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Kavanaugh BC, Legere C, Vigne M, Holler K, Spirito A. The Tower of London task in children and adolescents with neuropsychiatric disorders. Child Neuropsychol 2024:1-16. [PMID: 38829302 DOI: 10.1080/09297049.2024.2360224] [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: 12/15/2023] [Accepted: 05/17/2024] [Indexed: 06/05/2024]
Abstract
The Tower of London, Drexel Version, Second Edition (TOL-DX) is purported to measure multiple aspects of executive functions, although it also possesses inherent non-executive demands. Such complexity makes it useful in detecting impairment but difficult in interpreting the neurocognitive cause of impairment, particularly in children. This study investigated the developmental, neurocognitive, and symptom correlates of the TOL-DX in children and adolescents with neuropsychiatric disorders. Two-hundred and thirty-three children and adolescents (7-21 years old) completed the TOL-DX during a neuropsychological evaluation as part of clinical care within a children's psychiatric hospital. Pearson correlation, regression models, and receiver operating characteristic curve (ROC) analyses examined the association among variables. Visuospatial and executive functions (EF) were most consistently related to total moves, execution time, and violations. TOL-DX variables were associated with attention in younger participants and EF in older participants. No TOL-DX scores were related to parent-reported symptoms. The TOL-DX possesses inherent visuospatial and attention/executive demands in children and adolescents which are difficult to differentiate, differ by age group, and not associated to clinical symptoms. Taken together, the TOL-DX is complex to interpret, but psychometrically sound and sensitive to neurocognitive impairment in children and adolescents with transdiagnostic neuropsychiatric disorders.
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Affiliation(s)
- Brian C Kavanaugh
- Department of Psychiatry and Human Behavior, Emma Pendleton Bradley Hospital, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Christopher Legere
- Department of Psychiatry and Human Behavior, Emma Pendleton Bradley Hospital, Providence, RI, USA
| | - Megan Vigne
- Department of Psychiatry and Human Behavior, Butler Hospital, Providence, RI, USA
| | - Karen Holler
- Department of Psychiatry and Human Behavior, Emma Pendleton Bradley Hospital, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Anthony Spirito
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
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Whitaker AM, Wood ZB, Hawthorne K, Mendoza L. Assessing learning and memory among patients with pediatric brain tumor (PBT): a comparison of measures. Child Neuropsychol 2024; 30:551-562. [PMID: 37395295 DOI: 10.1080/09297049.2023.2229026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 06/16/2023] [Indexed: 07/04/2023]
Abstract
Patients with pediatric brain tumor (PBT) can have memory deficits due to tumor location, medical complications, and treatment. The main objective of this study was to investigate whether the California Verbal Learning Test-Children's Version (CVLT-C; 1994) and briefer Child and Adolescent Memory Profile (ChAMP; 2015) similarly identify such deficits. Seventy-five patients with PBT ages 8-16 (x ‾ = 13.1 years, SD = 2.1) were administered the ChAMP or CVLT-C. Rote verbal learning, long-term retrieval, and recognition were analyzed using standardized z-scores. Analyses of differences between measures did not reach statistical significance. Both measures indicated significant downward shifts across free retrieval trials from normative means, with scores approximately 1/3 (ChAMP) to 1/2 (CVLT-C) SD below means across learning and long-term retrieval trials. Scores on recognition trials did not differ significantly from the normative mean. Post-hoc analyses using a subset of the sample who received cranial irradiation (n = 45) similarly found no significant differences between memory measures. Additional post-hoc examination of proportion of participants falling within or below the "below average" range (≤8th percentile) revealed comparable performance between the two measures, whereas the proportion of participants falling at or below 1.5 SDs below the mean on retrieval trials was lower using ChAMP Lists as compared to the CVLT-C. Given the ChAMP is less demanding in terms of time and effort and utilizes more updated and representative normative data, this study supports the ChAMP as a useful tool to evaluate learning and memory within this population.
