Does the letter number sequencing task measure anything more than digit span?

Treatment as a moderator and executive function as a mediator of the effect of a mindfulness ecological momentary intervention for generalized anxiety disorder

BACKGROUND

Theory and research indicated that executive functioning (EF) correlated with, preceded, and stemmed from worry in generalized anxiety disorder (GAD). The present secondary analysis (Zainal & Newman, 2023b) thus determined whether EF domains mediated the effect of a 14-day (5 prompts/day) mindfulness ecological momentary intervention (MEMI) against a self-monitoring control (SM) for GAD.

METHOD

Participants (N = 110) diagnosed with GAD completed self-reported (Attentional Control Scale, GAD Questionnaire, Perseverative Cognitions Questionnaire) and performance-based tests (Letter-Number Sequencing, Stroop, Trail Making Test-B, Verbal Fluency) at baseline, post-treatment, and one-month follow-up (1MFU). Causal mediation analyses determined if pre-post changes in EF domains preceded and mediated the effect of MEMI against SM on pre-1MFU changes in GAD severity and trait repetitive negative thinking (RNT).

RESULTS

MEMI was more efficacious than SM in improving pre-post inhibition (β = -2.075, 95% [-3.388, -0.762], p = .002), working memory (β = 0.512, 95% [0.012, 1.011], p = .045), and set-shifting (β = -2.916, 95% [-5.142, -0.691], p = .010) but not verbal fluency and attentional control. Within groups, MEMI but not SM produced improvements in all examined pre-post EF outcomes except attentional control. Only pre-post improvements in inhibition mediated the effect of MEMI against SM on pre-1MFU reductions in GAD severity (β = -0.605, 95% [-1.357, -0.044], p = .030; proportion mediated = 7.1%) and trait RNT (β = -0.024, 95% [-0.054, -0.001], p = .040; proportion mediated = 7.4%). These patterns remained after conducting sensitivity analyses with non-linear mediator-outcome relations.

CONCLUSIONS

Optimizing MEMI for GAD might entail specifically boosting inhibition plausibly by augmenting it with dialectical behavioral therapy, encouraging high-intensity physical exercises, and targeting negative emotional contrast avoidance.

Apathy, gait slowness, and executive dysfunction (AGED) triad: opportunities to predict and delay dementia onset

This study investigates whether older adults diagnosed with the apathy, gait impairment, and executive dysfunction (AGED) triad, frequently associated with cerebrovascular disease and confounded with depression, have earlier dementia onset. We followed 322 community-dwelling older individuals (mean age 72.0 ± 6.4 years; 58.3% women) free of dementia at baseline for up to 9 years. The AGED triad was identified when gait slowness (< 1 m/s), apathy (assessed by Geriatric Depression Scale-3A with ≥ 2 items), and executive dysfunction (assessed by the 75th percentile of Trail Making Test-part B by age range) were simultaneously present. Incident dementia was diagnosed using the clinical dementia rating scale. Over the 9-year follow-up (mean 45.1 ± 28.6 months), 44 participants (13.6%) converted to dementia. Sixteen participants (5.0%) were diagnosed with AGED triad + and showed a significantly higher risk of earlier conversion to dementia compared with AGED triad- (hazard ratio = 5.08, 95%CI 2.16-11.97; p = 0.0001), as well as to those with only one AGED factor or fewer AGED factors. Hypertension and diabetes were 2 and 3 times more prevalent, respectively, in individuals with AGED triad + . These findings suggest that the AGED triad serves as a simplified and effective behavioral marker for accelerated progression to dementia.

A meta-analysis on the relationship between subjective cognitive failures as measured by the cognitive failures questionnaire (CFQ) and objective performance on executive function tasks

The Cognitive Failures Questionnaire (CFQ) has been widely used as a measure of subjective cognitive function in everyday life for decades. However, the evidence on how it relates to objective performance on executive function tasks is mixed. One possible reason for these mixed results is that the CFQ has selective relationships with some aspects of executive function and not others. Here, therefore, we classified tasks according to an influential framework of executive functions-switching, updating, inhibition, and we also considered the Sustained Attention to Response Task (SART) as a category because it was custom designed to gauge cognitive failures. We synthesized a large body of available evidence and performed four Bayesian meta-analyses on the relationship between CFQ scores and objective performance on executive function tasks in these four categories. Results suggested that CFQ scores were associated with objective performance on SART (18 effect sizes, μ = -.19, BF10 = 18.03, i.e., 18.03 times more evidence of a relationship versus no relationship), updating working memory (49 effect sizes, μ = -.06, BF10 = 17.80), and inhibition tasks (41 effect sizes, μ = -.07, BF10 = 15.40), whereas there was not definitive evidence regarding switching (34 effect sizes, μ = -.06, BF10 = .50, i.e., two times greater evidence for no relationship). This suggests that subjective cognitive function can predict objective performance on at least some executive function tasks. We discuss methodological and theoretical factors that constrain the maximum observable correlation and consider the relative insights that subjective measures versus task performance provide.

Working Memory and Cross-Linguistic Influence on Vocabulary Acquisition

The purpose of this study was to analyze the cross-linguistic influence of previously learned languages and working memory capacities on the vocabulary performance of two different typological languages. The objectives of this study were (1) to compare the working memory capacities of bilingual adults in relation to the vocabulary performance of two different languages never learned by the participants, and (2) to analyze to what extent the typology of previously learned languages influences working memory capacities in relation to the vocabulary performance of French and Nahuatl. A group of 43 Mexican Spanish college students participated in this experimental study. The participants completed a series of working memory tasks in Nahuatl and French. The results showed that working memory capacities were lower in Nahuatl than in French. Thus, a correlation was found between their first and second language and vocabulary performance in French. We can consider the influence of previously learned languages as a significant factor in vocabulary acquisition in accordance with the participants' working memory capacities.

Assessment tools for cognitive performance in Parkinson's disease and its genetic contributors

Background

We have shown that genetic factors associating with motor progression of Parkinson's disease (PD), but their roles in cognitive function is poorly understood. One reason is that while cognitive performance in PD can be evaluated by various cognitive scales, there is no definitive guide indicating which tool performs better.

Methods

Data were obtained from the Parkinson's Progression Markers Initiative, where cognitive performance was assessed using five cognitive screening tools, including Symbol Digit Modalities Test (SDMT), Montreal Cognitive Assessment, Benton Judgment of Line Orientation, Modified Semantic Fluency Test, and Letter Number Sequencing Test, at baseline and subsequent annual follow-up visit for 5 years. Genetic data including ApoE and other PD risk genetic information were also obtained. We used SPSS-receiver operating characteristic and ANOVA repeated measures to evaluate which cognitive assessment is the best reflecting cognitive performance in PD at early stage and over time. Logistic regression analyses were used to determine the genetic associations with the rapidity of cognitive decline in PD.

Results

SDMT performed better in detecting mild cognitive impairment at baseline (AUC = 0.763), and SDMT was the only tool showing a steady cognitive decline during longitudinal observation. Multigenetic factors significantly associated with cognitive impairment at early stage of the disease (AUC = 0.950) with IP6K2 rs12497850 more evident, and a significantly faster decline (AUC = 0.831) within 5 years after motor onset, particularly in those carrying FGF20 rs591323.

Conclusion

SDMT is a preferable cognitive assessment tool for PD and genetic factors synergistically contribute to the cognitive dysfunction in PD.

Novelty preference assessed by eye tracking: A sensitive measure of impaired recognition memory in epilepsy

OBJECTIVE

Epilepsy patients often report memory deficits despite normal objective testing, suggesting that available measures are insensitive or that non-mnemonic factors are involved. The Visual Paired Comparison Task (VPCT) assesses novelty preference, the tendency to fixate on novel images rather than previously viewed items, requiring recognition memory for the "old" images. As novelty preference is a sensitive measure of hippocampal-dependent memory function, we predicted impaired VPCT performance in epilepsy patients compared to healthy controls.

