Psychology and Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel.
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Grubert C, Hurlemann R, Bewernick BH, Kayser S, Hadrysiewicz B, Axmacher N, Sturm V, Schlaepfer TE. Neuropsychological safety of nucleus accumbens deep brain stimulation for major depression: effects of 12-month stimulation. World J Biol Psychiatry 2011; 12:516-27. [PMID: 21736514 DOI: 10.3109/15622975.2011.583940] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Deep brain stimulation (DBS) to the nucleus accumbens (NAcc-DBS) has antidepressant effects in patients suffering from treatment-resistant depression (TRD). However, limited information exists regarding the impact of NAcc-DBS on cognitive functioning. The aim of this study was to examine whether NAcc-DBS in patients with TRD has any cognitive effects. METHODS A comprehensive neuropsychological battery was administered to 10 patients with TRD before onset of bilateral NAcc-DBS and after 1 year of DBS stimulation. Neuropsychological testing covered the domains of attention, learning and memory, executive functions, visual perception, and language. Performance was analyzed at baseline and after 1 year of continuous DBS. RESULTS No evidence was found for cognitive decline following NAcc-DBS comparing test results after 1 year of NAcc-DBS with baseline. However, significantly improved cognitive performance on tests of attention, learning and memory, executive functions and visual perception was found. In addition, there was a general trend towards cognitive enhancement from below average to average performance. These procognitive effects were independent of the antidepressant effects of NAcc-DBS or changes in NAcc-DBS parameters. CONCLUSIONS These results not only support cognitive safety of NAcc-DBS but also stress its beneficial role in augmenting cognitive performance in patients with TRD.
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Affiliation(s)
- Christiane Grubert
- Department of Psychiatry and Psychotherapy, University Hospital, Bonn, Germany
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Zahodne LB, Bowers D, Price CC, Bauer RM, Nisenzon A, Foote KD, Okun MS. The case for testing memory with both stories and word lists prior to dbs surgery for Parkinson's Disease. Clin Neuropsychol 2011; 25:348-58. [PMID: 21491347 DOI: 10.1080/13854046.2011.562869] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Patients seeking deep brain stimulation (DBS) surgery for Parkinson's disease (PD) typically undergo neuropsychological assessment to determine candidacy for surgery, with poor memory performance interpreted as a contraindication. Patients with PD may exhibit worse memory for word lists than for stories due to the lack of inherent organization in a list of unrelated words. Unfortunately, word list and story tasks are typically developed from different normative datasets, and the existence of a memory performance discrepancy in PD has been challenged. We compared recall of stories and word lists in 35 non-demented PD candidates for DBS. We administered commonly used neuropsychological measures of word list and story memory (Hopkins Verbal Learning Test, Logical Memory), along with a second word list task that was co-normed with the story task. Age-corrected scores were higher for the story task than for both word list tasks. Compared to story recall, word list recall correlated more consistently with motor severity and composite measures of processing speed, working memory, and executive functioning. These results support the classic view of fronto-subcortical contributions to memory in PD and suggest that executive deficits may influence word list recall more than story recall. We recommend a multi-componential memory battery in the neuropsychological assessment of DBS candidates to characterize both mesial temporal and frontal-executive memory processes. One should not rely solely on a word list task because patients exhibiting poor memory for word lists may perform better with stories and therefore deserve an interdisciplinary discussion for DBS surgery.
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Affiliation(s)
- Laura B Zahodne
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
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Corbacio M, Brown S, Dubois S, Goulet D, Prato FS, Thomas AW, Legros A. Human cognitive performance in a 3 mT power-line frequency magnetic field. Bioelectromagnetics 2011; 32:620-33. [DOI: 10.1002/bem.20676] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2010] [Accepted: 04/10/2011] [Indexed: 11/07/2022]
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Heilbronner RL, Sweet JJ, Attix DK, Krull KR, Henry GK, Hart RP. Official position of the american academy of clinical neuropsychology on serial neuropsychological assessments: the utility and challenges of repeat test administrations in clinical and forensic contexts. Clin Neuropsychol 2010; 24:1267-78. [DOI: 10.1080/13854046.2010.526785] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Bartels C, Wegrzyn M, Wiedl A, Ackermann V, Ehrenreich H. Practice effects in healthy adults: a longitudinal study on frequent repetitive cognitive testing. BMC Neurosci 2010; 11:118. [PMID: 20846444 PMCID: PMC2955045 DOI: 10.1186/1471-2202-11-118] [Citation(s) in RCA: 266] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2010] [Accepted: 09/16/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cognitive deterioration is a core symptom of many neuropsychiatric disorders and target of increasing significance for novel treatment strategies. Hence, its reliable capture in long-term follow-up studies is prerequisite for recording the natural course of diseases and for estimating potential benefits of therapeutic interventions. Since repeated neuropsychological testing is required for respective longitudinal study designs, occurrence, time pattern and magnitude of practice effects on cognition have to be understood first under healthy good-performance conditions to enable design optimization and result interpretation in disease trials. METHODS Healthy adults (N = 36; 47.3 ± 12.0 years; mean IQ 127.0 ± 14.1; 58% males) completed 7 testing sessions, distributed asymmetrically from high to low frequency, over 1 year (baseline, weeks 2-3, 6, 9, months 3, 6, 12). The neuropsychological test battery covered 6 major cognitive domains by several well-established tests each. RESULTS Most tests exhibited a similar pattern upon repetition: (1) Clinically relevant practice effects during high-frequency testing until month 3 (Cohen's d 0.36-1.19), most pronounced early on, and (2) a performance plateau thereafter upon low-frequency testing. Few tests were non-susceptible to practice or limited by ceiling effects. Influence of confounding variables (age, IQ, personality) was minor. CONCLUSIONS Practice effects are prominent particularly in the early phase of high-frequency repetitive cognitive testing of healthy well-performing subjects. An optimal combination and timing of tests, as extractable from this study, will aid in controlling their impact. Moreover, normative data for serial testing may now be collected to assess normal learning curves as important comparative readout of pathological cognitive processes.
