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Karstens AJ, Christianson TJ, Lundt ES, Machulda MM, Mielke MM, Fields JA, Kremers WK, Graff-Radford J, Vemuri P, Jack CR, Knopman DS, Petersen RC, Stricker NH. Mayo normative studies: regression-based normative data for ages 30-91 years with a focus on the Boston Naming Test, Trail Making Test and Category Fluency. J Int Neuropsychol Soc 2024; 30:389-401. [PMID: 38014536 PMCID: PMC11014770 DOI: 10.1017/s1355617723000760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
OBJECTIVE Normative neuropsychological data are essential for interpretation of test performance in the context of demographic factors. The Mayo Normative Studies (MNS) aim to provide updated normative data for neuropsychological measures administered in the Mayo Clinic Study of Aging (MCSA), a population-based study of aging that randomly samples residents of Olmsted County, Minnesota, from age- and sex-stratified groups. We examined demographic effects on neuropsychological measures and validated the regression-based norms in comparison to existing normative data developed in a similar sample. METHOD The MNS includes cognitively unimpaired adults ≥30 years of age (n = 4,428) participating in the MCSA. Multivariable linear regressions were used to determine demographic effects on test performance. Regression-based normative formulas were developed by first converting raw scores to normalized scaled scores and then regressing on age, age2, sex, and education. Total and sex-stratified base rates of low scores (T < 40) were examined in an older adult validation sample and compared with Mayo's Older Americans Normative Studies (MOANS) norms. RESULTS Independent linear regressions revealed variable patterns of linear and/or quadratic effects of age (r2 = 6-27% variance explained), sex (0-13%), and education (2-10%) across measures. MNS norms improved base rates of low performance in the older adult validation sample overall and in sex-specific patterns relative to MOANS. CONCLUSIONS Our results demonstrate the need for updated norms that consider complex demographic associations on test performance and that specifically exclude participants with mild cognitive impairment from the normative sample.
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Affiliation(s)
- Aimee J. Karstens
- Division of Neurocognitive Disorders, Department of
Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Teresa J. Christianson
- Division of Biomedical Statistics and Informatics,
Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Emily S. Lundt
- Division of Biomedical Statistics and Informatics,
Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Mary M. Machulda
- Division of Neurocognitive Disorders, Department of
Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Michelle M. Mielke
- Department of Epidemiology and Prevention, Wake Forest
University School of Medicine, Winston-Salem, NC, USA
- Department of Gerontology and Geriatric Medicine, Wake
Forest University School of Medicine, Winston-Salem, NC, USA
| | - Julie A. Fields
- Division of Neurocognitive Disorders, Department of
Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Walter K. Kremers
- Division of Biomedical Statistics and Informatics,
Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | | | | | | | - Nikki H. Stricker
- Division of Neurocognitive Disorders, Department of
Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
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Smetana RM, Batchala PP, Lee BG, Albataineh T, Broshek DK, Fountain NB, Abbas S, Quigg M. Multifocal hypometabolic correlates to deficits of verbal memory in mesial temporal lobe epilepsy. Epilepsy Behav 2023; 143:109244. [PMID: 37192585 DOI: 10.1016/j.yebeh.2023.109244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND AND OBJECTIVES Neuropsychological research on mesial temporal lobe epilepsy (MTLE) often highlights material-specific memory deficits, but a lesion-focused model may not accurately reflect the underlying networks that support episodic memory in these patients. Our study evaluated the pathophysiology behind verbal learning/memory deficits as revealed by hypometabolism quantified through 18-fluorodeoxyglucose positron emission tomography (FDG-PET). METHODS This retrospective study included thirty presurgical patients with intractable unilateral MTLE who underwent interictal FDG-PET and verbal memory assessment (12 females, mean age: 38.73 years). Fluorodeoxyglucose-positron emission tomography mapping was performed with voxel-based mapping of glucose utilization to a database of age-matched controls to derive regional Z-scores. Neuropsychological outcome variables included scores on learning and recall trials of two distinct verbal memory measures validated for use in epilepsy research. Pearson's correlations evaluated relationships between clinical variables and verbal memory. Linear regression was used to relate regional hypometabolism and verbal memory assessment. Post hoc analyses assessed areas of FDG-PET hypometabolism (threshold Z ≤ -1.645 below mean) where verbal memory was impaired. RESULTS Verbal memory deficits correlated with hypometabolism in limbic structures ipsilateral to language dominance but also correlated with hypometabolism in networks involving the ipsilateral perisylvian cortex and contralateral limbic and nonlimbic structures. DISCUSSION We conclude that traditional models of verbal memory may not adequately capture cognitive deficits in a broader sample of patients with MTLE. This study has important implications for epilepsy surgery protocols that use neuropsychological data and FDG-PET to draw conclusions about surgical risks.
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Affiliation(s)
- Racheal M Smetana
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, USA.
| | - Prem P Batchala
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, USA.
| | - Bern G Lee
- Department of Neuropsychology, Ochsner Health, Baton Rouge, LA, USA.
| | - Tamer Albataineh
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, USA.
| | - Donna K Broshek
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, USA.
| | - Nathan B Fountain
- Comprehensive Epilepsy Program, Department of Neurology, University of Virginia, Charlottesville, VA, USA.
| | - Salma Abbas
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, USA.
| | - Mark Quigg
- Comprehensive Epilepsy Program, Department of Neurology, University of Virginia, Charlottesville, VA, USA.
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Loring DW, Saurman JL, John SE, Bowden SC, Lah JJ, Goldstein FC. The Rey Auditory Verbal Learning Test: Cross-validation of Mayo Normative Studies (MNS) demographically corrected norms with confidence interval estimates. J Int Neuropsychol Soc 2023; 29:397-405. [PMID: 35481552 PMCID: PMC9844155 DOI: 10.1017/s1355617722000248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The Mayo Normative Studies (MNS) represents a robust dataset that provides demographically corrected norms for the Rey Auditory Verbal Learning Test. We report MNS application to an independent cohort to evaluate whether MNS norms accurately adjust for age, sex, and education differences in subjects from a different geographic region of the country. As secondary goals, we examined item-level patterns, recognition benefit compared to delayed free recall, and derived Auditory Verbal Learning Test (AVLT) confidence intervals (CIs) to facilitate clinical performance characterization. METHOD Participants from the Emory Healthy Brain Study (463 women, 200 men) who were administered the AVLT were analyzed to demonstrate expected demographic group differences. AVLT scores were transformed using MNS normative correction to characterize the success of MNS demographic adjustment. RESULTS Expected demographic effects were observed across all primary raw AVLT scores. Depending on sample size, MNS normative adjustment either eliminated or minimized all observed statistically significant AVLT differences. Estimated CIs yielded broad CI ranges exceeding the standard deviation of each measure. The recognition performance benefit across age ranged from 2.7 words (SD = 2.3) in the 50-54-year-old group to 4.7 words (SD = 2.7) in the 70-75-year-old group. CONCLUSIONS These findings demonstrate generalizability of MNS normative correction to an independent sample from a different geographic region, with demographic adjusted performance differences close to overall performance levels near the expected value of T = 50. A large recognition performance benefit is commonly observed in the normal aging process and by itself does not necessarily suggest a pathological retrieval deficit.
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Affiliation(s)
- David W. Loring
- Department of Neurology, Emory University, School of Medicine, Atlanta, USA
- Department of Pediatrics, Emory University, School of Medicine, Atlanta, USA
| | - Jessica L. Saurman
- Department of Neurology, Emory University, School of Medicine, Atlanta, USA
| | - Samantha E. John
- Department of Brain Health, University of Nevada, Las Vegas, USA
| | - Stephen C. Bowden
- Melbourne School of Psychological Sciences, University of Melbourne, Australia
| | - James J. Lah
- Department of Neurology, Emory University, School of Medicine, Atlanta, USA
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Mock N, Balzer C, Gutbrod K, Jäncke L, Wandel J, Bonati L, Trost W. Nonverbal memory tests revisited: Neuroanatomical correlates and differential influence of biasing cognitive functions. Cortex 2023; 164:63-76. [PMID: 37201378 DOI: 10.1016/j.cortex.2023.03.012] [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: 09/14/2022] [Revised: 02/01/2023] [Accepted: 03/31/2023] [Indexed: 05/20/2023]
Abstract
The detection of right temporal lobe dysfunction with nonverbal memory tests has remained difficult in the past. Reasons for this might be the potential influence of other biasing cognitive functions such as executive functions or the verbalisability of nonverbal material. The aim of this study was to investigate three classic nonverbal memory tests by identifying their neuroanatomical correlates with lesion-symptom mapping (LSM) and by probing their independence from verbal encoding abilities and executive functions. In a cohort of 119 patients with first-time cerebrovascular accident, memory performance was assessed in the Nonverbal Learning and Memory Test for Routes (NLMTR), the Rey Complex Figure Test (RCFT), and the Visual Design Learning Test (VDLT). Calculating multivariate LSM, we identified crucial brain structures for these three nonverbal memory tests. Behavioural analyses were performed to assess the impact of executive functions and verbal encoding abilities with regression analyses and likelihood-ratio tests. LSM revealed for the RCFT mainly right-hemispheric frontal, insular, subcortical, and white matter structures and for the NLMTR right-hemispheric temporal (hippocampus), insular, subcortical, and white matter structures. The VDLT did not reach significance in LSM analyses. Behavioural results showed that amongst the three nonverbal memory tests the impact of executive functions was most pronounced for RCFT, and the impact of verbal encoding abilities was most important in VDLT. Likelihood-ratio tests confirmed that only for NLMTR did the goodness of fit not significantly improve by adding executive functions or verbal encoding abilities. These results suggest that amongst the three nonverbal memory tests the NLMTR, as a spatial navigation test, could serve as the most suitable marker of right-hemispheric temporal lobe functioning, with the right hippocampus being involved only in this test. In addition, the behavioural results propose that only NLMTR seems mostly unaffected by executive functions and verbal encoding abilities.
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Affiliation(s)
- Nadia Mock
- Research Department, Reha Rheinfelden, Rheinfelden, Switzerland; Department of Psychology, University of Zurich, Zurich, Switzerland; Department of Neurology, Zurich University Hospital, Zurich, Switzerland.
| | | | - Klemens Gutbrod
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Neurozentrum Bern, Switzerland
| | - Lutz Jäncke
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Jasmin Wandel
- Institute for Optimisation and Data Analysis, Bern University of Applied Sciences, Switzerland
| | - Leo Bonati
- Research Department, Reha Rheinfelden, Rheinfelden, Switzerland; Department of Neurology, Department of Clinical Research, Basel University Hospital, Switzerland
| | - Wiebke Trost
- Research Department, Reha Rheinfelden, Rheinfelden, Switzerland
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Puligheddu M, Congiu P, Figorilli M, Tamburrino L, Pisanu P, Coa R, Mascia MG, Fonti D, Lecca R, Grossi E, Gagliano A. Neuropsychological and Behavioral Profile in Sleep-Related Hypermotor Epilepsy (SHE) and Disorders of Arousal (DOA): A Multimodal Analysis. J Clin Med 2023; 12:jcm12010374. [PMID: 36615172 PMCID: PMC9820873 DOI: 10.3390/jcm12010374] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 12/22/2022] [Accepted: 12/27/2022] [Indexed: 01/04/2023] Open
Abstract
STUDY OBJECTIVES Disorder of arousal (DOA) and sleep-related hypermotor epilepsy (SHE) are complex, often bizarre, involuntary sleep behaviors, whose differential diagnosis may be challenging because they share some clinical features, such as sleep fragmentation. Mounting evidence highlights the critical role of sleep in cognitive functions. Controversial findings are raised about the cognitive profile in SHE; however, no studies have investigated the cognitive profile in DOA. This study aimed to assess whether sleep instability affects cognitive functions in patients with SHE or DOA. METHODS This study analyzed 11 patients with DOA, 11 patients with SHE, and 22 healthy controls (HC). They underwent full-night video polysomnography (vPSG) and comprehensive neuropsychological and behavioral evaluation. Differences in the variables of interest among the SHE group, DOA group, and their respective control groups were evaluated. The auto-contractive map (auto-CM) system was used to evaluate the strength of association across the collected data. RESULTS The SHE group had reduced sleep efficiency and increased wake after sleep onset (WASO); both the SHE and DOA groups showed increased % of N2 and REM sleep compared to the HC group. Neuropsychological and behavioral evaluations showed a different cognitive profile in the SHE group with respect to the HC group. The auto-CM showed that Pittsburgh Sleep Quality Index (PSQI), Beck depression inventory (BDI), MWCST_PE, Epworth sleepiness scale (ESS), WASO, N1, and % REM were strictly correlated with SHE, whereas the SE and arousal index (AI) were strictly related to DOA. CONCLUSIONS Patients with SHE and DOA present different cognitive and psychiatric profiles, with subtle and selective cognitive impairments only in those with SHE, supporting the discriminative power of cognitive and psychiatric assessment in these two conditions.