METHODS

We assessed 26 healthy adult controls and 31 epilepsy patients (16 focal-onset, 13 generalized-onset, 2 unknown-onset) with the VPCT using delays of 2 or 30 s between encoding and recognition. Fifteen healthy controls and 17 epilepsy patients (10 focal-onset, 5 generalized-onset, 2 unknown-onset) completed the task at 2-, 5-, and 30-minute delays. Subjects also performed standard memory measures, including the Medical College of Georgia (MCG) Paragraph Test, California Verbal Learning Test-Second Edition (CVLT-II), and Brief Visual Memory Test-Revised (BVMT-R).

RESULTS

The epilepsy group was high functioning, with greater estimated IQ (p = 0.041), greater years of education (p = 0.034), and higher BVMT-R scores (p = 0.024) compared to controls. Both the control group and epilepsy cohort, as well as focal- and generalized-onset subgroups, had intact novelty preference at the 2- and 30-second delays (p-values ≤ 0.001) and declined at 30 min (p-values > 0.05). Only the epilepsy patients had early declines at 2- and 5-minute delays (controls with intact novelty preference at p = 0.003 and p ≤ 0.001, respectively; epilepsy groups' p-values > 0.05).

CONCLUSIONS

Memory for the "old" items decayed more rapidly in overall, focal-onset, and generalized-onset epilepsy groups. The VPCT detected deficits while standard memory measures were largely intact, suggesting that the VPCT may be a more sensitive measure of temporal lobe memory function than standard neuropsychological batteries.

White matter alterations and their associations with biomarkers and behavior in subjective cognitive decline individuals: a fixel-based analysis

BACKGROUND

Subjective cognitive decline (SCD) is an early stage of dementia linked to Alzheimer's disease pathology. White matter changes were found in SCD using diffusion tensor imaging, but there are known limitations in voxel-wise tensor-based methods. Fixel-based analysis (FBA) can help understand changes in white matter fibers and how they relate to neurodegenerative proteins and multidomain behavior data in individuals with SCD.

METHODS

Healthy adults with normal cognition were recruited in the Northeastern Taiwan Community Medicine Research Cohort in 2018-2022 and divided into SCD and normal control (NC). Participants underwent evaluations to assess cognitive abilities, mental states, physical activity levels, and susceptibility to fatigue. Neurodegenerative proteins were measured using an immunomagnetic reduction technique. Multi-shell diffusion MRI data were collected and analyzed using whole-brain FBA, comparing results between groups and correlating them with multidomain assessments.

RESULTS

The final enrollment included 33 SCD and 46 NC participants, with no significant differences in age, sex, or education between the groups. SCD had a greater fiber-bundle cross-section than NC (pFWE < 0.05) at bilateral frontal superior longitudinal fasciculus II (SLFII). These white matter changes correlate negatively with plasma Aβ42 level (r = -0.38, p = 0.01) and positively with the AD8 score for subjective cognitive complaints (r = 0.42, p = 0.004) and the Hamilton Anxiety Rating Scale score for the degree of anxiety (Ham-A, r = 0.35, p = 0.019). The dimensional analysis of FBA metrics and blood biomarkers found positive correlations of plasma neurofilament light chain with fiber density at the splenium of corpus callosum (pFWE < 0.05) and with fiber-bundle cross-section at the right thalamus (pFWE < 0.05). Further examination of how SCD grouping interacts between the correlations of FBA metrics and multidomain assessments showed interactions between the fiber density at the corpus callosum with letter-number sequencing cognitive score (pFWE < 0.01) and with fatigue to leisure activities (pFWE < 0.05).

CONCLUSION

Based on FBA, our investigation suggests white matter structural alterations in SCD. The enlargement of SLFII's fiber cross-section is linked to plasma Aβ42 and neuropsychiatric symptoms, which suggests potential early axonal dystrophy associated with Alzheimer's pathology in SCD. The splenium of the corpus callosum is also a critical region of axonal degeneration and cognitive alteration for SCD.

Mind over mood: exploring the executive function's role in downregulation

Emotion regulation plays a key role in well adapted behaviour, however, factors influencing individual differences in ER are still under investigation. Across two studies we investigate the complex relationship between executive functions (EFs) and emotional downregulation through two complementary research designs. The focus lies on key components of EFs-working memory, inhibitory control, and switching-and their relationship with effective emotional regulation. Surprisingly, switching emerged as the sole significant predictor in two multiple linear regression models, challenging the conventional belief that all major EFs broadly contribute to emotional downregulation. The first study, involving 248 Ecuadorian adults between 18 and 60 years old, used experimental tasks to assess the association between EFs and emotional regulation, aligning with existing literature that posits a link between EFs and emotional control. The second study, involving 180 Ecuadorian adults between 18 and 43 years old, added depth by incorporating self-report measures, providing a broader, ecologically valid perspective. However, these measures did not significantly predict downregulation, highlighting a gap between self-perception and actual cognitive abilities. Additionally, demographic predictors varied between the two studies, urging future research to consider methodological design and task selection carefully. The study also raises questions about the validity of commonly used measures, emphasising the need for more nuanced tools to capture the complexity of EFs and emotional regulation. Our findings suggest a targeted research avenue focusing on EFs for both future research and clinical interventions. Attention is called to the methodological decisions that can influence the observed associations, and the need for broader demographic representation in future studies.

Magnetoencephalography reveals impaired sensory gating and change detection in older adults in the somatosensory system

Brain electrophysiological responses can provide information about age-related decline in sensory-cognitive functions with high temporal accuracy. Studies have revealed impairments in early sensory gating and pre-attentive change detection mechanisms in older adults, but no magnetoencephalographic (MEG) studies have been undertaken into both non-attentive and attentive somatosensory functions and their relationship to ageing. Magnetoencephalography was utilized to record cortical somatosensory brain responses in young (20-28 yrs), middle-aged (46-56 yrs), and older adults (64-78 yrs) under active and passive somatosensory oddball conditions. A repeated standard stimulus was occasionally replaced by a deviant stimulus (p = .1), which was an electrical pulse on a different finger. We examined the amplitudes of M50 and M100 responses reflecting sensory gating, and later components reflecting change detection and attention shifting (M190 and M250 for the passive condition, and M200 and M350 for the active condition, respectively). Spatiotemporal cluster-based permutation tests revealed that older adults had significantly larger M100 component amplitudes than young adults for task-irrelevant stimuli in both passive and active condition. Older adults also showed a reduced M250 component and an altered M350 in response to deviant stimuli. The responses of middle-aged adults did not differ from those of younger adults, but this study should be repeated with a larger sample size. By demonstrating changes in both somatosensory gating and attentional shifting mechanisms, our findings extend previous research on the effects of ageing on pre-attentive and attentive brain functions.