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Affiliation(s)
- Ashley M Whitaker
- Cancer and Blood Disease Institute, Children's Hospital Los Angeles, Los Angeles, CA, USA
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Zachary B Wood
- Cancer and Blood Disease Institute, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Kelsey Hawthorne
- Cancer and Blood Disease Institute, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Leanne Mendoza
- Cancer and Blood Disease Institute, Children's Hospital Los Angeles, Los Angeles, CA, USA
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Bakhshinezhad H, Darharaj M, Feyzi YF, Babaei S, Ahadi R, Jamei B, Pourhamzeh M, Daneshi A, Arezoomandan R. The Relationship Between Brain Metabolites Alterations and Neuropsychological Deficits in Patients with Methamphetamine Use Disorder: A Proton Magnetic Resonance Spectroscopy Study. Arch Clin Neuropsychol 2021; 37:160-172. [PMID: 33993207 DOI: 10.1093/arclin/acab033] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2021] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION Chronic use of methamphetamine induces neuropsychological deficits and neurochemical changes in frontostriatal regions. This study aimed to examine the relationship between brain metabolites alterations in frontostriatal regions and neuropsychological deficits in patients with methamphetamine use disorder. METHOD A total of 30 methamphetamine users and 20 control participants were selected and a battery of standardized executive function, attention, and memory tasks, including the Wisconsin Card Sorting Test, Stroop Test, and Wechsler Memory Scale, was administered to them. Proton-Magnetic resonance spectroscopy (H-MRS) of N-Acetylaspartate/Creatine (NAA/Cr), Choline/Creatine (Cho/Cr), and glutamate + glutamine/creatine (Glx/Cr) in dorsolateral prefrontal cortex (DLPFC), anterior cingulate cortex (ACC), and basal ganglia (BG) were also undertaken. RESULTS Current findings indicated that there were significant differences between two groups in metabolite ratios including NAA/Cr, Cho/Cr, and Glx/Cr in three areas, except for Glx/Cr in BG. Moreover, compared to healthy controls, methamphetamine users showed poorer performance in all neuropsychological tests. Finally, a significant relationship was found between regional metabolites alterations, particularly in the ACC, and neuropsychological deficits in methamphetamine users. CONCLUSIONS In addition to neurochemical changes and neuropsychological deficits in patients with methamphetamine use disorder, current results highlighted the relationship between these changes in DLPFC, ACC, and BG with cognitive deficits in methamphetamine users.
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Affiliation(s)
- Hamideh Bakhshinezhad
- Department of Anatomical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Darharaj
- Student Research Committee, Addiction Department, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Yasha Fayaz Feyzi
- Student Research Committee, Addiction Department, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Shirzad Babaei
- Student Research Committee, Psychology Department, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Reza Ahadi
- Department of Anatomical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Behnammaddin Jamei
- Neuroscience Research Center (NRC), Iran University of Medical Sciences, Tehran, Iran
| | - Mahsa Pourhamzeh
- Department of Anatomical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Abdolhadi Daneshi
- Haft-e-Tir Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Arezoomandan
- Addiction Department, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
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Kosky KM, Lace JW, Austin TA, Seitz DJ, Clark B. The utility of the Wisconsin card sorting test, 64-card version to detect noncredible attention-deficit/hyperactivity disorder. APPLIED NEUROPSYCHOLOGY-ADULT 2020; 29:1231-1241. [DOI: 10.1080/23279095.2020.1864633] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Karen M. Kosky
- Department of Health Psychology, University of Missouri, Columbia, MO, USA
| | - John W. Lace
- Department of Neurology, Cleveland Clinic, Cleveland, OH, USA
| | - Tara A. Austin
- University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Dylan J. Seitz
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Brook Clark
- Department of Health Psychology, University of Missouri, Columbia, MO, USA
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van den Berg L, de Weerd A, Reuvekamp M, van der Meere J. Cognitive control deficits in pediatric frontal lobe epilepsy. Epilepsy Behav 2020; 102:106645. [PMID: 31760200 DOI: 10.1016/j.yebeh.2019.106645] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 09/25/2019] [Accepted: 10/09/2019] [Indexed: 11/16/2022]
Abstract
Executive dysfunction and behavioral problems are common in children with epilepsy. Inhibition and shifting, both aspects of cognitive control, seem related to behavior problems and are thought to be driven mainly by the frontal lobes. We investigated if inhibition and shifting deficits are present in children with frontal lobe epilepsy (FLE). Secondly, we studied the relationship between these deficits and behavior problems. Thirty-one children were administered the Stroop Color Word Test and a digital version of the Wisconsin Card Sorting Test (WCST). Parents completed the Behavioral Rating Inventory for Executive Function (BRIEF) and the Achenbach scale (Child Behavior Checklist (CBCL)). About 20% of the children displayed significant low results on the Stroop Effect. About 60% showed shifting problems on the WCST. Parents reported cognitive control and behavioral deficits in about a third of the children. Also, behavioral problems and deficits in inhibition and shifting in daily life (BRIEF) seem to be related. There were no correlations between questionnaires and the Stroop and the WCST. Only in the group of children with many perseverative errors there were especially high correlations between Inhibit of the BRIEF.
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Affiliation(s)
- Lydia van den Berg
- Stichting Epilepsie Instellingen Nederland, Postbus 563, 8000 AN Zwolle, Netherlands; RijksUniversiteitGroningen, Faculteit Gedrags- & Maatschappijwetenschappen, Klinische & Ontwikkelingsneuropsychologie, Grote Kruisstraat 2/1, 9712 TS Groningen, Netherlands.
| | - Al de Weerd
- Stichting Epilepsie Instellingen Nederland, Postbus 563, 8000 AN Zwolle, Netherlands
| | - Marieke Reuvekamp
- Stichting Epilepsie Instellingen Nederland, Postbus 563, 8000 AN Zwolle, Netherlands
| | - Jaap van der Meere
- RijksUniversiteitGroningen, Faculteit Gedrags- & Maatschappijwetenschappen, Klinische & Ontwikkelingsneuropsychologie, Grote Kruisstraat 2/1, 9712 TS Groningen, Netherlands
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Abstract
First, executive functions are defined. Then the development of executive functions in children, from infancy to 10-11 years of age, is briefly described. The relation between the speed of processing and the development of executive functions is addressed. Finally, tools and pointers for evaluating executive functioning in younger and older children are discussed. A cautionary note is sounded, in that almost no executive function measure requires only one executive function. A child might fail a working memory task because of problems with inhibitory control (not working memory), fail an inhibitory control task because of working memory problems, or fail a cognitive flexibility, planning, or reasoning task because of problems with inhibitory control or working memory.