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Affiliation(s)
- Monica Puligheddu
- Sleep Disorder Center, Department of Public Health & Clinical and Molecular Medicine, University of Cagliari, 09042 Cagliari, Italy
- Correspondence: ; Tel.: +39-0706754952
| | - Patrizia Congiu
- Sleep Disorder Center, Department of Public Health & Clinical and Molecular Medicine, University of Cagliari, 09042 Cagliari, Italy
| | - Michela Figorilli
- Sleep Disorder Center, Department of Public Health & Clinical and Molecular Medicine, University of Cagliari, 09042 Cagliari, Italy
| | - Ludovica Tamburrino
- Sleep Disorder Center, Department of Public Health & Clinical and Molecular Medicine, University of Cagliari, 09042 Cagliari, Italy
| | - Patrizia Pisanu
- UOC Riabilitazione Funzionale e Neuroriabilitazione, Mater Olbia Hospital, 07026 Olbia, Italy
| | - Roberta Coa
- Sleep Disorder Center, Department of Public Health & Clinical and Molecular Medicine, University of Cagliari, 09042 Cagliari, Italy
| | | | - Davide Fonti
- Sleep Disorder Center, Department of Public Health & Clinical and Molecular Medicine, University of Cagliari, 09042 Cagliari, Italy
| | - Rosamaria Lecca
- Sleep Disorder Center, Department of Public Health & Clinical and Molecular Medicine, University of Cagliari, 09042 Cagliari, Italy
| | - Enzo Grossi
- Autism Research Unit, Villa Santa Maria Foundation, 22038 Tavernerio, Italy
| | - Antonella Gagliano
- Unità di Neuropsichiatria dell’infanzia e dell’adolescenza, Dipartimento di Scienze Biomediche, Università di Cagliari & Ospedale Pediatrico, 09100 Cagliari, Italy
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Abeare K, Cutler L, An KY, Razvi P, Holcomb M, Erdodi LA. BNT-15: Revised Performance Validity Cutoffs and Proposed Clinical Classification Ranges. Cogn Behav Neurol 2022; 35:155-168. [PMID: 35507449 DOI: 10.1097/wnn.0000000000000304] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 08/09/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Abbreviated neurocognitive tests offer a practical alternative to full-length versions but often lack clear interpretive guidelines, thereby limiting their clinical utility. OBJECTIVE To replicate validity cutoffs for the Boston Naming Test-Short Form (BNT-15) and to introduce a clinical classification system for the BNT-15 as a measure of object-naming skills. METHOD We collected data from 43 university students and 46 clinical patients. Classification accuracy was computed against psychometrically defined criterion groups. Clinical classification ranges were developed using a z -score transformation. RESULTS Previously suggested validity cutoffs (≤11 and ≤12) produced comparable classification accuracy among the university students. However, a more conservative cutoff (≤10) was needed with the clinical patients to contain the false-positive rate (0.20-0.38 sensitivity at 0.92-0.96 specificity). As a measure of cognitive ability, a perfect BNT-15 score suggests above average performance; ≤11 suggests clinically significant deficits. Demographically adjusted prorated BNT-15 T-scores correlated strongly (0.86) with the newly developed z -scores. CONCLUSION Given its brevity (<5 minutes), ease of administration and scoring, the BNT-15 can function as a useful and cost-effective screening measure for both object-naming/English proficiency and performance validity. The proposed clinical classification ranges provide useful guidelines for practitioners.
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Affiliation(s)
| | | | - Kelly Y An
- Private Practice, London, Ontario, Canada
| | - Parveen Razvi
- Faculty of Nursing, University of Windsor, Windsor, Ontario, Canada
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Espenes J, Eliassen IV, Öhman F, Hessen E, Waterloo K, Eckerström M, Lorentzen IM, Bergland C, Halvari Niska M, Timón-Reina S, Wallin A, Fladby T, Kirsebom BE. Regression‐based normative data for the Rey Auditory Verbal Learning Test in Norwegian and Swedish adults aged 49–79 and comparison with published norms. Clin Neuropsychol 2022:1-25. [PMID: 35968846 DOI: 10.1080/13854046.2022.2106890] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective: The Rey Auditory Verbal Learning Test (RAVLT) is a widely used measure of episodic verbal memory. To our knowledge, culturally adapted and demographically adjusted norms for the RAVLT are currently not available for Norwegian and Swedish adults, and imported North American norms are often used. We here develop regression-based norms for Norwegian and Swedish adults and compare our norms to North American norms in an independent sample of cognitively healthy adults. Method: Participants were 244 healthy adults from Norway and Sweden between the aged 49 and 79 years, with between 6 and 24 years of education. Using a multiple multivariate regression-based norming procedure, we estimated effects of age, sex, and years of education on basic and derived RAVLT test scores. The newly developed norms were assessed in an independent comparison group of cognitively healthy adults (n = 145) and compared to recently published North American regression-based norms. Results: Lower age, female sex and more years of education predicted higher performance on the RAVLT. The new norms adequately adjusted for age, education, and sex in the independent comparison group. The American norms corrected for demographics on all RAVLT trials except trials 4, 7, list B, and trials 1-5 total. Test-retest (M = 2.55 years) reliability varied from poor to good. Conclusion: We propose regression-based norms for the RAVLT adjusting for pertinent demographics. The norms may be used for assessment of Norwegian and Swedish adults between the aged of 49 and 79 years, with between 6 and 24 years of education.
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Affiliation(s)
- Jacob Espenes
- Department of Psychology, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway
- Department of Neurology, University Hospital of North Norway, Tromsø, Norway
| | - Ingvild Vøllo Eliassen
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Fredrik Öhman
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Erik Hessen
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Knut Waterloo
- Department of Psychology, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway
- Department of Neurology, University Hospital of North Norway, Tromsø, Norway
| | - Marie Eckerström
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ingrid Myrvoll Lorentzen
- Department of Psychology, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway
| | - Cecilie Bergland
- Department of Psychology, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway
| | - Madelene Halvari Niska
- Department of Psychology, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway
| | - Santiago Timón-Reina
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
- Departamento de Inteligencia Artificial, Universidad Nacional de Educación a Distancia, Madrid, Spain
| | - Anders Wallin
- Departamento de Inteligencia Artificial, Universidad Nacional de Educación a Distancia, Madrid, Spain
| | - Tormod Fladby
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Bjørn-Eivind Kirsebom
- Department of Psychology, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway
- Department of Neurology, University Hospital of North Norway, Tromsø, Norway
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Cavaco S, Moreira B, Dias D, Gonçalves A, Pinto C, Almeida E, Gomes F, Moreira I, Chaves J, Lopes J, Ramalheira J, Freitas J, Samões R, Rangel R, Martins da Silva A. Auditory verbal learning test can lateralize hippocampal sclerosis. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-7. [PMID: 35754382 DOI: 10.1080/23279095.2022.2090257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The ability of the Auditory Verbal Learning Test (AVLT) to lateralize hippocampal sclerosis (HS) in mesial temporal lobe epilepsy (MTLE) was explored in a sample of 50 patients with MTLE-HS (23 right and 27 left). Patients' AVLT scores were adjusted to the demographic characteristics of each individual in accordance with the Portuguese normative data. The laterality of the HS was determined by consensus by two neuroradiologists. ROC curves were used to identify the best AVLT cutoff scores to differentiate right vs. left HS. Diagnostic statistics were applied to different AVLT measures. The study results revealed that four AVLT scores can correctly classify the laterality of HS in the total sample and a sub-group of 39 right-handed patients (Edinburgh Laterality Inventory +100): delayed recall trial (76 and 80%, respectively), delayed recognition trial (64 and 67%, respectively), learning over trials index (64 and 74%, respectively), and long-term percent retention index (68 and 72%, respectively). In right-handed patients, the diagnostic capability of the delayed recall trial was improved by pairing it with the learning over trials index (accuracy of 85%). In sum, AVLT measures of verbal memory differentiate left from right HS in MTLE. The delayed recall trial demonstrated good diagnostic capacity.
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Affiliation(s)
- Sara Cavaco
- Neuropsychology Unit, Centro Hospitalar Universitario do Porto EPE, Porto, Portugal
- UMIB, Universidade do Porto Instituto de Ciencias Biomedicas Abel Salazar, Porto, Portugal
| | - Bruno Moreira
- Neuroradiology Department, Centro Hospitalar Universitario do Porto EPE, Porto, Portugal
| | - Daniel Dias
- Neuroradiology Department, Centro Hospitalar Universitario do Porto EPE, Porto, Portugal
| | - Alexandra Gonçalves
- Neuropsychology Unit, Centro Hospitalar Universitario do Porto EPE, Porto, Portugal
| | - Claudia Pinto
- Neuropsychology Unit, Centro Hospitalar Universitario do Porto EPE, Porto, Portugal
| | - Eduarda Almeida
- Neuropsychology Unit, Centro Hospitalar Universitario do Porto EPE, Porto, Portugal
| | - Filomena Gomes
- Neuropsychology Unit, Centro Hospitalar Universitario do Porto EPE, Porto, Portugal
| | - Inês Moreira
- Neuropsychology Unit, Centro Hospitalar Universitario do Porto EPE, Porto, Portugal
| | - João Chaves
- Neurology Department, Centro Hospitalar Universitario do Porto EPE, Porto, Portugal
| | - João Lopes
- Neurophysiology Department, Centro Hospitalar Universitario do Porto EPE, Porto, Portugal
| | - João Ramalheira
- Neurophysiology Department, Centro Hospitalar Universitario do Porto EPE, Porto, Portugal
| | - Joel Freitas
- Neurophysiology Department, Centro Hospitalar Universitario do Porto EPE, Porto, Portugal
| | - Raquel Samões
- Neurology Department, Centro Hospitalar Universitario do Porto EPE, Porto, Portugal
| | - Rui Rangel
- Department of Neurosurgery, Centro Hospitalar Universitario do Porto EPE, Porto, Portugal
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Bruder JC, Wagner K, Lachner-Piza D, Klotz KA, Schulze-Bonhage A, Jacobs J. Mesial-Temporal Epileptic Ripples Correlate With Verbal Memory Impairment. Front Neurol 2022; 13:876024. [PMID: 35720106 PMCID: PMC9204013 DOI: 10.3389/fneur.2022.876024] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 04/05/2022] [Indexed: 12/03/2022] Open
Abstract
Rationale High frequency oscillations (HFO; ripples = 80–200, fast ripples 200–500 Hz) are promising epileptic biomarkers in patients with epilepsy. However, especially in temporal epilepsies differentiation of epileptic and physiological HFO activity still remains a challenge. Physiological sleep-spindle-ripple formations are known to play a role in slow-wave-sleep memory consolidation. This study aimed to find out if higher rates of mesial-temporal spindle-ripples correlate with good memory performance in epilepsy patients and if surgical removal of spindle-ripple-generating brain tissue correlates with a decline in memory performance. In contrast, we hypothesized that higher rates of overall ripples or ripples associated with interictal epileptic spikes correlate with poor memory performance. Methods Patients with epilepsy implanted with electrodes in mesial-temporal structures, neuropsychological memory testing and subsequent epilepsy surgery were included. Ripples and epileptic spikes were automatically detected in intracranial EEG and sleep-spindles in scalp EEG. The coupling of ripples to spindles was automatically analyzed. Mesial-temporal spindle-ripple rates in the speech-dominant-hemisphere (left in all patients) were correlated with verbal memory test results, whereas ripple rates in the non-speech-dominant hemisphere were correlated with non-verbal memory test performance, using Spearman correlation). Results Intracranial EEG and memory test results from 25 patients could be included. All ripple rates were significantly higher in seizure onset zone channels (p < 0.001). Patients with pre-surgical verbal memory impairment had significantly higher overall ripple rates in left mesial-temporal channels than patients with intact verbal memory (Mann–Whitney-U-Test: p = 0.039). Spearman correlations showed highly significant negative correlations of the pre-surgical verbal memory performance with left mesial-temporal spike associated ripples (rs = −0.458; p = 0.007) and overall ripples (rs = −0.475; p = 0.006). All three ripple types in right-sided mesial-temporal channels did not correlate with pre-surgical nonverbal memory. No correlation for the difference between post- and pre-surgical memory and pre-surgical spindle-ripple rates was seen in patients with left-sided temporal or mesial-temporal surgery. Discussion This study fails to establish a clear link between memory performance and spindle ripples. This highly suggests that spindle-ripples are only a small portion of physiological ripples contributing to memory performance. More importantly, this study indicates that spindle-ripples do not necessarily compromise the predictive value of ripples in patients with temporal epilepsy. The majority of ripples were clearly linked to areas with poor memory function.