ARAS recent onset acute phase psychosis survey, a prospective observational cohort of first episode psychosis in Iran-the cohort profile

The Middle East is underrepresented in psychosis research. The ARAS recent onset acute phase psychosis survey (ARAS) is a longitudinal cohort across multiple centers in Iran, established to investigate characteristics, determinants and early course of psychosis in a non-Western, Middle East context. Here, baseline characteristics of the ARAS cohort are reported. The ARAS cohort enrolled patients with recent onset psychosis from September 2018 to September 2021 in East Azerbaijan, Kermanshah and Tehran, including Iranian patients from different sociocultural contexts. The baseline assessment included demographics, socioeconomic status, clinical (positive, negative, depressive symptoms) and psychosocial (religiosity, social support, self-stigma) characteristics, cognitive functioning, metabolic profile, substance use and medication use measured by validated questionnaires. These assessments will be followed up after one and five years. A total of 500 patients with a first episode of psychosis were enrolled from three provinces in Iran. With 74.1% being male, the mean age (SD) of patients was 32.3 (9.7) years. Nearly a quarter of patients was diagnosed with schizophrenia and 36.8% with substance induced psychotic disorder. Amphetamine (24%) and opium (12%) use were common, cannabis use was not (5%). Only 6.1% of patients lived alone while 29% of patients was married and had children. The majority of them had achieved secondary educational level and 34% had a paid job. The most common antipsychotic treatment was risperidone. There was a wide range for scores of PANSS, with 9.4% having dominant negative symptoms. The most common prescribed medication was risperidone. Near to 40% of patients had noticeable signs of depression and prevalence of metabolic syndrome was 13.4%. The majority of patients (57.2%) had moderate and 5.4% reported to have severe disability. More than 30% reported to be highly religious. Patients had the highest satisfaction with people living with, and the lowest for finance and job.

The association between head motion during functional magnetic resonance imaging and executive functioning in older adults

Minimizing head motion during functional magnetic resonance imaging (fMRI) is important for maintaining the integrity of neuroimaging data. While there are a variety of techniques to control for head motion, oftentimes, individuals with excessive in-scanner motion are removed from analyses. Movement in the scanner tends to increase with age; however, the cognitive profile of these "high-movers" in older adults has yet to be explored. This study aimed to assess the association between in-scanner head motion (i.e., number of "invalid scans" flagged as motion outliers) and cognitive functioning (e.g., executive functioning, processing speed, and verbal memory performance) in a sample of 282 healthy older adults. Spearman's Rank-Order correlations showed that a higher number of invalid scans was significantly associated with poorer performance on tasks of inhibition and cognitive flexibility and with older age. Since performance in these domains tend to decline as a part of the non-pathological aging process, these findings raise concerns regarding the potential systematic exclusion due to motion of older adults with lower executive functioning in neuroimaging samples. Future research should continue to explore prospective motion correction techniques to better ensure the collection of quality neuroimaging data without excluding informative participants from the sample.

Cingulo-opercular and frontoparietal control network connectivity and executive functioning in older adults

Executive function is a cognitive domain that typically declines in non-pathological aging. Two cognitive control networks that are vulnerable to aging-the cingulo-opercular (CON) and fronto-parietal control (FPCN) networks-play a role in various aspects of executive functioning. However, it is unclear how communication within these networks at rest relates to executive function subcomponents in older adults. This study examines the associations between CON and FPCN connectivity and executive function performance in 274 older adults across working memory, inhibition, and set-shifting tasks. Average CON connectivity was associated with better working memory, inhibition, and set-shifting performance, while average FPCN connectivity was associated solely with working memory. CON region of interest analyses revealed significant connections with classical hub regions (i.e., anterior cingulate and anterior insula) for each task, language regions for verbal working memory, right hemisphere dominance for inhibitory control, and widespread network connections for set-shifting. FPCN region of interest analyses revealed largely right hemisphere fronto-parietal connections important for working memory and a few temporal lobe connections for set-shifting. These findings characterize differential brain-behavior relationships between cognitive control networks and executive function in aging. Future research should target these networks for intervention to potentially attenuate executive function decline in older adults.

Long-term Effect of Regular Physical Activity and Exercise Habits in Patients With Early Parkinson Disease

Background and Objectives

Owing to the lack of long-term observations or comprehensive adjustment for confounding factors, reliable conclusions regarding long-term effects of exercise and regular physical activity in Parkinson disease (PD) have yet to be drawn. Here, using data from the Parkinson's Progression Markers Initiative study that includes longitudinal and comprehensive evaluations of many clinical parameters, we examined the long-term effects of regular physical activity and exercise habits on the course of PD.

Methods

In this retrospective, observational cohort study, we primarily used the multivariate linear mixed-effects models to analyze the interaction effects of their regular physical activity and moderate to vigorous exercise levels, measured with the Physical Activity Scale for the Elderly questionnaire, on the progression of clinical parameters, after adjusting for age, sex, levodopa equivalent dose, and disease duration. We also calculated bootstrapping 95% confidence intervals (CIs) and conducted sensitivity analyses using the multiple imputation method and subgroup analyses using propensity score matching to match for all baseline background factors.

Results

Two hundred thirty-seven patients with early PD (median [interquartile range] age, 63.0 [56.0–70.0] years, male 69.2%, follow-up duration 5.0 [4.0–6.0] years) were included. Regular physical activity and moderate to vigorous exercise levels at baseline did not significantly affect the subsequent clinical progression of PD. However, average regular overall physical activity levels over time were significantly associated with slower deterioration of postural and gait stability (standardized fixed-effects coefficients of the interaction term [β_interaction] = −0.10 [95% CI −0.14 to −0.06]), activities of daily living (β_interaction = 0.08 [95% CI 0.04–0.12]), and processing speed (β_interaction = 0.05 [95% CI 0.03–0.08]) in patients with PD. Moderate to vigorous exercise levels were preferentially associated with slower decline of postural and gait stability (β_interaction = −0.09 [95% CI −0.13 to −0.05]), and work-related activity levels were primarily associated with slower deterioration of processing speed (β_interaction = 0.07 [95% CI 0.04–0.09]). Multiple imputation and propensity score matching confirmed the robustness of our results.

Discussion

In the long term, the maintenance of high regular physical activity levels and exercise habits was robustly associated with better clinical course of PD, with each type of physical activity having different effects.

Trial Registration Information

ClinicalTrials.gov Identifier: NCT01176565.

Classification of Evidence

This study provides Class II evidence that sustained increase in overall regular physical activity levels in patients with early PD was associated with slower decline of several clinical parameters.

Verbal Working Memory Error Patterns and Speech-Language Outcomes in Youth With Cochlear Implants

PURPOSE

Verbal working memory (VWM) delays are commonly found in prelingually deaf youth with cochlear implants (CIs), albeit with considerable interindividual variability. However, little is known about the neurocognitive information-processing mechanisms underlying these delays and how these mechanisms relate to spoken language outcomes. The goal of this study was to use error analysis of the letter-number sequencing (LNS) task to test the hypothesis that VWM delays in CI users are due, in part, to fragile, underspecified phonological representations in short-term memory.

METHOD

Fifty-one CI users aged 7-22 years and 53 normal hearing (NH) peers completed a battery of speech, language, and neurocognitive tests. LNS raw scores and error profiles were compared between samples, and a hierarchical regression model was used to test for associations with measures of speech, language, and hearing.

RESULTS

Youth with CIs scored lower on the LNS test than NH peers and committed a significantly higher number of errors involving phonological confusions (recalling an incorrect letter/digit in place of a phonologically similar one). More phonological errors were associated with poorer performance on measures of nonword repetition and following spoken directions but not with hearing quality.

CONCLUSIONS

Study findings support the hypothesis that poorer VWM in deaf children with CIs is due, in part, to fragile, underspecified phonological representations in short-term/working memory, which underlie spoken language delays. Programs aimed at strengthening phonological representations may improve VWM and spoken language outcomes in CI users.