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Affiliation(s)
- Claudia Bartels
- Division of Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Martin Wegrzyn
- Division of Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Anne Wiedl
- Division of Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Verena Ackermann
- Division of Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Hannelore Ehrenreich
- Division of Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
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Wefel JS, Saleeba AK, Buzdar AU, Meyers CA. Acute and late onset cognitive dysfunction associated with chemotherapy in women with breast cancer. Cancer 2010; 116:3348-56. [PMID: 20564075 DOI: 10.1002/cncr.25098] [Citation(s) in RCA: 353] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Growing evidence supports cognitive dysfunction associated with standard dose chemotherapy in breast cancer survivors. We determined the incidence, nature, and chronicity of cognitive dysfunction in a prospective longitudinal randomized phase 3 treatment trial for patients with T1-3, N0-1, M0 breast cancer receiving 5-fluorouracil, doxorubicin, and cyclophosphamide with or without paclitaxel. METHODS Forty-two patients underwent a neuropsychological evaluation including measures of cognition, mood, and quality of life. Patients were scheduled to be assessed before chemotherapy, during and shortly after chemotherapy, and 1 year after completion of chemotherapy. RESULTS Before chemotherapy, 21% (9 of 42) evidenced cognitive dysfunction. In the acute interval, 65% (24 of 37) demonstrated cognitive decline. At the long-term evaluation, 61% (17 of 28) evidenced cognitive decline after cessation of treatment. Within this group of patients, 71% (12 of 17) evidenced continuous decline from the acute interval, and, notably, 29% (5 of 17) evidenced new delayed cognitive decline. Cognitive decline was most common in the domains of learning and memory, executive function, and processing speed. Cognitive decline was not associated with mood or other measured clinical or demographic characteristics, but late decline may be associated with baseline level of performance. CONCLUSIONS Standard dose systemic chemotherapy is associated with decline in cognitive function during and shortly after completion of chemotherapy. In addition, delayed cognitive dysfunction occurred in a large proportion of patients. These findings are consistent with a developing body of translational animal research demonstrating both acute and delayed structural brain changes as well as functional changes associated with common chemotherapeutic agents such as 5-fluorouracil.
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Affiliation(s)
- Jeffrey S Wefel
- The University of Texas M. D. Anderson Cancer Center, Section of Neuropsychology, Department of Neuro-Oncology, Houston, Texas 77230-1402, USA.
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Hoekert M, Vingerhoets G, Aleman A. Results of a pilot study on the involvement of bilateral inferior frontal gyri in emotional prosody perception: an rTMS study. BMC Neurosci 2010; 11:93. [PMID: 20698964 PMCID: PMC2925361 DOI: 10.1186/1471-2202-11-93] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2009] [Accepted: 08/10/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The right hemisphere may play an important role in paralinguistic features such as the emotional melody in speech. The extent of this involvement however is unclear. Imaging studies have shown involvement of both left and right inferior frontal gyri in emotional prosody perception. The present pilot study examined whether these brain areas are critically involved in the processing of emotional prosody and of semantics in 9 healthy subjects. Repetitive transcranial magnetic stimulation was used with a coil centred over left and right inferior frontal gyri, as localized by neuronavigation based on the subject's MRI. A sham condition was included. An online-TMS approach was applied; an emotional language task was completed during stimulation. This computerized task consisted of sentences pronounced by actors. In the semantics condition an emotion (fear, anger or neutral) was expressed in the content pronounced with a neutral intonation. In the prosody condition the emotion was expressed in the intonation, while the content was neutral. RESULTS Reaction times on the emotional prosody task condition were significantly longer after rTMS over both the right and the left inferior frontal gyrus as compared to sham stimulation and after controlling for learning effects associated with order of condition. When taking all emotions together, there was no difference in effect on reaction times between the right and left stimulation. For the emotion Fear, reaction times were significantly longer after stimulating the left inferior frontal gyrus as compared to the right inferior frontal gyrus. Reaction times in the semantics task condition were not significantly different between the three TMS conditions. CONCLUSIONS The data indicate a critical involvement of both the right and the left inferior frontal gyrus in emotional prosody perception. The findings of this pilot study need replication. Future studies should include more subjects and examine whether the left and right inferior frontal gyrus play a differential role and complement each other, e.g. in the integrated processing of linguistic and prosodic aspects of speech, respectively.