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Affiliation(s)
- Jonas Christian Bruder
- Clinic of Neuropediatrics and Muscle Disorders, Freiburg University Medical Center, Breisgau, Germany
- *Correspondence: Jonas Christian Bruder
| | - Kathrin Wagner
- Abteilung Epileptologie Epilepsiezentrum, Klinik Für Neurochirurgie, Universitätsklinikum Freiburg, Breisgau, Germany
| | - Daniel Lachner-Piza
- Clinic of Neuropediatrics and Muscle Disorders, Freiburg University Medical Center, Breisgau, Germany
| | - Kerstin Alexandra Klotz
- Clinic of Neuropediatrics and Muscle Disorders, Freiburg University Medical Center, Breisgau, Germany
| | - Andreas Schulze-Bonhage
- Abteilung Epileptologie Epilepsiezentrum, Klinik Für Neurochirurgie, Universitätsklinikum Freiburg, Breisgau, Germany
| | - Julia Jacobs
- Clinic of Neuropediatrics and Muscle Disorders, Freiburg University Medical Center, Breisgau, Germany
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10
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Exploring the Semantic Structure of WMS-IV Verbal Paired Associates using the Hub-and-Spoke Model. J Int Neuropsychol Soc 2022; 28:494-502. [PMID: 34024287 DOI: 10.1017/s1355617721000709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES This study aimed to identify a well-fitting and theoretically justified item-level latent factor structure for the Wechsler Memory Scales (WMS)-IV verbal paired associates (VerbalPA) subtest to facilitate the ease and accuracy of score interpretations for patients with lateralized temporal lobe epilepsy (TLE). METHODS Archival data were used from 250 heterogeneous neurosciences patients who were administered the WMS-IV as part of a standard neuropsychological assessment. Three theoretically motivated models for the latent structure of VerbalPA were tested using confirmatory factor analysis. The first model, based on cognitive principles of semantic processing from hub-and-spoke theory, tested whether performance is related to specific semantic features of target words. The second, motivated by the Cattell-Horn-Carroll (CHC) model of cognitive abilities, investigated whether the associative properties of items influence performance. A third, Hybrid model tested whether performance is related to both semantic and associative properties of items. The best-fitting model was tested for diagnostic group effects contrasting the heterogeneous neuroscience patients with subsets of left and right TLE (n = 51, n = 26, respectively) patients. RESULTS The Hybrid model was found to have the best fit. Patients with left TLE scored significantly less well than the heterogeneous neurosciences sample on selected semantic factor scores, although the effect size was small. CONCLUSIONS Future editions of the WMS may consider implementing a semantic scoring structure for the VerbalPA to facilitate test score interpretation. Additionally, these results suggest that principles of hub-and-spoke theory may be integrated into CHC cognitive ability taxonomy.
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11
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Nussbaum S, May N, Cutler L, Abeare CA, Watson M, Erdodi LA. Failing Performance Validity Cutoffs on the Boston Naming Test (BNT) Is Specific, but Insensitive to Non-Credible Responding. Dev Neuropsychol 2022; 47:17-31. [PMID: 35157548 DOI: 10.1080/87565641.2022.2038602] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
This study was designed to examine alternative validity cutoffs on the Boston Naming Test (BNT).Archival data were collected from 206 adults assessed in a medicolegal setting following a motor vehicle collision. Classification accuracy was evaluated against three criterion PVTs.The first cutoff to achieve minimum specificity (.87-.88) was T ≤ 35, at .33-.45 sensitivity. T ≤ 33 improved specificity (.92-.93) at .24-.34 sensitivity. BNT validity cutoffs correctly classified 67-85% of the sample. Failing the BNT was unrelated to self-reported emotional distress. Although constrained by its low sensitivity, the BNT remains a useful embedded PVT.
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Affiliation(s)
- Shayna Nussbaum
- Department of Psychology, Neuropsychology Track, University of Windsor, Windsor, ON, Canada
| | - Natalie May
- Department of Psychology, Neuropsychology Track, University of Windsor, Windsor, ON, Canada
| | - Laura Cutler
- Department of Psychology, Neuropsychology Track, University of Windsor, Windsor, ON, Canada
| | - Christopher A Abeare
- Department of Psychology, Neuropsychology Track, University of Windsor, Windsor, ON, Canada
| | - Mark Watson
- Mark S. Watson Psychology Professional Corporation, Mississauga, ON, Canada
| | - Laszlo A Erdodi
- Department of Psychology, Neuropsychology Track, University of Windsor, Windsor, ON, Canada
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12
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OUP accepted manuscript. Arch Clin Neuropsychol 2022; 37:891-903. [DOI: 10.1093/arclin/acac012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2022] [Indexed: 11/12/2022] Open
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13
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Furey RT, Petrauskas V, Bowden SC, Simpson LC, Meade CE, Davis BM, D'Souza WJ. Latent Semantic Structure of the WMS-III Verbal Paired-Associates. Arch Clin Neuropsychol 2021; 37:970-980. [PMID: 34929041 DOI: 10.1093/arclin/acab093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To investigate the factor structure of the verbal paired-associates (VPA) subtest in the WMS-III using a theoretically driven model of semantic processing previously found to be well-fitting for the WMS-IV version of the test. METHOD Archival data were used from 267 heterogeneous neurosciences patients and 223 seizure disorder patients who completed the WMS-III as part of a standard neuropsychological evaluation. Confirmatory factor analysis was used to test theoretically driven models for VPA based on principles of semantic processing. Four nested models of different complexities were examined and compared for goodness-of-fit using chi-squared difference testing. Measurement invariance testing was conducted across heterogeneous neuroscience and seizure disorder samples to test generality of the factor model. RESULTS After removing items with limited variability (very easy or very hard; 12 of 40 items), a four-factor model was found to be best-fitting in the present patient samples. The four factors were "recreational", "functional", "material", and "symbolic", each representing semantic knowledge associated with the function of the target word referent. This model subsequently met the criteria for the strict measurement invariance, showing good overall fit when factor loadings, thresholds, and residuals were held to equality across samples. CONCLUSIONS The results of this study provide further evidence that "arbitrary" associations between word pairs in VPA items have an underlying semantic structure, challenging the idea that unrelated hard-pairs are semantic-free. These results suggest that a semantic-structure model may be implemented as an alternative scoring in future editions of the WMS to facilitate interpretation.
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Affiliation(s)
- Rachel T Furey
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Vilija Petrauskas
- Department of Psychology, Neuropsychology Service, British Columbia Children's Hospital, British Columbia, Vancouver, Canada
| | - Stephen C Bowden
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia.,Department of Medicine, St. Vincent's Hospital Melbourne, Melbourne, VIC, Australia
| | - Leonie C Simpson
- Neuropsychology, Department of Allied Health, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Catherine E Meade
- Department of Medicine, St. Vincent's Hospital Melbourne, Melbourne, VIC, Australia
| | - Brooke M Davis
- Private Practice, Launch Psychology, Melbourne, VIC, Australia
| | - Wendyl J D'Souza
- Department of Medicine, St. Vincent's Hospital Melbourne, Melbourne, VIC, Australia
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14
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Enaud R, Cambos S, Viaud E, Guichoux E, Chancerel E, Marighetto A, Etchamendy N, Clark S, Mohammedi K, Cota D, Delhaes L, Gatta-Cherifi B. Gut Microbiota and Mycobiota Evolution Is Linked to Memory Improvement after Bariatric Surgery in Obese Patients: A Pilot Study. Nutrients 2021; 13:nu13114061. [PMID: 34836316 PMCID: PMC8620125 DOI: 10.3390/nu13114061] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 11/07/2021] [Accepted: 11/11/2021] [Indexed: 12/23/2022] Open
Abstract
Patients with obesity are known to exhibit gut microbiota dysbiosis and memory deficits. Bariatric surgery (BS) is currently the most efficient anti-obesity treatment and may improve both gut dysbiosis and cognition. However, no study has investigated association between changes of gut microbiota and cognitive function after BS. We prospectively evaluated 13 obese patients on anthropometric data, memory functions, and gut microbiota-mycobiota before and six months after BS. The Rey Auditory Verbal Learning Test (AVLT) and the symbol span (SS) of the Weschler Memory Scale were used to assess verbal and working memory, respectively. Fecal microbiota and mycobiota were longitudinally analyzed by 16S and ITS2 rRNA sequencing respectively. AVLT and SS scores were significantly improved after BS (AVLT scores: 9.7 ± 1.7 vs. 11.2 ± 1.9, p = 0.02, and SS scores: 9.7 ± 23.0 vs. 11.6 ± 2.9, p = 0.05). An increase in bacterial alpha-diversity, and Ruminococcaceae, Prevotella, Agaricus, Rhodotorula, Dipodascus, Malassezia, and Mucor were significantly associated with AVLT score improvement after BS, while an increase in Prevotella and a decrease in Clostridium, Akkermansia, Dipodascus and Candida were linked to SS scores improvement. We identified several changes in the microbial communities that differ according to the improvement of either the verbal or working memories, suggesting a complex gut-brain-axis that evolves after BS.
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Affiliation(s)
- Raphaël Enaud
- Centre Hospitalier de Bordeaux, CRCM Pédiatrique, CIC 1401, 33000 Bordeaux, France;
- Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Hôpital Xavier Arnozan, University of Bordeaux, Avenue du Haut Lévêque, 33604 Pessac, France;
- Centre Hospitalier de Bordeaux, University of Bordeaux, FHU ACRONIM, 33000 Bordeaux, France;
| | - Sophie Cambos
- Centre Hospitalier de Bordeaux, Department of Endocrinology, Diabetes and Nutrition, University Hospital of Bordeaux, 33604 Pessac, France;
- Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U862, INSERM, 146 rue Léo Saignat, 33076 Bordeaux, France; (E.V.); (A.M.); (N.E.); (S.C.); (D.C.)
| | - Esther Viaud
- Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U862, INSERM, 146 rue Léo Saignat, 33076 Bordeaux, France; (E.V.); (A.M.); (N.E.); (S.C.); (D.C.)
| | - Erwan Guichoux
- BIOGECO, INRAE, University of Bordeaux, 69 route d’Arcachon, 33610 Cestas, France; (E.G.); (E.C.)
| | - Emilie Chancerel
- BIOGECO, INRAE, University of Bordeaux, 69 route d’Arcachon, 33610 Cestas, France; (E.G.); (E.C.)
| | - Aline Marighetto
- Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U862, INSERM, 146 rue Léo Saignat, 33076 Bordeaux, France; (E.V.); (A.M.); (N.E.); (S.C.); (D.C.)
| | - Nicole Etchamendy
- Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U862, INSERM, 146 rue Léo Saignat, 33076 Bordeaux, France; (E.V.); (A.M.); (N.E.); (S.C.); (D.C.)
| | - Samantha Clark
- Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U862, INSERM, 146 rue Léo Saignat, 33076 Bordeaux, France; (E.V.); (A.M.); (N.E.); (S.C.); (D.C.)
| | - Kamel Mohammedi
- Centre Hospitalier de Bordeaux, University of Bordeaux, FHU ACRONIM, 33000 Bordeaux, France;
- Centre Hospitalier de Bordeaux, Department of Endocrinology, Diabetes and Nutrition, University Hospital of Bordeaux, 33604 Pessac, France;
| | - Daniela Cota
- Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U862, INSERM, 146 rue Léo Saignat, 33076 Bordeaux, France; (E.V.); (A.M.); (N.E.); (S.C.); (D.C.)
- Centre Hospitalier de Bordeaux, University of Bordeaux, FHU TALISMENT, 33000 Bordeaux, France
| | - Laurence Delhaes
- Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Hôpital Xavier Arnozan, University of Bordeaux, Avenue du Haut Lévêque, 33604 Pessac, France;
- Centre Hospitalier de Bordeaux, University of Bordeaux, FHU ACRONIM, 33000 Bordeaux, France;
| | - Blandine Gatta-Cherifi
- Centre Hospitalier de Bordeaux, Department of Endocrinology, Diabetes and Nutrition, University Hospital of Bordeaux, 33604 Pessac, France;
- Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U862, INSERM, 146 rue Léo Saignat, 33076 Bordeaux, France; (E.V.); (A.M.); (N.E.); (S.C.); (D.C.)