Visual and Verbal Working Memory and Processing Speed Across the Adult Lifespan: The Effect of Age, Sex, Educational Level, Awakeness, and Hearing Sensitivity

Objective: To strengthen future methodological choices regarding the measurement of cognition within the field of audiology, the current study aimed to examine the effect of, among other things, hearing sensitivity on the backward corsi tapping task (i.e., visual working memory and processing speed) and the letter-number sequencing task (i.e., verbal working memory and processing speed). Design and Study Sample: The backward corsi tapping task and the letter-number sequencing task were administered to 184 participants, aged between 18 and 69 years. The effect of age, sex, educational level, awakeness, and hearing sensitivity on verbal and visual working memory and processing speed was assessed using stepwise multiple regression analyses. Results: For all outcome variables, a decrease in performance was observed with increasing age. For visual and verbal working memory, males outperformed females, whereas no clear sex effect was observed for visual and verbal processing speed. Hearing sensitivity had only a significant impact on visual processing speed. Conclusion: The importance to evaluate cognitive construct validity within audiological research was highlighted. Further research should focus on investigating the associations between speech understanding on the one hand and the backward corsi tapping task and letter-number sequencing task on the other hand.

Abnormal phase discontinuity of alpha- and theta-frequency oscillations in schizophrenia

BACKGROUND

Schizophrenia patients have abnormal electroencephalographic (EEG) power over multiple frequency bands, even at rest, though the primary neural generators and spatiotemporal dynamics of these abnormalities are largely unknown. Disturbances in the precise synchronization of oscillations within and across cortical sources may underlie abnormal resting-state EEG activity in schizophrenia patients.

METHODS

A novel assessment method was applied to identify the independent contributing sources of resting-state EEG and assess the phase discontinuity in schizophrenia patients (N = 148) and healthy subjects (N = 143).

RESULTS

A network of 11 primary contributing sources of scalp EEG was identified in both groups. Schizophrenia patients showed abnormal elevations of EEG power in the temporal region in the theta, beta, and gamma-bands, as well as the posterior cingulate gyrus in the delta, theta, alpha, and beta-bands. The higher theta-band power in the middle temporal gyrus was significantly correlated with verbal memory impairment in patients. The peak frequency of alpha was lower in patients in the cingulate and temporal regions. Furthermore, patients showed a higher rate of alpha phase discontinuity in the temporal region as well as a lower rate of theta phase discontinuity in the temporal and posterior cingulate regions.

CONCLUSIONS

Abnormal rates of phase discontinuity of alpha- and theta-band, abnormal elevations of EEG power in multiple bands, and a lower peak frequency of alpha were identified in schizophrenia patients at rest. Clarification of the mechanistic substrates of abnormal phase discontinuity may clarify core pathophysiologic abnormalities of schizophrenia and contribute to the development of novel biomarkers for therapeutic interventions.

Association between secondhand smoke exposure at home and cognitive performance among rural primary school children in Malaysia

INTRODUCTION

Secondhand smoke (SHS) exposure is linked to a series of serious health problems. Children may be particularly vulnerable to the effects of SHS exposure at home. This study aimed to determine the association between SHS exposure at home and cognitive performance in school children.

METHODS

A multistage sampling was performed across rural primary schools in Kuala Krai, Kelantan, Malaysia. Data were collected using self-administered questionnaires and the children aged 10-11 years (n=312) were subjected to cognitive tests including digit span, letter-number sequencing, coding, and symbol search. Cognitive performance was tested using subscales derived from the Wechsler Intelligence Scale for Children.

RESULTS

The prevalence of SHS exposure at home was 55.8%, where 11.9% of children lived with one smoker, while 43.9% of children lived with ≥2 smokers. There was a significant difference in the mean score of the combined cognitive tests between SHS-exposed and non-exposed children after adjustment for sex, parental educational level, family income and academic performance [Pillai's Trace=0.084, F statistic (df)=6.803 (4302), p<0.001].

CONCLUSIONS

More than half of the primary school children in rural Kuala Krai were exposed to SHS from at least one smoker at home. There was a significant association between SHS exposure at home and cognitive performance.

Hierarchical Pathways from Sensory Processing to Cognitive, Clinical, and Functional Impairments in Schizophrenia

Cognitive impairment is a hallmark of schizophrenia and a robust predictor of functional outcomes. Impairments are found in all phases of the illness and are only moderately attenuated by currently approved therapeutics. Neurophysiological indices of sensory discrimination (ie, mismatch negativity (MMN) and P3a amplitudes) and gamma-band auditory steady-state response (ASSR; power and phase locking) are translational biomarkers widely used in the development of novel therapeutics for neuropsychiatric disorders. It is unclear whether laboratory-based EEG measures add explanatory power to well-established models that use only cognitive, clinical, and functional outcome measures. Moreover, it is unclear if measures of sensory discrimination and gamma-band ASSR uniquely contribute to putative causal pathways linking sensory discrimination, neurocognition, negative symptoms, and functional outcomes in schizophrenia. To answer these questions, hierarchical associations among sensory processing, neurocognition, clinical symptoms, and functional outcomes were assessed via structural equation modeling in a large sample of schizophrenia patients (n = 695) and healthy comparison subjects (n = 503). The results showed that the neurophysiologic indices of sensory discrimination and gamma-band ASSR both significantly contribute to and yield unique hierarchical, "bottom-up" effects on neurocognition, symptoms, and functioning. Measures of sensory discrimination showed direct effects on neurocognition and negative symptoms, while gamma-band ASSR had a direct effect on neurocognition in patients. Continued investigation of the neural mechanisms underlying abnormal networks of MMN/P3a and gamma-band ASSR is needed to clarify the pathophysiology of schizophrenia and the development of novel therapeutic interventions.

Sex effects on brain structure in de novo Parkinson's disease: a multimodal neuroimaging study

Parkinson's disease varies in severity and age of onset. One source of this variability is sex. Males are twice as likely as females to develop Parkinson's disease, and tend to have more severe symptoms and greater speed of progression. However, to date, there is little information in large cohorts on sex differences in the patterns of neurodegeneration. Here we used MRI and clinical information from the Parkinson Progression Markers Initiative to measure structural brain differences between sexes in Parkinson's disease after regressing out the expected effect of age and sex. We derived atrophy maps from deformation-based morphometry of T1-weighted MRI and connectivity from diffusion-weighted MRI in de novo Parkinson's disease patients (149 males: 83 females) with comparable clinical severity, and healthy control participants (78 males: 39 females). Overall, even though the two patient groups were matched for disease duration and severity, males demonstrated generally greater brain atrophy and disrupted connectivity. Males with Parkinson's disease had significantly greater tissue loss than females in 11 cortical regions including bilateral frontal and left insular lobe, right postcentral gyrus, left inferior temporal and cingulate gyrus and left thalamus, while females had greater atrophy in six cortical regions, including regions in the left frontal lobe, right parietal lobe, left insular gyrus and right occipital cortex. Local efficiency of white matter connectivity showed greater disruption in males in multiple regions such as basal ganglia, hippocampus, amygdala and thalamus. These findings support the idea that development of Parkinson's disease may involve different pathological mechanisms and yield distinct prognosis in males and females, which may have implications for research into neuroprotection, and stratification for clinical trials.

An Observational Cohort of First Episode Psychosis in Iran: The Azeri Recent Onset Acute Phase Psychosis Survey (ARAS Cohort) Study Protocol

Background: Most of our knowledge about the etiology, course, treatment, and outcome of schizophrenia spectrum and other psychotic disorders stems from Western countries. Data from populations living in other geographical areas and low- and middle-income countries, with different genomes (ethnicity) and exposomes (e.g., culture and social support, drugs of abuse, religion), will add to our knowledge of this complex disorder. Methods: The Azeri Acute phase/Recent onset psychosis Survey (ARAS) has been initiated to study the course of the disorder in patients with recent-onset psychosis using validated diagnostic tools and a comprehensive outcome monitoring system, aiming to reveal indicators for understanding the risk and resilience factors and for choosing the best-personalized treatment strategy. All participants will be evaluated for clinical signs and symptoms as well as risk and resilience factors and will be followed up for 1, 3, and 5 years for outcomes in several domains. A hierarchical cluster method will be applied to identify the number of clusters for each outcome. Defined models will be applied to assess the predictive value of cognition on symptomatic and functional outcomes at follow-up. Discussion: The ARAS cohort will yield significant academic- (research and education) and care-related achievements. ARAS data and experience will have value both in being a useful model for other parts of this region and in an expansion of the currently available knowledge.