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Affiliation(s)
- Marjolijn Hoekert
- BCN-Neuroimaging Center, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 2, PO Box 196, 9700 AD Groningen, the Netherlands.
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Friedman MA, Fernandez M, Wefel JS, Myszka KA, Champlin RE, Meyers CA. Course of Cognitive Decline in Hematopoietic Stem Cell Transplantation: A Within-subjects Design. Arch Clin Neuropsychol 2009; 24:689-98. [DOI: 10.1093/arclin/acp060] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
The cognitive profile and outcome of Encephalitis Lethargica has not been systematically described in the literature. Treatment has typically focused upon medical management. The first case report of a patient with Encephalitis Lethargica who underwent a systematic programme of cognitive rehabilitation is presented. Initial neuropsychological assessment conducted during her acute presentation indicated generalized cognitive dysfunction, including memory and executive function impairments. An outpatient cognitive rehabilitation programme addressed the development of awareness and the remediation of memory and executive function impairments. Repeat assessment indicated significant improvement in cognitive function. The components of her rehabilitation programme are discussed. She has been able to successfully return to her pre-morbid level of work responsibility within 8 months of her admission.
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Affiliation(s)
- Bonnie-Kate Dewar
- MRC Cognition and Brain Sciences Unit, Aldenbrooke's Hospital, Cambridge, UK.
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Watson MJ, Crosby P, Matthews M. An evaluation of the effects of a dynamic lycra® orthosis on arm function in a late stage patient with acquired brain injury. Brain Inj 2009; 21:753-61. [PMID: 17653949 DOI: 10.1080/02699050701481613] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PRIMARY OBJECTIVE The aim of this study was to assess the effect of a dynamic lycra orthosis in the management of upper limb paresis in a late stage stroke patient. RESEARCH DESIGN A single case experiment, adopting a 3-phase ABA withdrawal design (without follow-up), approximately 6-weeks per phase, intervention being delivered in the middle/B phase. METHOD AND PROCEDURES Assessment of arm function was carried out on a weekly basis for the 18-weeks, using a battery of upper limb tests. The subject was prescribed a tailor-made lycra orthosis which was worn daily during the middle phase of the trial. MAIN OUTCOMES AND RESULTS Orthosis wear appeared to result in improvements in active range of movement, self-rated function and one component of a writing test, with some suggestion of a carryover effect when treatment was withdrawn. No intervention-related changes were seen in a dressing test. Ambiguous results were seen in a further writing test and a peg board manipulation assessment. Irrespective of intervention, the subject made positive changes in scores in the majority of assessments used, throughout the 18-week period. CONCLUSIONS The findings suggest that a lycra orthosis may have some beneficial effects on upper limb function late after brain injury. Results were however equivocal, suggesting (a) that effect mechanisms may be quite complex and (b) that future evaluations may require careful construction.
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Affiliation(s)
- Martin J Watson
- School of Allied Health Professions, Faculty of Health, University of East Anglia, Norwich, UK.
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Macniven JAB, Graham NL, Davies RR, Wilson BA. A 5-year follow-up study of an atypical case of myotonic dystrophy. Brain Inj 2009; 19:1213-21. [PMID: 16286337 DOI: 10.1080/02699050500283509] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study presents 5-year follow-up data on NG, a woman with adult onset myotonic dystrophy and progressive cognitive decline who was first described by Wilson et al. The extent of the cognitive impairment is atypical of symptom-onset in adulthood and of paternal inheritance, both of which apply to this case. Together, the present and earlier studies report the results of regular neuropsychological assessments over a 16-year period. Severe impairment in executive functioning, episodic and semantic memory were apparent early in the history, while visuospatial skills and working memory were only mildly impaired after 16 years of follow-up. There was also a progressive dyslexia, initially characterized by the regularization errors typical of surface dyslexia, but subsequently dominated by visual/phonological reading errors. This pattern of impairment is not typical of myotonic dystrophy but resembles semantic dementia. Whilst the deficits may be attributable wholly to myotonic dystrophy pathology, the co-existence of a form of semantic dementia is also possible. It is noted that the aggregation of tau protein is a neuropathological feature common to both diseases.
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Affiliation(s)
- J A B Macniven
- Medical School, c/o Psychopharmacology, University Hospital, Queen's Medical Centre, Nottingham, UK.
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