- Centre Hospitalier de Bordeaux, University of Bordeaux, FHU TALISMENT, 33000 Bordeaux, France
- Correspondence:
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Janecek JK, Binder JR, Mueller WM, Swanson SJ. Cognitive and functional outcomes following a traumatic brain injury sustained 22 years after epilepsy surgery: A case report. Epilepsy Behav Rep 2021; 16:100482. [PMID: 34693245 PMCID: PMC8515403 DOI: 10.1016/j.ebr.2021.100482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/20/2021] [Accepted: 09/08/2021] [Indexed: 11/30/2022] Open
Abstract
Long-term outcomes were presented for a patient status post epilepsy surgery and TBI. Cognitive stability was documented over a 22-year follow-up period. Good cognitive and functional outcomes were demonstrated in late life. Protective factors include seizure outcome, cognitive reserve, and medical status.
Anterior temporal lobectomy (ATL) is an effective treatment for drug-resistant epilepsy, and risk for post-surgical naming and verbal memory decline after dominant hemisphere ATL is well-established. However, less is known about later life cognitive and functional outcomes following ATL performed in early or mid-life, as there are few studies that report very long-term outcomes, and the intersection of epilepsy and the aging process is not well-understood. Factors that may promote healthy cognitive aging or confer increased risk for cognitive decline in late life for those with seizure onset in early or mid-life have yet to be determined. This case report describes an individual with drug-resistant epilepsy who was treated with left ATL in mid-life, and then subsequently sustained a moderate traumatic brain injury 22 years later. The excellent recovery and remarkable stability of cognitive performance over time may be associated with several protective factors such as favorable seizure outcome, high cognitive reserve, and the absence of co-occurring medical conditions. This case also highlights the clinical utility of serial neuropsychological testing at multiple timepoints across the lifespan for those with epilepsy, and the importance of considering the clinical significance, or functional impact, of cognitive deficits in this population.
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Affiliation(s)
- Julie K. Janecek
- Department of Neurology, Medical College of Wisconsin, 8701 W. Watertown Plank Rd., Milwaukee, WI 53226, USA
- Corresponding author at: Division of Neuropsychology, Department of Neurology, Medical College of Wisconsin, 8701 W. Watertown Plank Rd., Milwaukee, WI 53226, USA.
| | - Jeffrey R. Binder
- Department of Neurology, Medical College of Wisconsin, 8701 W. Watertown Plank Rd., Milwaukee, WI 53226, USA
| | - Wade M. Mueller
- Department of Neurosurgery, Medical College of Wisconsin, 8701 W. Watertown Plank Rd., Milwaukee, WI 53226, USA
| | - Sara J. Swanson
- Department of Neurology, Medical College of Wisconsin, 8701 W. Watertown Plank Rd., Milwaukee, WI 53226, USA
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16
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Witt JA, Meschede C, Helmstaedter C. Hazardous employment of invalid measures for cognitive outcome assessment: You only see what your test can show you. Epilepsy Behav 2021; 117:107865. [PMID: 33662843 DOI: 10.1016/j.yebeh.2021.107865] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 02/05/2023]
Affiliation(s)
| | - Carolin Meschede
- Department of Epileptology, University Hospital Bonn (UKB), Bonn, Germany
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17
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Mayo Normative Studies: Regression-Based Normative Data for the Auditory Verbal Learning Test for Ages 30-91 Years and the Importance of Adjusting for Sex. J Int Neuropsychol Soc 2021; 27:211-226. [PMID: 32815494 PMCID: PMC7895855 DOI: 10.1017/s1355617720000752] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Rey's Auditory Verbal Learning Test (AVLT) is a widely used word list memory test. We update normative data to include adjustment for verbal memory performance differences between men and women and illustrate the effect of this sex adjustment and the importance of excluding participants with mild cognitive impairment (MCI) from normative samples. METHOD This study advances the Mayo's Older Americans Normative Studies (MOANS) by using a new population-based sample through the Mayo Clinic Study of Aging, which randomly samples residents of Olmsted County, Minnesota, from age- and sex-stratified groups. Regression-based normative T-score formulas were derived from 4428 cognitively unimpaired adults aged 30-91 years. Fully adjusted T-scores correct for age, sex, and education. We also derived T-scores that correct for (1) age or (2) age and sex. Test-retest reliability data are provided. RESULTS From raw score analyses, sex explained a significant amount of variance in performance above and beyond age (8-10%). Applying original age-adjusted MOANS norms to the current sample resulted in significantly fewer-than-expected participants with low delayed recall performance, particularly in women. After application of new T-scores adjusted only for age, even in normative data derived from this sample, these age-adjusted T-scores showed scores <40 T occurred more frequently among men and less frequently among women relative to T-scores that also adjusted for sex. CONCLUSIONS Our findings highlight the importance of using normative data that adjust for sex with measures of verbal memory and provide new normative data that allow for this adjustment for the AVLT.
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18
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Barrett Jones S, A Miller L, Kleitman S, Nikpour A, Lah S. Semantic and episodic memory in adults with temporal lobe epilepsy. APPLIED NEUROPSYCHOLOGY-ADULT 2021; 29:1352-1361. [PMID: 33595395 DOI: 10.1080/23279095.2021.1876692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The primary aims were to (1) identify the factor structure of tests thought to measure semantic and episodic memory and (2) examine whether patterns of impairment would show a double dissociation between these two memory systems at an individual level in patients with temporal lobe epilepsy (TLE). The secondary aim was to explore the impact of epilepsy-related variables on performance. This retrospective study involved a cohort of 54 adults who had been diagnosed with TLE and had undergone a neuropsychological assessment that included four memory tests traditionally used to measure either semantic memory (picture naming, animal fluency) or episodic memory (story recall, word list recall) at a single epilepsy surgery center in Australia. Principal component analysis revealed two factors albeit with unexpected loadings. Picture naming and story recall loaded on one factor. Animal fluency and word list recall loaded on another factor. There was no evidence of a double dissociation between semantic and episodic memory at an individual level. Left hemisphere seizure focus and early age of seizure onset related to worse performance on word list recall, picture naming and animal fluency, respectively. Our study highlights the importance of caution when interpreting the results of neuropsychological assessments, as not all putative tests of semantic and episodic memory may necessarily be measuring the same construct. Future directions for research are also considered.
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Affiliation(s)
| | - Laurie A Miller
- Central Clinical School, University of Sydney, New South Wales, Australia
| | - Sabina Kleitman
- School of Psychology, University of Sydney, Sydney, Australia
| | - Armin Nikpour
- Central Clinical School, University of Sydney, New South Wales, Australia.,University of Sydney, Sydney, Australia
| | - Suncica Lah
- School of Psychology, University of Sydney, Sydney, Australia
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19
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Vicente SG, Benito-Sánchez I, Barbosa F, Gaspar N, Dores AR, Rivera D, Arango-Lasprilla JC. Normative data for Verbal Fluency and Object Naming Tests in a sample of European Portuguese adult population. APPLIED NEUROPSYCHOLOGY-ADULT 2021; 29:1268-1279. [PMID: 33438451 DOI: 10.1080/23279095.2020.1868472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The purpose of the present study was to calculate the construct validity, internal consistency and normative data of the Phonological Verbal Fluency Test (letters F, A, S, and M), Semantic Verbal Fluency Test (Animals, Fruits and Professions categories), and Boston Naming Test (short and standard version), and to generate normative data for these tests after adjusting for age, education, and sex. A sample of 293 European Portuguese adults participated in the study. Results showed adequate construct validity and internal consistency for all of the tests and the final multiple regression models found that age and education were significantly associated with P-VFT (letters F, A, S, and M), S-VFT (Animals, Fruits and Professions categories), and BNT performance. Sex was only found to have an effect on the fruit category, with women scoring higher than men. The normative data provided in this study will contribute to improving the clinical practice of neuropsychology in Portugal.
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Affiliation(s)
- Selene G Vicente
- Centre for Psychology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Itziar Benito-Sánchez
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Biomedical Research Doctorate Program, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Fernando Barbosa
- Faculty of Psychology and Education Sciences, Laboratory of Neuropsychophysiology, University of Porto, Porto, Portugal
| | - Nuno Gaspar
- Centre for Psychology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Artemisa R Dores
- Faculty of Psychology and Education Sciences, Laboratory of Neuropsychophysiology, University of Porto, Porto, Portugal.,School of Health, Polytechnic of Porto, Porto, Portugal
| | - Diego Rivera
- Departamento de Ciencias de la Salud, Universidad Pública de Navarra, Pamplona, Spain
| | - Juan Carlos Arango-Lasprilla
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,IKERBASQUE, Basque Foundation for Science, Bilbao, Spain.,Department of Cell Biology and Histology, University of the Basque Country (UPV/EHU), Leioa, Spain
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20
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A Review of Accelerated Long-Term Forgetting in Epilepsy. Brain Sci 2020; 10:brainsci10120945. [PMID: 33297371 PMCID: PMC7762289 DOI: 10.3390/brainsci10120945] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 11/30/2020] [Accepted: 12/03/2020] [Indexed: 11/16/2022] Open
Abstract
Accelerated long-term forgetting (ALF) is a memory disorder that manifests by a distinct pattern of normal memory for up to an hour after learning, but an increased rate of forgetting during the subsequent hours and days. The topic of ALF has gained much attention in group studies with epilepsy patients and the phenomenon has been shown to have contradictory associations with seizures, epileptiform activity, imaging data, sleep, and antiepileptic medication. The aim of this review was to explore how clinical and imaging data could help determine the topographic and physiological substrate of ALF, and what is the possible use of this information in the clinical setting. We have reviewed 51 group studies in English to provide a synthesis of the existing findings concerning ALF in epilepsy. Analysis of recently reported data among patients with temporal lobe epilepsy, transient epileptic amnesia, and generalized and extratemporal epilepsies provided further indication that ALF is likely a disorder of late memory consolidation. The spatial substrate of ALF might be located along the parts of the hippocampal-neocortical network and novel studies reveal the increasingly possible importance of damage in extrahippocampal sites. Further research is needed to explore the mechanisms of cellular impairment in ALF and to develop effective methods of care for patients with the disorder.
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21
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Tailby C, Collins AJ, Vaughan DN, Abbott DF, O'Shea M, Helmstaedter C, Jackson GD. Teleneuropsychology in the time of COVID-19: The experience of The Australian Epilepsy Project. Seizure 2020; 83:89-97. [PMID: 33120327 PMCID: PMC7561524 DOI: 10.1016/j.seizure.2020.10.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/30/2020] [Accepted: 10/10/2020] [Indexed: 01/17/2023] Open
Abstract
PURPOSE Traditional neuropsychological testing carries elevated COVID-19 risk for both examinee and examiner. Here we describe how the pilot study of the Australian Epilepsy Project (AEP) has transitioned to tele-neuropsychology (teleNP), enabling continued safe operations during the pandemic. METHODS The AEP includes adults (age 18-60) with a first unprovoked seizure, new diagnosis of epilepsy or drug resistant focal epilepsy. Shortly after launching the study, COVID-related restrictions necessitated adaptation to teleNP, including delivery of verbal tasks via videoconference; visual stimulus delivery via document camera; use of web-hosted, computerised assessment; substitution of oral versions for written tests; online delivery of questionnaires; and discontinuation of telehealth incompatible tasks. RESULTS To date, we have completed 24 teleNP assessments: 18 remotely (participant in own home) and six on-site (participant using equipment at research facility). Five face-to-face assessments were conducted prior to the transition to teleNP. Eight of 408 tests administered via teleNP (1.9 %) have been invalidated, for a variety of reasons (technical, procedural, environmental). Data confirm typical patterns of epilepsy-related deficits (p < .05) affecting processing speed, executive function, language and memory. Questionnaire responses indicate elevated rates of patients at high risk of mood (34 %) and anxiety disorder (38 %). CONCLUSION Research teleNP assessments reveal a typical pattern of impairments in epilepsy. A range of issues must be considered when introducing teleNP, such as technical and administrative set up, test selection and delivery, and cohort suitability. TeleNP enables large-scale neuropsychological research during periods of social distancing (and beyond), and offers an opportunity to expand the reach and breadth of neuropsychological services.