Increased random exploration in schizophrenia is associated with inflammation

One aspect of goal-directed behavior, which is known to be impaired in patients with schizophrenia (SZ), is balancing between exploiting a familiar choice with known reward value and exploring a lesser known, but potentially more rewarding option. Despite its relevance to several symptom domains of SZ, this has received little attention in SZ research. In addition, while there is increasing evidence that SZ is associated with chronic low-grade inflammation, few studies have investigated how this relates to specific behaviors, such as balancing exploration and exploitation. We therefore assessed behaviors underlying the exploration-exploitation trade-off using a three-armed bandit task in 45 patients with SZ and 19 healthy controls (HC). This task allowed us to dissociate goal-unrelated (random) from goal-related (directed) exploration and correlate them with psychopathological symptoms. Moreover, we assessed a broad range of inflammatory proteins in the blood and related them to bandit task behavior. We found that, compared to HC, patients with SZ showed reduced task performance. This impairment was due to a shift from exploitation to random exploration, which was associated with symptoms of disorganization. Relative to HC, patients with SZ showed a pro-inflammatory blood profile. Furthermore, high-sensitivity C-reactive protein (hsCRP) positively correlated with random exploration, but not with directed exploration or exploitation. In conclusion, we show that low-grade inflammation in patients with SZ is associated with random exploration, which can be considered a behavioral marker for disorganization. hsCRP may constitute a marker for severity of, and a potential treatment target for maladaptive exploratory behaviors.

The effect of a secondary task on drivers' gap acceptance and situational awareness at junctions

The current studies explored the roles of the visuospatial and phonological working memory subsystems on drivers' gap acceptance and memory for approaching vehicles at junctions. Drivers' behaviour was measured in a high-fidelity driving simulator when at a junction, with, and without a visuospatial or phonological load. When asked to judge when to advance across the junction, gap acceptance thresholds, memory for vehicles and eye movements were not different when there was a secondary task compared to control. However, drivers' secondary task performance was more impaired in the visuospatial than phonological domain. These findings suggest that drivers were able to accept impairment in the secondary task while maintaining appropriate safety margins and situational awareness. These findings can inform the development of in-car technologies, improving the safety of road users at junctions. Practitioner summary: Despite research indicating that concurrent performance on working memory tasks impairs driving, a matched visuospatial or phonological memory load did not change drivers' gap acceptance or situational awareness at junctions. Drivers displayed appropriate compensatory behaviour by prioritising the driving task over the visuospatial secondary task. Abbreviations: ROW: right of way; RIG: random time interval generation.

Demographically-adjusted norms for the paced auditory serial addition test and letter number sequencing test in Spanish-speaking adults: Results from the neuropsychological norms for the U.S.-Mexico border region in Spanish (NP-NUMBRS) Project

OBJECTIVE

The Paced Auditory Serial Addition Test (PASAT) and Wechsler Adult Intelligence Scale Letter Number Sequencing subtest (LNS) are two commonly used measures of working memory. Demographic variables (age, education, ethnicity, etc.) can impact performance on these measures, underscoring the need for demographically adjusted norms. We aimed to develop normative data for the PASAT and LNS for Spanish-speaking adults living in the U.S.-Mexico border region as part of a larger normative effort.

METHOD

Participants were native Spanish-speakers from the Neuropsychological Norms for the U.S. Mexico Border Region in Spanish (NP-NUMBRS) project. Two hundred and forty-nine participants completed the PASAT and 202 participants completed LNS. Ages ranged from 19 to 60 and education from 0 to 20 years.

RESULTS

Older age was associated with lower scores on LNS (p < .01) but not PASAT. Lower education was associated with lower scores on both tests (ps < .001). Women obtained lower raw scores than men on PASAT (ps < .003), and there were no significant main effects of gender on LNS raw scores. Raw-to-scaled score conversions were calculated, and fractional polynomial equations were developed to calculate demographically-adjusted T-scores accounting for age, education, and gender. Published norms for English-speaking non-Hispanic Whites substantially overestimated rates of impairment (defined as T-score < 40) on both the PASAT and LNS.

CONCLUSIONS

The use of the population-specific normative data may improve detection of working memory dysfunction in U.S. Spanish-speaking adults and contribute to improved diagnostic accuracy and treatment planning in this population. Whether the norms generalize to U.S. Spanish-speakers from other countries remains to be determined.

Unique contributions of sensory discrimination and gamma synchronization deficits to cognitive, clinical, and psychosocial functional impairments in schizophrenia

BACKGROUND

Schizophrenia patients show widespread deficits in neurocognitive, clinical, and psychosocial functioning. Mismatch negativity (MMN) and gamma-band auditory steady-state response (ASSR) are robust translational biomarkers associated with schizophrenia and associated with cognitive dysfunction, negative symptom severity, and psychosocial disability. Although these biomarkers are conceptually linked as measures of early auditory information processing, it is unclear whether MMN and gamma-band ASSR account for shared vs. non-shared variance in cognitive, clinical, and psychosocial functioning.

METHODS

Multiple regression analyses with MMN, gamma-band ASSR, and clinical measures were performed in large cohorts of schizophrenia outpatients (N = 428) and healthy comparison subjects (N = 283).

RESULTS

Reduced MMN (d = 0.67), gamma-band ASSR (d = -0.40), and lower cognitive function were confirmed in schizophrenia patients. Regression analyses revealed that reduced MMN amplitude showed unique associations with lower verbal learning and negative symptoms, reduced gamma-band ASSR showed a unique association with working memory deficits, and both reduced MMN amplitude and reduced gamma-band ASSR showed an association with daily functioning impairment in schizophrenia patients.

CONCLUSION

MMN and ASSR measures are non-redundant and complementary measures of early auditory information processing that are associated with important domains of functioning. Studies are needed to clarify the neural substrates of MMN and gamma-band ASSR to improve our understanding of the pathophysiology of schizophrenia and accelerate their use in the development of novel therapeutic interventions.

Cognition and daily life functioning among persons with serious mental illness: A cluster analytic examination of heterogeneity on the Test of Grocery Shopping Skills

OBJECTIVE

To characterize variability in daily life functioning among individuals with serious mental illness based on a naturalistic performance measure of grocery shopping and standard neuropsychological tasks using cluster analytic methods.

METHODS

A naturalistic performance measure, the Test of Grocery Shopping Skills (TOGSS), and standard neuropsychological tasks, were completed by 191 participants with serious mental illness. Hierarchical cluster analytic techniques were used to explore functional subgroups based on naturalistic performance measure variables. Multivariate analyses of variance were utilized to compare subgroups on TOGSS variables and neuropsychological measures, respectively.

RESULTS

Two distinct functional subgroups emerged from the cluster analysis. On average, participants in cluster one were faster, more efficient, and more accurate compared to cluster two. Based on performance on neuropsychological tasks, cluster one had better verbal memory, visual attention, and processing speed, and executive functioning scores, compared to cluster two. The clusters did not differ on a measure of auditory working memory.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

Naturalistic performance measures can assist with characterizing the heterogeneity in real life functioning among people with serious mental illness. Further work to illuminate the relationship between specific cognitive abilities and specific functional abilities is warranted and may assist with targeting effective treatment plans for functional recovery. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Component process analysis of verbal memory in a sample of students with a binge drinking pattern

Background

Many studies have emphasized the harmful impact of binge drinking on several cognitive functions, including memory. However, the exact nature of the memory processes involved is still unknown. The present study was designed to assess verbal working memory and verbal episodic memory, especially its encoding, storage and retrieval processes, in binge drinking to identify the processes impacted by this behavior.