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Affiliation(s)
- Adele Diamond
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
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Yuan M, Yan DY, Xu FS, Zhao YD, Zhou Y, Pan LF. Effects of sepsis on hippocampal volume and memory function. World J Emerg Med 2020; 11:223-230. [PMID: 33014218 PMCID: PMC7517393 DOI: 10.5847/wjem.j.1920-8642.2020.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 04/02/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND This study aimed to determine the effects of sepsis on brain integrity, memory, and executive function. METHODS Twenty sepsis patients who were not diagnosed with sepsis-associated encephalopathy (SAE) but had abnormal electroencephalograms (EEGs) were included. The control group included twenty healthy persons. A neuropsychological test of memory and executive function and a brain magnetic resonance imaging scan were performed. The volumes of cortex and subcortex were measured using the FreeSurfer software. Acute Physiology and Chronic Health Evaluation II (APACHE II) score was used to determine the disease severity. RESULTS In the sepsis group, the levels of immediate free recall, immediate cued recall, and delayed cued recall in the California Verbal Learning Test-II (CVLT-II) were significantly lower; the explicit memory (recollection process) in the process dissociation procedure test was lower; and the volumes of the left and right hippocampi were significantly lower compared with the control group. The volume of the presubiculum in the hippocampus of sepsis patients showed statistically significant decrease. In the sepsis group, the volumes of the left and right hippocampi were negatively correlated with the APACHE II score and positively with immediate free recall, immediate cued recall, and delayed cued recall in the CVLT-II; moreover, the hippocampal volume was significantly correlated with recollection but not with familiarity. CONCLUSIONS Patients with abnormal EEGs during hospitalization but with no SAE still have reduced hippocampal volume and memory deficits. This finding indicates that sepsis leads to damage to specific parts of the hippocampus.
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Affiliation(s)
- Miao Yuan
- Emergency Department, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Ding-yi Yan
- Department of Cardiology, Xi’an No. 3 Hospital, Xi’an, China
| | - Fang-shi Xu
- Emergency Department, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Yi-di Zhao
- Emergency Department, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Yang Zhou
- Emergency Department, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Long-fei Pan
- Emergency Department, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
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Parental Demandingness and Executive Functioning in Predicting Anxiety among Children in a Longitudinal Community Study. J Youth Adolesc 2019; 49:299-310. [PMID: 31422499 DOI: 10.1007/s10964-019-01103-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 08/01/2019] [Indexed: 10/26/2022]
Abstract
Theoretical models and empirical studies of anxiety have predominately focused on the main effects of various predictors such as executive functioning deficits on anxiety. This study examined the moderating role of parental demandingness in the relationship between executive functioning deficits and anxiety in children. Ninety children (46.67% female) aged from 9 to 14 years completed several executive functioning tasks and a measure of anxiety. Parental demandingness was rated based on an observation of parent-child interactions. The children completed the anxiety measure again at one-year follow-up. The results showed that parental demandingness significantly moderated the prospective relationship between executive functioning deficits and anxiety, such that the association between executive functioning deficits and anxiety in children was weaker when parental demandingness was lower. These findings suggest that low parental demandingness may serve as a protective factor that buffers the detrimental effects of executive functioning deficits on anxiety.
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van den Berg L, de Weerd A, Reuvekamp M, Hagebeuk E, van der Meere J. Working memory in pediatric frontal lobe epilepsy. APPLIED NEUROPSYCHOLOGY-CHILD 2019; 10:101-110. [PMID: 31092008 DOI: 10.1080/21622965.2019.1611431] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Thirty-two children with frontal lobe epilepsy (FLE) were assessed using different working memory measures. In addition, parents and teachers completed the working memory scale of the Behavioral Rating Inventory of Executive Functioning (BRIEF) to assess the children's "daily life behavior." Results suggested minimal working memory deficits as assessed with performance-based measures. However, the BRIEF showed more working memory deficits suggesting that, on a daily life level, working memory problems seem to be associated with FLE. We discuss why the results of the performance-based measures are not consistent with results of the BRIEF.HighlightsParents as well as teachers report working memory dysfunction in daily life to the same extent.Performance based measures show minimal deficits of working memory.Correlation between working memory tasks and proxy measures are low.
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Affiliation(s)
- Lydia van den Berg
- Stichting Epilepsie Instellingen Nederland, Zwolle, Netherlands.,Faculteit Clinical and developmental neuropsychology, Faculty behavioral science, University of Groningen, Netherlands
| | - Al de Weerd
- Stichting Epilepsie Instellingen Nederland, Zwolle, Netherlands
| | | | | | - Jaap van der Meere
- Faculteit Clinical and developmental neuropsychology, Faculty behavioral science, University of Groningen, Netherlands
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