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Affiliation(s)
- Chris Tailby
- The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia; Department of Clinical Neuropsychology, Austin Health, Heidelberg, Australia.
| | - Alana J Collins
- The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
| | - David N Vaughan
- The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia; Department of Neurology, Austin Health, Heidelberg, Australia
| | - David F Abbott
- The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia; The Florey Department of Neuroscience and Mental Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
| | - Marie O'Shea
- Department of Clinical Neuropsychology, Austin Health, Heidelberg, Australia; School of Psychological Sciences, University of Melbourne, Parkville, Australia
| | | | - Graeme D Jackson
- The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia; Department of Neurology, Austin Health, Heidelberg, Australia; The Florey Department of Neuroscience and Mental Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
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22
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Hewitt KC, Loring DW. Emory university telehealth neuropsychology development and implementation in response to the COVID-19 pandemic. Clin Neuropsychol 2020; 34:1352-1366. [DOI: 10.1080/13854046.2020.1791960] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Kelsey C. Hewitt
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - David W. Loring
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
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23
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Ovsiew GP, Resch ZJ, Nayar K, Williams CP, Soble JR. Not so fast! Limitations of processing speed and working memory indices as embedded performance validity tests in a mixed neuropsychiatric sample. J Clin Exp Neuropsychol 2020; 42:473-484. [DOI: 10.1080/13803395.2020.1758635] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Gabriel P. Ovsiew
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
| | - Zachary J Resch
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Kritika Nayar
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Psychiatry and Behavioral Sciences, Northwestern Feinberg School of Medicine, Chicago, IL, USA
| | - Christopher P. Williams
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Jason R. Soble
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Neurology, University of Illinois College of Medicine, Chicago, IL, USA
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Roger E, Torlay L, Gardette J, Mosca C, Banjac S, Minotti L, Kahane P, Baciu M. A machine learning approach to explore cognitive signatures in patients with temporo-mesial epilepsy. Neuropsychologia 2020; 142:107455. [DOI: 10.1016/j.neuropsychologia.2020.107455] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 02/25/2020] [Accepted: 03/27/2020] [Indexed: 12/18/2022]
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Olabarrieta-Landa L, Ramos Usuga D, Rivera D, Leal G, Bailey KC, Calderón Chagualá A, Rabago B, Esenarro L, Mascialino G, Arango-Lasprilla JC. Prevalence of low scores on language tests as a potential factor in misdiagnosis of cognitive impairment in a Spanish-speaking adult population. APPLIED NEUROPSYCHOLOGY-ADULT 2019; 29:41-52. [PMID: 31881159 DOI: 10.1080/23279095.2019.1704409] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: In this study, the prevalence of low scores for two neuropsychological tests of language has been determined.Methods: In total, N = 5218 healthy adults from 11 countries in Latin America (LA) were administered the Boston Naming Test (BNT) and the Verbal Fluency Test (VFT) as part of a comprehensive neuropsychological evaluation. Z-scores were calculated for BNT Total score, and phonological (letters F, A, S, M) and semantic (Animals, Fruits). Scores were adjusted for age, age2, sex, education, and interaction variables if significant for the given country. Each Z-score was converted to a percentile for each of the seven test-scores. Each participant was categorized based on his/her number of low scoring tests in specific percentile cutoff groups (25th, 16th, 10th, 5th, and 2nd).Results: Between 53% (Paraguay) and 71% (Mexico) of the sample had at least 1-score below the 25th percentile, and between 41% (Paraguay) and 55% (Cuba) scored below the 16th percentile. Between 27% (Paraguay) and 39% (Peru) scored below the 10th percentile on at least 1-score, and between 17% (Chile) and 23% (Argentina) scored below the 5th percentile.Conclusions: Clinicians should use these data to reduce false-positive diagnoses and to improve the neuropsychological assessments in Spanish-speaking individuals from LA countries.
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Affiliation(s)
| | - Daniela Ramos Usuga
- Biomedical Research Doctorate Program, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Diego Rivera
- Departamento de Ciencias de la Salud, Universidad Pública de Navarra, Pamplona, España
| | - Giselle Leal
- University of Miami Miller, School of Medicine, Miami, FL, USA
| | - K Chase Bailey
- University of Texas Southwestern Medical Center, Dallas, FX, USA
| | | | - Brenda Rabago
- Departamento de Neurociencias, CUCS, Universidad de Guadalajara, Guadalajara, México
| | | | - Guido Mascialino
- School of Psychology, Universidad de Las Américas, Quito, Ecuador
| | - Juan Carlos Arango-Lasprilla
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,IKERBASQUE, Basque Foundation for Science, Bilbao, Spain.,Department of Cell Biology and Histology, University of the Basque Country (UPV/EHU), Leioa, Spain
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26
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Cook CJ, Hwang G, Mathis J, Nair VA, Conant LL, Allen L, Almane DN, Birn R, DeYoe EA, Felton E, Forseth C, Humphries CJ, Kraegel P, Nencka A, Nwoke O, Raghavan M, Rivera-Bonet C, Rozman M, Tellapragada N, Ustine C, Ward BD, Struck A, Maganti R, Hermann B, Prabhakaran V, Binder JR, Meyerand ME. Effective Connectivity Within the Default Mode Network in Left Temporal Lobe Epilepsy: Findings from the Epilepsy Connectome Project. Brain Connect 2019; 9:174-183. [PMID: 30398367 DOI: 10.1089/brain.2018.0600] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The Epilepsy Connectome Project examines the differences in connectomes between temporal lobe epilepsy (TLE) patients and healthy controls. Using these data, the effective connectivity of the default mode network (DMN) in patients with left TLE compared with healthy controls was investigated using spectral dynamic causal modeling (spDCM) of resting-state functional magnetic resonance imaging data. Group comparisons were made using two parametric empirical Bayes (PEB) models. The first level of each PEB model consisted of each participant's spDCM. Two different second-level models were constructed: the first comparing effective connectivity of the groups directly and the second using the Rey Auditory Verbal Learning Test (RAVLT) delayed free recall index as a covariate at the second level to assess effective connectivity controlling for the poor memory performance of left TLE patients. After an automated search over the nested parameter space and thresholding parameters at 95% posterior probability, both models revealed numerous connections in the DMN, which lead to inhibition of the left hippocampal formation. Left hippocampal formation inhibition may be an inherent result of the left temporal epileptogenic focus as memory differences were controlled for in one model and the same connections remained. An excitatory connection from the posterior cingulate cortex to the medial prefrontal cortex was found to be concomitant with left hippocampal formation inhibition in TLE patients when including RAVLT delayed free recall at the second level.
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Affiliation(s)
- Cole J Cook
- 1 Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin
| | - Gyujoon Hwang
- 1 Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin
| | - Jedidiah Mathis
- 2 Department of Radiology, Froedtert and Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Veena A Nair
- 3 Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Lisa L Conant
- 4 Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Linda Allen
- 5 Department of Neurology, Froedtert Hospital, Milwaukee, Wisconsin
| | - Dace N Almane
- 6 Department of Neurology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Rasmus Birn
- 1 Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin.,7 Department of Psychiatry, University of Wisconsin-Madison, Madison, Wisconsin
| | - Edgar A DeYoe
- 2 Department of Radiology, Froedtert and Medical College of Wisconsin, Milwaukee, Wisconsin.,8 Department of Biophysics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Elizabeth Felton
- 6 Department of Neurology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Courtney Forseth
- 6 Department of Neurology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Colin J Humphries
- 4 Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Peter Kraegel
- 4 Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Andrew Nencka
- 8 Department of Biophysics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Onyekachi Nwoke
- 9 School of Pharmacy, University of Wisconsin-Madison, Madison, Wisconsin
| | - Manoj Raghavan
- 4 Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Charlene Rivera-Bonet
- 10 Neuroscience Training Program, University of Wisconsin-Madison, Madison, Wisconsin
| | - Megan Rozman
- 4 Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Neelima Tellapragada
- 3 Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Candida Ustine
- 6 Department of Neurology, University of Wisconsin-Madison, Madison, Wisconsin
| | - B Douglas Ward
- 8 Department of Biophysics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Aaron Struck
- 5 Department of Neurology, Froedtert Hospital, Milwaukee, Wisconsin
| | - Rama Maganti
- 5 Department of Neurology, Froedtert Hospital, Milwaukee, Wisconsin
| | - Bruce Hermann
- 6 Department of Neurology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Vivek Prabhakaran
- 3 Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin.,6 Department of Neurology, University of Wisconsin-Madison, Madison, Wisconsin.,10 Neuroscience Training Program, University of Wisconsin-Madison, Madison, Wisconsin
| | - Jeffrey R Binder
- 4 Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin.,7 Department of Psychiatry, University of Wisconsin-Madison, Madison, Wisconsin
| | - Mary E Meyerand
- 1 Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin.,3 Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin.,11 Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin
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Standardization of an Arabic-Language Neuropsychological Battery for Epilepsy Surgical Evaluations. J Int Neuropsychol Soc 2019; 25:761-771. [PMID: 31084648 DOI: 10.1017/s1355617719000432] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES This study provides a standardized Arabic language neuropsychological test battery and tests its ability to distinguish patients with left and right hemisphere epileptic foci who are candidates for surgical resection. METHODS An Arabic language battery of 15 tests was developed based on the neuropsychological test battery used at the Johns Hopkins Hospital for surgical evaluation of patients undergoing temporal lobe resection. With modifications where culturally required, 11 tests were translated to Arabic by the principal investigator and back-translated by two bilingual health professionals; four tests were available in Arabic and added to the battery. The battery was administered to 21 Arabic-speaking patients with left temporal epileptic foci, 21 with right temporal epileptic foci, and 46 neurologically and psychiatrically healthy adults. RESULTS Nearly all the Arabic test versions were capable of differentiating healthy controls and the temporal lobe epilepsy (TLE) groups. Tests known to distinguish left and right temporal lobectomy candidates, such as wordlist memory and prose recall, were able to do so as accurately as the English versions. Also, a roughly "culturally free" task (the Baltimore Board) and a newly developed version of the Boston Naming Test demonstrated some sensitivity to left temporal lobe involvement. CONCLUSIONS Arabic-language neuropsychological tests for epilepsy surgical evaluations are made available, demonstrate cultural sensitivity and clinical validity, and require further psychometric property and normative research. (JINS, 2019, 25, 761-771).
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Aversi-Ferreira TA, Tamaishi-Watanabe BH, Magri MPDF, Aversi-Ferreira RA. Neuropsychology of the temporal lobe: Luria's and contemporary conceptions. Dement Neuropsychol 2019; 13:251-258. [PMID: 31555397 PMCID: PMC6753908 DOI: 10.1590/1980-57642018dn13-030001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 07/25/2019] [Indexed: 11/22/2022] Open
Abstract
Brain lesion studies currently employ techniques such as computed tomography, functional magnetic resonance imaging, single photon emission tomography and positron emission tomography. Famous neuropsychologist Alexander Romanovich Luria's studies on cognition were conducted without the use of imaging technology for many years, in a large number of patients with brain lesions, and explored complex behavior and specific brain functions involving the lobes and subareas. For instance, he carried out several specific studies on memory and mental organization, reported in his books. The objective of this study is to associate recent studies in neuropsychology with Luria's work specifically on the temporal lobe. According to the data studied, Luria's epistemological foundation remains the basis for neuropsychological studies today, but new data on the temporal lobe in relation to epilepsy and hippocampus analysis have been introduced into the scope of neuropsychology. This study focuses on earlier data from Luria's studies on the neuropsychological functions of the temporal lobe, comparing these with more recent data. However, in order to improve clinical aspects, a detailed study on the neuropsychological tests used for the temporal lobe should be performed.
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Affiliation(s)
- Tales Alexandre Aversi-Ferreira
- Federal University of AlfenasInstitute of Biomedical SciencesDepartment of AnatomyAlfenasMGBrazilLaboratory of Biomathematics and Physical Anthropology, Department of Anatomy, Institute of Biomedical Sciences, Federal University of Alfenas, Alfenas, MG, Brazil.
| | - Bruno Hideki Tamaishi-Watanabe
- Federal University of AlfenasInstitute of Biomedical SciencesDepartment of AnatomyAlfenasMGBrazilLaboratory of Biomathematics and Physical Anthropology, Department of Anatomy, Institute of Biomedical Sciences, Federal University of Alfenas, Alfenas, MG, Brazil.
| | - Micheli Patrícia de Fátima Magri
- Federal University of AlfenasInstitute of Biomedical SciencesDepartment of AnatomyAlfenasMGBrazilLaboratory of Biomathematics and Physical Anthropology, Department of Anatomy, Institute of Biomedical Sciences, Federal University of Alfenas, Alfenas, MG, Brazil.
- Universidade PaulistaDepartment of HealthNursing SchoolSão José do Rio PardoSPBrazilNursing School, Department of Health, Universidade Paulista, São José do Rio Pardo, SP, Brazil.
| | - Roqueline A.G.M.F. Aversi-Ferreira
- Federal University of AlfenasInstitute of Biomedical SciencesDepartment of AnatomyAlfenasMGBrazilLaboratory of Biomathematics and Physical Anthropology, Department of Anatomy, Institute of Biomedical Sciences, Federal University of Alfenas, Alfenas, MG, Brazil.