Methods

Participants were 48 community-recruited college students aged 18-25 years and categorized as either binge drinkers (BDs) or social drinkers (SDs). They were assessed with (a) subtests of the Wechsler scale (digit span, letter-number sequencing) measuring verbal working memory, and (b) a modified version of the Free and Cued Selective Reminding Test (FCSRT), which measures verbal episodic memory functioning in various conditions of encoding (controlled) and recollection (free recall, cued recall, and recognition).

Results

Verbal working memory was unaffected by binge drinking, whereas verbal episodic memory performances were reduced. In particular, analysis of the modified FCSRT scores suggested that BDs had less proficient storage and retrieval processes. Furthermore, correlational analyses indicated that the proficiency of these memory components was negatively correlated with several indicators of binge drinking behavior.

Conclusions

Results suggest that binge drinking behavior affects the storage and recollection processes of verbal episodic memory. The academic failure described in binge drinkers could be partly related to this harmful effect. Our results on the negative impact of binge drinking on memory should be used to develop information campaigns targeting students.

Evaluation of cognitive function in adult patients with juvenile idiopathic arthritis

OBJECTIVE

To evaluate cognitive function in adult patients with juvenile idiopathic arthritis (JIA) and associated factors.

PATIENTS AND METHODS

We performed a cross-sectional observational study of adult patients with JIA and a healthy control group (no inflammatory diseases) matched for age, gender, and educational level. Cognitive function was assessed using Wechsler Adult Intelligence Scale-III. The cognitive domains measured were attention/concentration, verbal function, visuospatial organization, working memory, and problem solving (Similarities). Other measures included clinical-epidemiological characteristics, comorbid conditions, and treatment. We performed a descriptive bivariate analysis and logistic regression to identify factors associated with visuospatial involvement.

RESULTS

The study population comprised 104 subjects (52 with JIA and 52 healthy controls). Patients with JIA had poorer results for visuospatial function, with a lower median scaled score on the Block Design test (5.0 [4.0-8.0] vs 8.0 [5.0-10.0]; P = .014). The number of patients with scaled scores below the average range (<8) in visuospatial organization was significantly greater in the JIA group (67.3% vs 40.4%; P = .006). The multivariate analysis revealed time since diagnosis (odds ratio [95% CI], 1.03 [1.01-1.06]), inflammatory activity according to Juvenile Arthritis Disease Activity Score 27-joint count (1.94 [1.01-3.75]), and educational level (0.28 [0.08-0.94]) to be factors associated with visuospatial function.

CONCLUSION

Cognitive function in adult patients with JIA is poorer than in healthy controls at the expense of visuospatial function. Visuospatial function in JIA patients was inversely associated with disease duration, inflammatory activity, and lower educational level.

The Role of Executive and General Cognitive Functioning in the Attention Problems of Very and Extremely Preterm Adults

OBJECTIVE

To determine whether the attention problems in adults born very preterm/very low birth weight (VP/VLBW; <32 weeks' gestation/<1500 g) or extremely preterm (EP; <26 weeks' gestation) are associated with specific executive or general cognitive deficits.

METHOD

Cohorts of VP/VLBW (the Bavarian Longitudinal Study [BLS]) and EP (the EPICure Study) participants were followed from birth to early adulthood, each also following a respective control group. Adult attention deficit hyperactivity disorder (ADHD) symptoms were assessed via self-report in both cohorts and additionally by parent report in the BLS. Participants in both cohorts also had their attention span rated by trained observers. Performed separately in each cohort, hierarchical regression analyses were used to assess whether the association between preterm birth status and attention problems remained after accounting for executive functioning (inhibitory control and working memory) in adulthood, childhood intelligence score (IQ), or sex.

RESULTS

In the discovery cohort of the BLS, significant differences were found between VP/VLBW adults and controls for parent-rated inattention (p < 0.001). However, for self-reported measures of ADHD, no significant differences were found in the BLS or in the EPICure replication cohort. In both cohorts, observer-rated attention spans were lower for VP/VLBW and EP participants in comparison to their respective control groups (p < 0.001). In final models for the BLS, inhibitory control and childhood IQ were significantly associated with parent-rated inattention symptoms (p < 0.006), whereas working memory and childhood IQ were significantly associated with observer-rated attention span (p < 0.001). The effect of childhood IQ on observer-rated attention span was replicated in EPICure.

CONCLUSION

VP/VLBW and EP adults are at increased risk of observer-rated attention problems. These problems were predominantly associated with poorer general cognitive ability in early childhood and somewhat with adult executive functioning.

Trail Making Test: Normative Data for Patients with Severe Alcohol Use Disorder

Background: Patients with alcohol use disorders (AUD) often show cognitive impairment, particularly in executive functions that has been linked to poor treatment outcomes. The Trail Making Test (TMT) is the most widely used neuropsychological test to investigate executive functions with available normative data. However, no such norms exist for patients with AUD, although there is extensive evidence that TMT performance is altered in AUD patients. Purpose: To provide normative data for patients with AUD and compare the performance of AUD patients with already existing normative data from healthy subjects. Methods: Data of 494 recently detoxified patients with AUD who entered an abstinence-oriented residential treatment program were analyzed. Patients completed a standardized diagnostic procedure and the TMT Parts A and B at treatment admission. Results: AUD patients' performance on the TMT was impaired compared to the normative data of healthy individuals and decreased with increasing age and lower levels of education, with stronger effects in Part B assessing more complex executive functioning. Alcohol-related variables showed no direct associations with TMT performance. Conclusions: The results replicate the association of age and education with TMT performance, suggesting that AUD may be associated with impaired cognitive functioning earlier in life in abstinent patients shortly after withdrawal from alcohol compared to healthy individuals. The presented normative data for patients with AUD particularly improve the examination of executive deficits, and may enable clinicians to evaluate patients' cognitive functioning in treatment more precisely.

Abnormal Spontaneous Gamma Power Is Associated With Verbal Learning and Memory Dysfunction in Schizophrenia

BACKGROUND

Schizophrenia patients exhibit cognitive deficits across multiple domains, including verbal memory, working memory, and executive function, which substantially contribute to psychosocial disability. Gamma oscillations are associated with a wide range of cognitive operations, and are important for cortico-cortical transmission and the integration of information across neural networks. While previous reports have shown that schizophrenia patients have selective impairments in the ability to support gamma oscillations in response to 40-Hz auditory stimulation, it is unclear if patients show abnormalities in gamma power at rest, or whether resting-state activity in other frequency bands is associated with cognitive functioning in schizophrenia patients.

METHODS

Resting-state electroencephalogram (EEG) was assessed over 3 min in 145 healthy comparison subjects and 157 schizophrenia patients. Single-word reading ability was measured via the reading subtest of the Wide Range Achievement Test-3 (WRAT). Auditory attention and working memory were evaluated using Letter-Number Span and Letter-Number Sequencing. Executive function was assessed via perseverative responses on the Wisconsin Card Sorting Test (WCST). Verbal learning performance was measured using the California Verbal Learning Test second edition (CVLT-II).

RESULTS

Schizophrenia patients showed normal levels of delta-band power but abnormally elevated EEG power in theta, alpha, beta, and gamma bands. An exploratory correlation analysis showed a significant negative correlation of gamma-band power and verbal learning performance in schizophrenia patients.

CONCLUSIONS

Patients with schizophrenia have abnormal resting-state EEG power across multiple frequency bands; gamma-band abnormalities were selectively and negatively associated with impairments in verbal learning. Resting-state gamma-band EEG power may be useful for understanding the pathophysiology of cognitive dysfunction and developing novel therapeutics in schizophrenia patients.