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Ljung H, Strandberg MC, Björkman-Burtscher IM, Psouni E, Källén K. Test-specific differences in verbal memory assessments used prior to surgery in temporal lobe epilepsy. Epilepsy Behav 2018; 87:18-24. [PMID: 30153652 DOI: 10.1016/j.yebeh.2018.08.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 07/28/2018] [Accepted: 08/12/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To study the relationship between two commonly used verbal memory tests in presurgical evaluation for temporal lobe epilepsy (TLE) in Sweden, the Claeson-Dahl Test for verbal learning and retention (CDT) and the Swedish version of the Rey Auditory Verbal Learning Test (RAVLT). METHODS Fifty-nine patients with TLE (male: 41%, mean: age 41.7 ± 12.3 years; epilepsy onset at mean age: 18.3 ± 13.1 years) previously tested with the CDT, the RAVLT, and three nonverbal memory tests on the same occasion were included. We performed (1) a principal component analysis (PCA) on test performances in the CDT and the RAVLT as well as in nonverbal memory tests; (2) a Pearson's correlation analysis for memory components, biological age, education, age at epilepsy onset, and self-rating scores for depression and anxiety; and (3) an estimation of clinically significant verbal memory impairment in patients with left TLE and left-sided hippocampal sclerosis. RESULTS The PCAs showed coherence between the learning variables of the CDT and the RAVLT and divergence between the recall variables of the two tests. The RAVLT delayed recall variable was correlated to four out of five nonverbal memory measures. Both tests showed 70-80% clinically significant impairment of verbal memory in patients with left TLE, with or without hippocampal sclerosis, similar to other cohorts with resistant TLE. CONCLUSIONS The construct structure of the two verbal memory differs. It was shown that the RAVLT correlated with visuospatial memory, whereas the CDT did not. The study highlights that there are important nonoverlapping features regarding verbal recall of the two tests, indicating that these tests cannot fully replace one another.
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Affiliation(s)
- Hanna Ljung
- Skåne University Hospital, Department of Neurology and Rehabilitation Medicine, Lund, Sweden; Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Division of Clinical Sciences Helsingborg, Sweden; Lund University, Faculty of Medicine, Department of Clinical Neurosciences, Division of Neurology, Lund, Sweden.
| | - Maria Compagno Strandberg
- Skåne University Hospital, Department of Neurology and Rehabilitation Medicine, Lund, Sweden; Lund University, Faculty of Medicine, Department of Clinical Neurosciences, Division of Neurology, Lund, Sweden
| | - Isabella M Björkman-Burtscher
- Lund University, Department of Diagnostic Radiology, Clinical Sciences Lund, Lund University BioImaging Center, Lund, Sweden; Skåne University Hospital, Department of Medical Imaging and Physiology, Lund, Sweden
| | - Elia Psouni
- Lund University, Faculty of Social Sciences, Department of Psychology, Lund, Sweden
| | - Kristina Källén
- Skåne University Hospital, Department of Neurology and Rehabilitation Medicine, Lund, Sweden; Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Division of Clinical Sciences Helsingborg, Sweden; Lund University, Faculty of Medicine, Department of Clinical Neurosciences, Division of Neurology, Lund, Sweden
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Frank B, Hurley L, Scott TM, Olsen P, Dugan P, Barr WB. Machine learning as a new paradigm for characterizing localization and lateralization of neuropsychological test data in temporal lobe epilepsy. Epilepsy Behav 2018; 86:58-65. [PMID: 30082202 DOI: 10.1016/j.yebeh.2018.07.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 07/05/2018] [Accepted: 07/05/2018] [Indexed: 10/28/2022]
Abstract
In this study, we employed a kernel support vector machine to predict epilepsy localization and lateralization for patients with a diagnosis of epilepsy (n = 228). We assessed the accuracy to which indices of verbal memory, visual memory, verbal fluency, and naming would localize and lateralize seizure focus in comparison to standard electroencephalogram (EEG). Classification accuracy was defined as models that produced the least cross-validated error (CVϵ). In addition, we assessed whether the inclusion of norm-based standard scores, demographics, and emotional functioning data would reduce CVϵ. Finally, we obtained class probabilities (i.e., the probability of a particular classification for each case) and produced receiver operating characteristic (ROC) curves for the primary analyses. We obtained the least error assessing localization data with the Gaussian radial basis kernel function (RBF; support vectors = 157, CVϵ = 0.22). There was no overlap between the localization and lateralization models, such that the poorest localization model (the hyperbolic tangent kernel function; support vectors = 91, CVϵ = 0.36) outperformed the strongest lateralization model (RBF; support vectors = 201, CVϵ = 0.39). Contrary to our hypothesis, the addition of norm, demographics, and emotional functioning data did not improve the accuracy of the models. Receiver operating characteristic curves suggested clinical utility in classifying epilepsy lateralization and localization using neuropsychological indicators, albeit with better discrimination for localizing determinations. This study adds to the existing literature by employing an analytic technique with inherent advantages in generalizability when compared to traditional single-sample, not cross-validated models. In the future, class probabilities extracted from these and similar analyses could supplement neuropsychological practice by offering a quantitative guide to clinical judgements.
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Affiliation(s)
- Brandon Frank
- Department of Psychology, Fordham University, 441 East Fordham Road, Bronx, NY 10458, United States of America
| | - Landon Hurley
- Department of Psychology, Fordham University, 441 East Fordham Road, Bronx, NY 10458, United States of America
| | - Travis M Scott
- Department of Psychology, Fordham University, 441 East Fordham Road, Bronx, NY 10458, United States of America
| | - Pat Olsen
- Department of Psychology, Fordham University, 441 East Fordham Road, Bronx, NY 10458, United States of America
| | - Patricia Dugan
- Department of Neurology, NYU School of Medicine, New York, NY 10016, United States of America
| | - William B Barr
- Department of Neurology, NYU School of Medicine, New York, NY 10016, United States of America.
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Loring DW, Bowden SC, Staikova E, Bishop JA, Drane DL, Goldstein FC. NIH Toolbox Picture Sequence Memory Test for Assessing Clinical Memory Function: Diagnostic Relationship to the Rey Auditory Verbal Learning Test. Arch Clin Neuropsychol 2018; 34:268-276. [DOI: 10.1093/arclin/acy028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 03/20/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- David W Loring
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Stephen C Bowden
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Ekaterina Staikova
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - James A Bishop
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Daniel L Drane
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Felicia C Goldstein
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
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Witt JA, Hoppe C, Helmstaedter C. Neuropsychologist's (re-)view: Resective versus ablative amygdalohippocampectomies. Epilepsy Res 2017; 142:161-166. [PMID: 28890320 DOI: 10.1016/j.eplepsyres.2017.08.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 06/27/2017] [Accepted: 08/30/2017] [Indexed: 10/18/2022]
Abstract
Pharmacoresistant mesial temporal lobe epilepsy (mTLE) represents the major indication for epilepsy surgery. Since epilepsy surgery is an elective treatment option, preserving cognition is a high priority. Given the essential role of temporomesial structures in declarative long-term memory formation, surgical treatment for mTLE is primarily associated with a risk of material-specific memory decline, but other cognitive domains may be affected as well. The major determinants for the neuropsychological outcome are the functional integrity of surgically affected tissues, the functional reserve capacities of the remnant brain, the postoperative seizure outcome, as well as the quantitative and qualitative changes of antiepileptic drugs. Anterior temporal lobectomy has long been the standard procedure for treating mTLE. However, if an exclusive mesial pathology is present, then functional non-pathological tissues of the temporal pole and neocortex are sacrificed. As a result, more selective or tailored surgical approaches have been developed which strive towards minimizing iatrogenic effects. However, whether or not these approaches are equipotential with regard to seizure control is still a matter of debate. The quality of the presurgical diagnostics could also be decisive. Selective surgery should indeed be selective in terms of preventing evitable collateral cortical damage along the approach. Invasivity and risks of collateral damage associated with "open" selective resective surgery are further minimized by stereotactic ablative surgery via thermocoagulation, or eventually even eliminated by gamma knife surgery. From a neuropsychological point of view, this development is consequent and desirable, but no clear scientific evidence of a superior cognitive outcome after radiosurgery or thermocoagulation currently exists. The studies that are available contain significant methodological limitations. Thus, randomized head-to-head cognitive outcome studies of competing selective procedures are needed, which should meet the minimum requirements for study design and neuropsychological evaluations. Finally, none of the surgical treatment variants can systematically prevent memory decline when the hippocampus is targeted.
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Affiliation(s)
- Juri-Alexander Witt
- Department of Epileptology, University of Bonn Medical Center, Bonn, Germany.
| | - Christian Hoppe
- Department of Epileptology, University of Bonn Medical Center, Bonn, Germany
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Abstract
OBJECTIVES Little is known about the very long-term cognitive outcome in patients with childhood-onset epilepsy. The aim of this unique prospective population-based cohort study was to examine cognitive outcomes in aging participants with childhood-onset epilepsy (mean onset age=5.3 years) five decades later (mean age at follow-up=56.5 years). METHODS The sample consisted of 48 participants with childhood-onset epilepsy and 48 age-matched healthy controls aged 48-63 years. Thirty-six epilepsy participants were in remission and 12 continued to have seizures. Cognitive function was examined with 11 neuropsychological tests measuring language and semantic function, episodic memory, and learning, visuomotor function, executive function, and working memory. RESULTS The risk of cognitive impairment was very high in participants with continuing seizures; odds ratio (OR)=11.7 (95% confidence interval [CI] (2.8, 49.6), p=.0008). They exhibited worse performances across measures of language and semantic function, and visuomotor function compared to participants with remitted epilepsy and healthy controls. In the participants with remitted epilepsy, the risk of cognitive impairment was somewhat elevated, but not statistically significant; OR=2.6 (95% CI [0.9, 7.5], p=.08). CONCLUSIONS Our results showed that the distinction of continued versus discontinued seizures was critical for determining long-term cognitive outcome in childhood-onset epilepsy. Few participants in remission exhibited marked cognitive impairment compared to age-matched peers. However, a subgroup of participants with decades long active epilepsy, continuous seizure activity and anti-epileptic drug (AED) medication, showed clinically significant cognitive impairment and are thus in a more precarious position when entering older age. (JINS, 2017, 23, 332-340).
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Spontaneous ripples in the hippocampus correlate with epileptogenicity and not memory function in patients with refractory epilepsy. Epilepsy Behav 2016; 62:258-66. [PMID: 27517349 DOI: 10.1016/j.yebeh.2016.05.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 04/22/2016] [Accepted: 05/23/2016] [Indexed: 11/20/2022]
Abstract
INTRODUCTION High-frequency oscillations (HFOs, 80-500Hz) are newly-described EEG markers of epileptogenicity. The proportion of physiological and pathological HFOs is unclear, as frequency analysis is insufficient for separating the two types of events. For instance, ripples (80-250Hz) also occur physiologically during memory consolidation processes in medial temporal lobe structures. We investigated the correlation between HFO rates and memory performance. METHODS Patients investigated with bilateral medial temporal electrodes and an intellectual capacity allowing for memory testing were included. High-frequency oscillations were visually marked, and rates of HFOs were calculated for each channel during slow-wave sleep. Patients underwent three verbal and three nonverbal memory tests. They were grouped into severe impairment, some impairment, mostly intact, or intact for verbal and nonverbal memory. We calculated a Pearson correlation between HFO rates in the hippocampi and the memory category and compared HFO rates in each hippocampus with the corresponding (verbal - left, nonverbal - right) memory result using Wilcoxon rank-sum test. RESULTS Twenty patients were included; ten had bilateral, five had unilateral, and five had no memory impairment. Unilateral memory impairment was verbal in one patient and nonverbal in four. There was no correlation between HFO rates and memory performance in seizure onset areas. There was, however, a significant negative correlation between the overall memory performance and ripple rates (r=-0.50, p=0.03) outside the seizure onset zone. CONCLUSION Our results suggest that the majority of spontaneous hippocampal ripples, as defined in the present study, may reflect pathological activity, taking into account the association with memory impairment. The absence of negative correlation between memory performance and HFO rates in seizure onset areas could be explained by HFO rates in the SOZ being generally so high that differences between areas with remaining and impaired memory function cannot be seen.