Cognitive-motor exergaming for reducing fall risk in people with chronic stroke: A randomized controlled trial

BACKGROUND

Dual-task (simultaneous motor and cognitive task) (DT) training via virtual-reality exergaming is known to benefit balance control post-stroke. However, the efficacy of such training on DT balance control (volitional and reactive) and cognitive (executive function and attention) domains associated with fall risk remains unclear.

OBJECTIVE

We evaluated the efficacy of cognitive-motor exergame training (CMT) (Wii-fit games in conjunction with cognitive tasks) for improving balance control (volitional and reactive) and cognition (executive function and attention) among people with chronic stroke (PwCS).

METHODS

Hemiparetic, ambulatory PwCS were randomly assigned to either CMT (n = 12) or conventional training (CT) (n = 12) and underwent six weeks of high-intensity, tapered balance training. The CMT group performed Wii-fit games in conjunction with cognitive tasks, while CT group underwent customized, progressive balance training. Performance under DT conditions on Limits of Stability (volitional) and Slip-Perturbation (reactive) tests, and letter-number sequencing (cognition) determined the efficacy of CMT.

RESULTS

Post-intervention, under DT reactive conditions, CMT group improved both motor and cognition, while the CT group improved motor alone. Under DT volitional conditions, motor performance improved only in CMT group.

CONCLUSION

Cognitive-motor exergaming appears to be effective for improving balance control and cognition and could be implemented in clinical stroke rehabilitation settings.

Transcranial Magnetic Stimulation as a Potential Biomarker in Multiple Sclerosis: A Systematic Review with Recommendations for Future Research

Multiple sclerosis (MS) is a demyelinating disorder of the central nervous system. Disease progression is variable and unpredictable, warranting the development of biomarkers of disease status. Transcranial magnetic stimulation (TMS) is a noninvasive method used to study the human motor system, which has shown potential in MS research. However, few reviews have summarized the use of TMS combined with clinical measures of MS and no work has comprehensively assessed study quality. This review explored the viability of TMS as a biomarker in studies of MS examining disease severity, cognitive impairment, motor impairment, or fatigue. Methodological quality and risk of bias were evaluated in studies meeting selection criteria. After screening 1603 records, 30 were included for review. All studies showed high risk of bias, attributed largely to issues surrounding sample size justification, experimenter blinding, and failure to account for key potential confounding variables. Central motor conduction time and motor-evoked potentials were the most commonly used TMS techniques and showed relationships with disease severity, motor impairment, and fatigue. Short-latency afferent inhibition was the only outcome related to cognitive impairment. Although there is insufficient evidence for TMS in clinical assessments of MS, this review serves as a template to inform future research.

The Internet-Based Cognitive Assessment Tool: System Design and Feasibility Study

BACKGROUND

Persistent cognitive impairment is prevalent in unipolar and bipolar disorders and is associated with decreased quality of life and psychosocial dysfunction. The screen for cognitive impairment in psychiatry (SCIP) test is a validated paper-and-pencil instrument for the assessment of cognition in affective disorders. However, there is no digital cognitive screening tool for the brief and accurate assessment of cognitive impairments in this patient group.

OBJECTIVE

In this paper, we present the design process and feasibility study of the internet-based cognitive assessment tool (ICAT) that is designed based on the cognitive tasks of the SCIP. The aims of this feasibility study were to perform the following tasks among healthy individuals: (1) evaluate the usability of the ICAT, (2) investigate the feasibility of the ICAT as a patient-administered cognitive assessment tool, and (3) examine the performance of automatic speech recognition (ASR) for the assessment of verbal recall.

METHODS

The ICAT was developed in a user-centered design process. The cognitive measures of the ICAT were immediate and delayed recall, working memory, and psychomotor speed. Usability and feasibility studies were conducted separately with 2 groups of healthy individuals (N=21 and N=19, respectively). ICAT tests were available in the English and Danish languages. The participants were asked to fill in the post study system usability questionnaire (PSSUQ) upon completing the ICAT test. Verbal recall in the ICAT was assessed using ASR, and the performance evaluation criterion was word error rate (WER). A Pearson 2-tailed correlation analysis significant at the .05 level was applied to investigate the association between the SCIP and ICAT scores.

RESULTS

The overall psychometric factors of PSSUQ for both studies gave scores above 4 (out of 5). The analysis of the feasibility study revealed a moderate to strong correlation between the total scores of the SCIP and ICAT (r=0.63; P=.009). There were also moderate to strong correlations between the SCIP and ICAT subtests for immediate verbal recall (r=0.67; P=.002) and psychomotor speed (r=0.71; P=.001). The associations between the respective subtests for working memory, executive function, and delayed recall, however, were not statistically significant. The corresponding WER for English and Danish responses were 17.8% and 6.3%, respectively.

CONCLUSIONS

The ICAT is the first digital screening instrument modified from the SCIP using Web-based technology and ASR. There was good accuracy of the ASR for verbal memory assessment. The moderate correlation between the ICAT and SCIP scores suggests that the ICAT is a valid tool for assessing cognition, although this should be confirmed in a larger study with greater statistical power. Taken together, the ICAT seems to be a valid Web-based cognitive assessment tool that, after some minor modifications and further validation, may be used to screen for cognitive impairment in clinical settings.

Relationship of Working Memory, Processing Speed, and Fluid Reasoning in Psychiatric Patients

OBJECTIVE

The present study aimed to investigate relationship among cognitive factors (working memory and processing speed) and fluid reasoning (Gf) in psychiatric patients using a standardized clinical tool.

METHODS

We included the responses of 115 heterogeneous patients who were diagnosed with the MINI-Plus 5.0 and WAIS-IV/WMSIV was administered. For our analysis, structured equation modeling (SEM) was conducted to evaluate which cognitive variables are closely related to the Gf.

RESULTS

The results showed that the visual working memory was the strongest predictor of the Gf compared to other cognitive factors.

CONCLUSION

Processing speed was capable of predicting the Gf, when visual working memory was controlled. The inter-relationship among the Gf and other cognitive factors and its clinical implications were further discussed.

Amnestic mild cognitive impairment individuals with dissimilar pathologic origins show common regional vulnerability in the default mode network

INTRODUCTION

Alzheimer's and Parkinson's disease (AD and PD) are distinct disorders but share similar biomarker profiles. The regions of the default mode network are implicated in these diseases and are associated with amnestic symptoms. The role of apolipoprotein-ε4 (APOE-ε4), which is associated with cognitive function, is unclear in PD.

METHODS

In this work, we evaluated cortical thickness of default mode network regions that are likely affected in both early AD and PD individuals, that is, with amnestic mild cognitive impairment. We identified the prevalence of APOE-ε4 and evaluated its association with cortical atrophy.

RESULTS

We observed significant parahippocampal atrophy and hippocampal atrophy rates in amnestic mild cognitive impairment subjects, regardless of disease origins (AD or PD). Similarly, mild cognitive impairment ε4 carriers showed significant precuneal atrophy compared with noncarriers.

DISCUSSION

This work supports that converging changes to default mode network regions, especially the temporal lobe and precuneus, are shared in AD and PD.

Construct validity of the NIH Toolbox Cognition Battery in individuals with stroke

OBJECTIVE

The National Institutes of Health (NIH) Toolbox (NIHTB) for the Assessment of Behavior and Neurological Function Cognition Battery (NIHTB-CB) provides a brief assessment (approximately 30 min) of key components of cognition. This article examines construct validity to support the clinical utility of the NIHTB-CB in individuals with stroke.