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Short-term neurocognitive outcomes following anterior temporal lobectomy. Epilepsy Behav 2016; 62:140-6. [PMID: 27474963 DOI: 10.1016/j.yebeh.2016.06.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 04/28/2016] [Accepted: 06/18/2016] [Indexed: 11/20/2022]
Abstract
Changes in cognitive function are a well established risk of anterior temporal lobectomy (ATL). Deficits in verbal memory are a common postoperative finding, though a small proportion of patients may improve. Postoperative evaluation typically occurs after six to 12months. Patients may benefit from earlier evaluation to identify potential needs; however, the results of a formal neuropsychological assessment at an early postoperative stage are not described in the literature. We compared pre- and postoperative cognitive function for 28 right ATL and 23 left ATL patients using repeated measures ANOVA. Changes in cognitive function were compared to ILAE seizure outcome. The mean time to postoperative neuropsychological testing was 11.1weeks (SD=6.7weeks). There was a side×surgery interaction for the verbal tasks: immediate memory recall (F(1,33)=20.68, p<0.001), short delay recall (F(1,29)=4.99, p=0.03), long delay recall (F(1,33)=10.36, p=0.003), recognition (F(1,33)=5.69, p=0.02), and naming (F(1,37)=15.86, p<0.001). This indicated that the left ATL group had a significant decrement in verbal memory following surgery, while the right ATL group experienced a small but significant improvement. For the right ATL group, there was a positive correlation between ILAE outcome and improvement in immediate recall (r=-0.62, p=0.02) and long delay recall (r=-0.57, p=0.03). There was no similar finding for the left ATL group. This study demonstrates that short-interval follow-up is effective in elucidating postoperative cognitive changes. Right ATL was associated with improvement in verbal memory, while left ATL resulted in a decrement in performance. Improvement in the right ATL group was related to improved seizure outcome. Short-interval follow-up may lend itself to the identification of patients who could benefit from early intervention.
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Soble JR, Osborn KE, Mattingly ML, Vale FL, Benbadis SR, Rodgers-Neame NT, Schoenberg MR. Utility of Green's Word Memory Test Free Recall Subtest as a Measure of Verbal Memory: Initial Evidence from a Temporal Lobe Epilepsy Clinical Sample. Arch Clin Neuropsychol 2015; 31:79-87. [PMID: 26663824 DOI: 10.1093/arclin/acv084] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2015] [Indexed: 11/14/2022] Open
Abstract
This study investigated the Word Memory Test (WMT) Free Recall (FR) subtest as a conventional memory measure. Nineteen participants with pharmacoresistant left temporal lobe epilepsy (LTLE) and 16 with right temporal lobe epilepsy (RTLE) completed the WMT, Rey Auditory Verbal Learning Test (RAVLT), and Wechsler Memory Scale-Fourth Edition Logical Memory (LM) subtest during presurgical evaluation. LTLE participants performed significantly worse on FR subtest (p < .05, [Formula: see text]) and RAVLT Trial 7 (p < .01, [Formula: see text]), but not on LM subtest. Age was a significant covariate for FR (p < .01, [Formula: see text]). Logistic regression revealed FR plus age and RAVLT age-adjusted T-scores both yielded 77.1% classification accuracy and respective diagnostic odds ratios of 11.36 and 11.84. Receiver operating characteristic curves to classify seizure laterality found that RAVLT and FR were significant (area under the curve [AUC] = 0.82 and 0.74), whereas LM was nonsignificant (AUC = 0.67). Cut scores and positive/negative predictive values were established for improved clinical classification.
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Affiliation(s)
- Jason R Soble
- Psychology Service, South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Katie E Osborn
- Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Michelle L Mattingly
- Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Fernando L Vale
- Department of Neurosurgery and Brain Repair, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Selim R Benbadis
- Department of Neurology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Nancy T Rodgers-Neame
- Private Practice, Florida Comprehensive Epilepsy and Seizure Disorders Center, Tampa, FL, USA
| | - Mike R Schoenberg
- Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA Department of Neurosurgery and Brain Repair, Morsani College of Medicine, University of South Florida, Tampa, FL, USA Department of Neurology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
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Brown FC, Hirsch LJ, Spencer DD. Spatial memory for asymmetrical dot locations predicts lateralization among patients with presurgical mesial temporal lobe epilepsy. Epilepsy Behav 2015; 52:19-24. [PMID: 26398592 DOI: 10.1016/j.yebeh.2015.08.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 07/24/2015] [Accepted: 08/17/2015] [Indexed: 10/23/2022]
Abstract
This study examined the ability of an asymmetrical dot location memory test (Brown Location Test, BLT) and two verbal memory tests (Verbal Selective Reminding Test (VSRT) and California Verbal Learning Test, Second Edition (CVLT-II)) to correctly lateralize left (LTLE) or right (RTLE) mesial temporal lobe epilepsy that was confirmed with video-EEG. Subjects consisted of 16 patients with medically refractory RTLE and 13 patients with medically refractory LTLE who were left hemisphere language dominant. Positive predictive values for lateralizing TLE correctly were 87.5% for the BLT, 72.7% for the VSRT, and 80% for the CVLT-II. Binary logistic regression indicated that the BLT alone correctly classified 76.9% of patients with left temporal lobe epilepsy and 87.5% of patients with right temporal lobe epilepsy. Inclusion of the verbal memory tests improved this to 92.3% of patients with left temporal lobe epilepsy and 100% correct classification of patients with right temporal lobe epilepsy. Though of a limited sample size, this study suggests that the BLT alone provides strong laterality information which improves with the addition of verbal memory tests.
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Affiliation(s)
- Franklin C Brown
- Comprehensive Epilepsy Center, Department of Neurology, Yale University, New Haven, CT, USA.
| | - Lawrence J Hirsch
- Comprehensive Epilepsy Center, Department of Neurology, Yale University, New Haven, CT, USA
| | - Dennis D Spencer
- Comprehensive Epilepsy Center, Department of Neurosurgery, Yale University, New Haven, CT, USA
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Witt JA, Coras R, Schramm J, Becker AJ, Elger CE, Blümcke I, Helmstaedter C. Relevance of hippocampal integrity for memory outcome after surgical treatment of mesial temporal lobe epilepsy. J Neurol 2015; 262:2214-24. [DOI: 10.1007/s00415-015-7831-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 06/17/2015] [Accepted: 06/18/2015] [Indexed: 11/29/2022]
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Miller JP, Sweet JA, Bailey CM, Munyon CN, Luders HO, Fastenau PS. Visual-spatial memory may be enhanced with theta burst deep brain stimulation of the fornix: a preliminary investigation with four cases. Brain 2015; 138:1833-42. [PMID: 26106097 DOI: 10.1093/brain/awv095] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 02/02/2015] [Indexed: 11/13/2022] Open
Abstract
Memory loss after brain injury can be a source of considerable morbidity, but there are presently few therapeutic options for restoring memory function. We have previously demonstrated that burst stimulation of the fornix is able to significantly improve memory in a rodent model of traumatic brain injury. The present study is a preliminary investigation with a small group of cases to explore whether theta burst stimulation of the fornix might improve memory in humans. Four individuals undergoing stereo-electroencephalography evaluation for drug-resistant epilepsy were enrolled. All participants were implanted with an electrode into the proximal fornix and dorsal hippocampal commissure on the language dominant (n = 3) or language non-dominant (n = 1) side, and stimulation of this electrode reliably produced a diffuse evoked potential in the head and body of the ipsilateral hippocampus. Each participant underwent testing of verbal memory (Rey Auditory-Verbal Learning Test), visual-spatial memory (Medical College of Georgia Complex Figure Test), and visual confrontational naming (Boston Naming Test Short Form) once per day over at least two consecutive days using novel test forms each day. For 50% of the trials, the fornix electrode was continuously stimulated using a burst pattern (200 Hz in 100 ms trains, five trains per second, 100 µs, 7 mA) and was compared with sham stimulation. Participants and examiners were blinded to whether stimulation was active or not, and the order of stimulation was randomized. The small sample size precluded use of inferential statistics; therefore, data were analysed using descriptive statistics and graphic analysis. Burst stimulation of the fornix was not perceived by any of the participants but was associated with a robust reversible improvement in immediate and delayed performance on the Medical College of Georgia Complex Figure Test. There were no apparent differences on either Rey Auditory-Verbal Learning Test or Boston Naming Test. There was no apparent relationship between performance and side of stimulation (language dominant or non-dominant). There were no complications. Preliminary evidence in this small sample of patients with drug-resistant epilepsy suggests that theta burst stimulation of the fornix may be associated with improvement in visual-spatial memory.
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Affiliation(s)
- Jonathan P Miller
- 1 Neurological Institute, University Hospitals Case Medical Centre, Cleveland, Ohio, USA 2 Department of Neurological Surgery, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Jennifer A Sweet
- 1 Neurological Institute, University Hospitals Case Medical Centre, Cleveland, Ohio, USA 2 Department of Neurological Surgery, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Christopher M Bailey
- 1 Neurological Institute, University Hospitals Case Medical Centre, Cleveland, Ohio, USA 3 Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Charles N Munyon
- 1 Neurological Institute, University Hospitals Case Medical Centre, Cleveland, Ohio, USA 2 Department of Neurological Surgery, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Hans O Luders
- 1 Neurological Institute, University Hospitals Case Medical Centre, Cleveland, Ohio, USA 3 Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Philip S Fastenau
- 1 Neurological Institute, University Hospitals Case Medical Centre, Cleveland, Ohio, USA 3 Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
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Soble JR, Eichstaedt KE, Waseem H, Mattingly ML, Benbadis SR, Bozorg AM, Vale FL, Schoenberg MR. Clinical utility of the Wechsler Memory Scale--Fourth Edition (WMS-IV) in predicting laterality of temporal lobe epilepsy among surgical candidates. Epilepsy Behav 2014; 41:232-7. [PMID: 25461222 DOI: 10.1016/j.yebeh.2014.10.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Revised: 10/10/2014] [Accepted: 10/11/2014] [Indexed: 11/15/2022]
Abstract
This study evaluated the accuracy of the Wechsler Memory Scale--Fourth Edition (WMS-IV) in identifying functional cognitive deficits associated with seizure laterality in localization-related temporal lobe epilepsy (TLE) relative to a previously established measure, the Rey Auditory Verbal Learning Test (RAVLT). Emerging WMS-IV studies have highlighted psychometric improvements that may enhance its ability to identify lateralized memory deficits. Data from 57 patients with video-EEG-confirmed unilateral TLE who were administered the WMS-IV and RAVLT as part of a comprehensive presurgical neuropsychological evaluation for temporal resection were retrospectively reviewed. We examined the predictive accuracy of the WMS-IV not only in terms of verbal versus visual composite scores but also using individual subtests. A series of hierarchal logistic regression models were developed, including the RAVLT, WMS-IV delayed subtests (Logical Memory, Verbal Paired Associates, Designs, Visual Reproduction), and a WMS-IV verbal-visual memory difference score. Analyses showed that the RAVLT significantly predicted laterality with overall classification rates of 69.6% to 70.2%, whereas neither the individual WMS-IV subtests nor the verbal-visual memory difference score accounted for additional significant variance. Similar to previous versions of the WMS, findings cast doubt as to whether the WMS-IV offers significant incremental validity in discriminating seizure laterality in TLE beyond what can be obtained from the RAVLT.
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Affiliation(s)
- Jason R Soble
- Psychology Service (116B), South Texas Veterans Health Care System, 7400 Merton Minter, San Antonio, TX 78229, USA.
| | - Katie E Eichstaedt
- Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, 3515 East Fletcher Ave., Tampa, FL 33613, USA.
| | - Hena Waseem
- Department of Neurosurgery and Brain Repair, Morsani College of Medicine, University of South Florida, 2 Tampa General Circle, USF Health, 7th Floor, Tampa, FL 33606, USA.
| | - Michelle L Mattingly
- Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, 3515 East Fletcher Ave., Tampa, FL 33613, USA.
| | - Selim R Benbadis
- Department of Neurology, Morsani College of Medicine, University of South Florida, 2 Tampa General Circle, USF Health, 6th Floor, Tampa, FL 33606, USA.
| | - Ali M Bozorg
- Department of Neurology, Morsani College of Medicine, University of South Florida, 2 Tampa General Circle, USF Health, 6th Floor, Tampa, FL 33606, USA.
| | - Fernando L Vale
- Department of Neurosurgery and Brain Repair, Morsani College of Medicine, University of South Florida, 2 Tampa General Circle, USF Health, 7th Floor, Tampa, FL 33606, USA.
| | - Mike R Schoenberg
- Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, 3515 East Fletcher Ave., Tampa, FL 33613, USA; Department of Neurosurgery and Brain Repair, Morsani College of Medicine, University of South Florida, 2 Tampa General Circle, USF Health, 7th Floor, Tampa, FL 33606, USA; Department of Neurology, Morsani College of Medicine, University of South Florida, 2 Tampa General Circle, USF Health, 6th Floor, Tampa, FL 33606, USA.
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Vogt VL, Witt JA, Malter MP, Schoene-Bake JC, Lehe MV, Elger CE, Helmstaedter C. Neuropsychological outcome after epilepsy surgery in patients with bilateral Ammon's horn sclerosis. J Neurosurg 2014; 121:1247-56. [DOI: 10.3171/2014.7.jns132037] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Object
The purpose of this study was to retrospectively assess the objective and subjective neuropsychological outcome after epilepsy surgery in patients with bilateral Ammon's horn sclerosis (AHS).
Methods
Memory and executive functions were evaluated at baseline and at follow-up in 11 surgically treated patients and compared with 8 pharmacologically treated patients with temporal lobe epilepsy and bilateral AHS. The median follow-up duration was 16 months in the surgically treated patients and 80.5 months in the pharmacologically treated group. Subjective outcome was evaluated by questionnaires and included mood, quality of life, subjective memory, and activities of daily living.
Results
At the follow-up assessment, 82% of the surgically treated patients as opposed to 0% of the nonsurgery patients were seizure free. In the surgical group, nonverbal memory performance did not change significantly in any patient after surgery, but there was a floor effect in 55% of the surgical patients. Regarding verbal memory, 9% of the surgical patients improved while 73% declined, despite severe impairments already evident at baseline. In the nonsurgery control group, 13% of the patients declined in nonverbal memory (floor effect in 63%) and 25% declined in verbal memory (floor effect in 25%) at follow-up. None of the controls improved at follow-up. Executive functions remained unchanged on an impaired level in both groups. At follow-up, the patient groups did not differ significantly with respect to mood, quality of life, subjective memory, or activities of daily living. However, in most aspects, surgically treated patients reported a slightly better subjective outcome than pharmacologically treated patients and a significantly improved quality of life.
Conclusions
These results suggest that beyond benefits concerning seizure control, surgically treated patients with bilateral AHS, despite already poor baseline performance, are still at risk for severe postoperative decline in memory. In the light of predominantly minor benefits on a subjective level, the findings put the overall outcome of epilepsy surgery in bilateral AHS patients into perspective.
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Affiliation(s)
| | | | | | | | - Marec von Lehe
- 2Neurosurgery, University of Bonn, Medical Center, Bonn, Germany
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Larrabee GJ. Test validity and performance validity: considerations in providing a framework for development of an ability-focused neuropsychological test battery. Arch Clin Neuropsychol 2014; 29:695-714. [PMID: 25280794 DOI: 10.1093/arclin/acu049] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Literature on test validity and performance validity is reviewed to propose a framework for specification of an ability-focused battery (AFB). Factor analysis supports six domains of ability: first, verbal symbolic; secondly, visuoperceptual and visuospatial judgment and problem solving; thirdly, sensorimotor skills; fourthly, attention/working memory; fifthly, processing speed; finally, learning and memory (which can be divided into verbal and visual subdomains). The AFB should include at least three measures for each of the six domains, selected based on various criteria for validity including sensitivity to presence of disorder, sensitivity to severity of disorder, correlation with important activities of daily living, and containing embedded/derived measures of performance validity. Criterion groups should include moderate and severe traumatic brain injury, and Alzheimer's disease. Validation groups should also include patients with left and right hemisphere stroke, to determine measures sensitive to lateralized cognitive impairment and so that the moderating effects of auditory comprehension impairment and neglect can be analyzed on AFB measures.
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Umfleet LG, Janecek JK, Quasney E, Sabsevitz DS, Ryan JJ, Binder JR, Swanson SJ. Sensitivity and Specificity of Memory and Naming Tests for Identifying Left Temporal-Lobe Epilepsy. APPLIED NEUROPSYCHOLOGY-ADULT 2014; 22:189-96. [DOI: 10.1080/23279095.2014.895366] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | - Julie K. Janecek
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Erin Quasney
- Department of Psychology, Marquette University, Milwaukee, Wisconsin
| | - David S. Sabsevitz
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Joseph J. Ryan
- Department of Psychological Science, University of Central Missouri, Warrensburg, Missouri
| | - Jeffrey R. Binder
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Sara J. Swanson
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin
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Eichstaedt KE, Clifton WE, Vale FL, Benbadis SR, Bozorg AM, Rodgers-Neame NT, Schoenberg MR. Sensitivity of Green’s Word Memory Test Genuine Memory Impairment Profile to Temporal Pathology: A Study in Patients With Temporal Lobe Epilepsy. Clin Neuropsychol 2014; 28:941-53. [DOI: 10.1080/13854046.2014.942374] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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45
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Magnitude of cognitive dysfunction in adults with type 2 diabetes: a meta-analysis of six cognitive domains and the most frequently reported neuropsychological tests within domains. J Int Neuropsychol Soc 2014; 20:278-91. [PMID: 24555960 PMCID: PMC4132660 DOI: 10.1017/s1355617713001483] [Citation(s) in RCA: 221] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The objectives were to conduct a meta-analysis in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards to determine effect sizes (Cohen's d) for cognitive dysfunction in adults with type 2 diabetes, relative to nondiabetic controls, and to obtain effect sizes for the most commonly reported neuropsychological tests within domains. Twenty-four studies, totaling 26,137 patients (n = 3351 with diabetes), met study inclusion criteria. Small to moderate effect sizes were obtained for five of six domains: motor function (3 studies, n = 2374; d = -0.36), executive function (12 studies, n = 1784; d = -0.33), processing speed (16 studies, n = 3076; d = -0.33), verbal memory (15 studies, n = 4,608; d = -0.28), and visual memory (6 studies, n = 1754; d = -0.26). Effect size was smallest for attention/concentration (14 studies, n = 23,143; d = -0.19). The following tests demonstrated the most notable performance decrements in diabetes samples: Grooved Pegboard (dominant hand) (d = -0.60), Rey Auditory Verbal Learning Test (immediate) (d = -0.40), Trails B (d = -0.39), Rey-Osterreith Complex Figure (delayed) (d = -0.38), Trails A (d = -0.34), and Stroop Part I (d = -0.28). This study provides effect sizes to power future epidemiological and clinical diabetes research studies examining cognitive function and to help inform the selection of neuropsychological tests.
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Brown FC, Westerveld M, Langfitt JT, Hamberger M, Hamid H, Shinnar S, Sperling MR, Devinsky O, Barr W, Tracy J, Masur D, Bazil CW, Spencer SS. Influence of anxiety on memory performance in temporal lobe epilepsy. Epilepsy Behav 2014; 31:19-24. [PMID: 24291525 PMCID: PMC3946774 DOI: 10.1016/j.yebeh.2013.10.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 10/04/2013] [Accepted: 10/08/2013] [Indexed: 11/19/2022]
Abstract
This study examined the degree to which anxiety contributed to inconsistent material-specific memory difficulties among 243 patients with temporal lobe epilepsy from the Multisite Epilepsy Study. Visual memory performance on the Rey Complex Figure Test (RCFT) was poorer for those with high versus low levels of anxiety but was not found to be related to the TLE side. The verbal memory score on the California Verbal Learning Test (CVLT) was significantly lower for patients with left-sided TLE than for patients with right-sided TLE with low anxiety levels but equally impaired for those with high anxiety levels. These results suggest that we can place more confidence in the ability of verbal memory tests like the CVLT to lateralize to left-sided TLE for those with low anxiety levels, but that verbal memory will be less likely to produce lateralizing information for those with high anxiety levels. This suggests that more caution is needed when interpreting verbal memory tests for those with high anxiety levels. These results indicated that RCFT performance was significantly affected by anxiety and did not lateralize to either side, regardless of anxiety levels. This study adds to the existing literature which suggests that drawing-based visual memory tests do not lateralize among patients with TLE, regardless of anxiety levels.
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Affiliation(s)
| | - Michael Westerveld
- Walt Disney Pavilion - Florida Hospital for Children, Winter Park, FL, USA
| | - John T Langfitt
- Department of Neurology, University of Rochester Medical Center, School of Medicine and Dentistry, Rochester, NY, USA
| | - Marla Hamberger
- Department of Neurology, Columbia University, New York, NY 10032, USA
| | - Hamada Hamid
- Department of Neurology, Yale University, New Haven, CT, USA
| | - Shlomo Shinnar
- Department of Neurology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Michael R Sperling
- Department of Neurology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Orrin Devinsky
- Departments of Neurology, Neurosurgery, and Psychiatry, New York University Comprehensive Epilepsy Center, New York, NY, USA
| | - William Barr
- Department of Neurology, New York University School of Medicine, New York, NY, USA
| | - Joseph Tracy
- Department of Neurology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - David Masur
- Department of Neurology, Albert Einstein School of Medicine, Yeshiva University, Bronx, NY, USA
| | - Carl W Bazil
- Department of Neurology, Columbia University, New York, NY 10032, USA
| | - Susan S Spencer
- Department of Neurology, Yale University, New Haven, CT, USA.
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Chapin JS, Busch RM, Silveira DC, Wehner T, Naugle RI, Ferguson L, Najm IM. Memory performance in older adults before and after temporal lobectomy for pharmacoresistant epilepsy. Clin Neuropsychol 2013; 27:1316-27. [PMID: 24159928 DOI: 10.1080/13854046.2013.850535] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Little is known about the effects of epilepsy surgery on memory in older adults. The purpose of this study was to determine if older adults exhibit greater memory decline than younger adults after anterior temporal lobectomy (ATL). Patients 55 years and older at time of surgery (23 left, 14 right ATL, range 55-66 years) were compared to patients age 25-35 years (44 left, 33 right ATL) to assess differences in preoperative to postoperative change in WMS-III index scores. Repeated-measures ANOVAs and ANCOVAs revealed that older patients did not demonstrate greater decline than younger patients across any of the memory indices. Rather, in the left ATL group, older patients showed less decline than younger patients on the Auditory Delayed Memory Index. Similarly, in the right ATL group, older patients showed less decline than younger patients on the Visual Delayed Memory Index. These patterns were also apparent in frequency of individual change. Results provide preliminary evidence that older adults who are good candidates for ATL are not at greater risk for memory decline when measured at 7 months postoperatively.
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48
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Ferreira Correia A, Campagna Osorio I. The Rey Auditory Verbal Learning Test: Normative Data Developed for the Venezuelan Population. Arch Clin Neuropsychol 2013; 29:206-15. [DOI: 10.1093/arclin/act070] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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49
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Benke T, Kuen E, Schwarz M, Walser G. Proper name retrieval in temporal lobe epilepsy: naming of famous faces and landmarks. Epilepsy Behav 2013; 27:371-7. [PMID: 23542541 DOI: 10.1016/j.yebeh.2013.02.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2013] [Revised: 02/13/2013] [Accepted: 02/16/2013] [Indexed: 11/29/2022]
Abstract
The objective of this study was to further explore proper name (PN) retrieval and conceptual knowledge in patients with left and right temporal lobe epilepsy (69 patients with LTLE and 62 patients with RTLE) using a refined assessment procedure. Based on the performance of a large group of age- and education-matched normals, a new test of famous faces and famous landmarks was designed. Recognition, naming, and semantic knowledge were assessed consecutively, allowing for a better characterization of deficient levels in the naming system. Impairment in PN retrieval was common in the cohort with TLE. Furthermore, side of seizure onset impaired stages of name retrieval differently: LTLE impaired the lexico-phonological processing, whereas RTLE mainly impaired the perceptual-semantic stage of object recognition. In addition to deficient PN retrieval, patients with TLE had reduced conceptual knowledge regarding famous persons and landmarks.
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Affiliation(s)
- Thomas Benke
- Clinic of Neurology, Medical University Innsbruck, Austria.
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50
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Loring DW, Bowden SC. The STROBE statement and neuropsychology: lighting the way toward evidence-based practice. Clin Neuropsychol 2013; 28:556-74. [PMID: 23356727 DOI: 10.1080/13854046.2012.762552] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Reporting appropriate research detail across clinical disciplines is often inconsistent or incomplete. Insufficient report detail reduces confidence in findings, makes study replication more difficult, and decreases the precision of data available for critical review including meta-analysis. In response to these concerns, cooperative attempts across multiple specialties have developed explicit research reporting standards to guide publication detail. These recommendations have been widely adopted by high impact medical journals, but have not yet been widely embraced by neuropsychology. The STROBE Statement (STrengthening the Reporting of Observational studies in Epidemiology) is particularly relevant to neuropsychology since clinical research is often based on non-funded studies of patient samples. In this paper we describe the STROBE Statement and demonstrate how STROBE criteria, applied to reporting of neuropsychological findings, will maintain neuropsychology's position as a leader in quantifying brain-behavior relationships. We also provide specific recommendations for data reporting and disclosure of perceived conflicts of interest that will further enhance reporting transparency for possible perceived sources of bias. In an era in which evidence-based practice assumes an increasingly prominent role, improved reporting standards will promote better patient care, assist in developing quality practice guidelines, and ensure that neuropsychology remains a vigorous discipline in the clinical neurosciences that consciously aspires to high methodological rigor.
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Affiliation(s)
- David W Loring
- a Departments of Neurology and Pediatrics , Emory University School of Medicine , Atlanta , GA , USA
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