RESEARCH METHOD

A total of 131 individuals with stroke (n = 71 mild stroke; n = 60 moderate/severe stroke) completed the NIHTB-CB. Univariate analyses were conducted to examine the cognitive profiles of the two different stroke groups (mild vs. moderate/severe stroke) on NIHTB-CB measures and composite scores. Pearson correlations were conducted between NIHTB-CB and established measures to examine convergent and discriminant validity. Effect sizes and clinical impairment rates for the different NIHTB-CB measures and composite scores were also examined.

RESULTS

Participants experiencing moderate to severe stroke had poorer performance than did individuals with mild stroke on several of the NIHTB cognition measures. Evidence of convergent validity was provided by moderate to strong correlations between the NIHTB measures and the corresponding standard neuropsychological test (Pearson rs ranged from 0.31 to 0.88; median = .60). Evidence of discriminant validity was provided by smaller correlations between different cognitive domains than correlations of measures within the same domain. Effect sizes for composite and subtest scores regarding stroke severity were generally moderate-to-large. In addition, 42% of the sample were exhibiting mild cognitive impairment (i.e., ≥2 low scores on fluid tests).

CONCLUSIONS

Findings provide support for the construct validity of the NIHTB-CB in individuals with stroke. (PsycINFO Database Record

Differentiating bipolar disorders from unipolar depression by applying the Brief Assessment of Cognition in Affective Disorders

BACKGROUND

Scholars continue to argue about whether bipolar disorders (BD) and unipolar depression (UD) are distinguishable with regard to neurocognitive function. This study aims to explore the cognitive profiles of UD and BD by applying the Brief Assessment of Cognition in Affective Disorders (BAC-A) for neuropsychological assessment.

METHOD

This cross-sectional study included 68 patients with UD, 67 patients with BD, and 135 healthy control subjects. We evaluated the participants' cognitive functions at euthymic status using the BAC-A, which is made up of six traditional cognitive subtests and the Affective Processing Test. We then used a discriminant function analysis (DFA) to determine whether cognitive performance can be used to distinguish these participant groups.

RESULTS

Healthy controls demonstrated better performance in all subtests of the BAC-A than both the UD and BD patients, with the exception of delayed recognition of affective interference. Compared with the BD group, the UD group exhibited better performance in working memory and emotion inhibition. Furthermore, using all BAC-A indexes, a total of 70% of participants could be correctly classified using a DFA model, and the discriminating validity between UD and BD was superior to using either the traditional cognitive domains or the Affective Processing Test alone.

CONCLUSIONS

We have found that UD patients may exhibit an intermediate performance between healthy subjects and BD patients in working memory and emotional inhibition tests. The BAC-A can potentially assist in differentiating BD patients from UD patients at euthymic status in clinical settings.

Working Memory And Brain Tissue Microstructure: White Matter Tract Integrity Based On Multi-Shell Diffusion MRI

Working memory is a complex cognitive process at the intersection of sensory processing, learning, and short-term memory and also has a general executive attention component. Impaired working memory is associated with a range of neurological and psychiatric disorders, but very little is known about how working memory relates to underlying white matter (WM) microstructure. In this study, we investigate the association between WM microstructure and performance on working memory tasks in healthy adults (right-handed, native English speakers). We combine compartment specific WM tract integrity (WMTI) metrics derived from multi-shell diffusion MRI as well as diffusion tensor/kurtosis imaging (DTI/DKI) metrics with Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) subtests tapping auditory working memory. WMTI is a novel tool that helps us describe the microstructural characteristics in both the intra- and extra-axonal environments of WM such as axonal water fraction (AWF), intra-axonal diffusivity, extra-axonal axial and radial diffusivities, allowing a more biophysical interpretation of WM changes. We demonstrate significant positive correlations between AWF and letter-number sequencing (LNS), suggesting that higher AWF with better performance on complex, more demanding auditory working memory tasks goes along with greater axonal volume and greater myelination in specific regions, causing efficient and faster information process.

Cognitive functioning following stabilisation from first episode mania

Background

The purpose of this study was to examine cognitive functioning in people following first-episode mania relative to a demographically similar healthy control group.

Methods

Forty-one patients, who had recently stabilised from a first manic episode, and twenty-one healthy controls, were compared in an extensive cognitive assessment.

Results

First-episode mania participants had significantly lower Full-Scale IQ (FSIQ) relative to healthy controls; however, this finding could be driven by premorbid differences in intellectual functioning. There were no significant differences between groups in Verbal IQ (VIQ) and Performance IQ (PIQ). First-episode mania participants performed significantly poorer than healthy controls in processing speed, verbal learning and memory, working memory, and cognitive flexibility with medium-to-large effects. There were no group differences in other measures of cognition.

Conclusions

Participants following first-episode mania have poorer global intelligence than healthy controls, and have cognitive difficulties in some, but not all areas of cognitive functioning. This highlights the importance of early intervention and cognitive assessment in the early course of the disorder.

Season-independent cognitive deficits in seasonal affective disorder and their relation to depressive symptoms

Although cognitive impairments are common in depressed individuals, it is unclear which aspects of cognition are affected and whether they represent state or trait features of depression. We here exploited a naturalistic model, namely the seasonal fluctuations in depressed status in individuals with Seasonal Affective Disorder (SAD), to study depression-related cognition, longitudinally. Twenty-nine medication-free individuals diagnosed with winter-SAD and 30 demographically matched healthy controls with no seasonality symptoms completed the Letter-number Sequencing task (LNS), the Symbol Digit Modalities Test (SDMT) and the Simple Reaction Time (SRT) twice; in summer and in winter. Compared to controls, SAD individuals showed significant season-independent impairments in tasks measuring working memory (LNS), cognitive processing speed (SDMT) and motor speed (SRT). In SAD individuals, cognitive processing speed was significantly negatively associated with the seasonal change in SAD depressive symptoms. We present novel evidence that in SAD individuals, working memory, cognitive processing- and motor speed is not only impaired in the winter but also in the summer. This suggests that certain cognitive impairments are SAD traits. Furthermore, impairments in cognitive processing speed appear to be related to depressive symptoms in SAD. Reduced processing speed may thus constitute a SAD vulnerability trait marker.

Discrete memory impairments in largely pure chronic users of MDMA

Chronic use of 3,4-methylenedioxymethamphetamine (MDMA, "ecstasy") has repeatedly been associated with deficits in working memory, declarative memory, and executive functions. However, previous findings regarding working memory and executive function are inconclusive yet, as in most studies concomitant stimulant use, which is known to affect these functions, was not adequately controlled for. Therefore, we compared the cognitive performance of 26 stimulant-free and largely pure (primary) MDMA users, 25 stimulant-using polydrug MDMA users, and 56 MDMA/stimulant-naïve controls by applying a comprehensive neuropsychological test battery. Neuropsychological tests were grouped into four cognitive domains. Recent drug use was objectively quantified by 6-month hair analyses on 17 substances and metabolites. Considerably lower mean hair concentrations of stimulants (amphetamine, methamphetamine, methylphenidate, cocaine), opioids (morphine, methadone, codeine), and hallucinogens (ketamine, 2C-B) were detected in primary compared to polydrug users, while both user groups did not differ in their MDMA hair concentration. Cohen's d effect sizes for both comparisons, i.e., primary MDMA users vs. controls and polydrug MDMA users vs. controls, were highest for declarative memory (d_primary=.90, d_polydrug=1.21), followed by working memory (d_primary=.52, d_polydrug=.96), executive functions (d_primary=.46, d_polydrug=.86), and attention (d_primary=.23, d_polydrug=.70). Thus, primary MDMA users showed strong and relatively discrete declarative memory impairments, whereas MDMA polydrug users displayed broad and unspecific cognitive impairments. Consequently, even largely pure chronic MDMA use is associated with decreased performance in declarative memory, while additional deficits in working memory and executive functions displayed by polydrug MDMA users are likely driven by stimulant co-use.

The contributions of handedness and working memory to episodic memory

Past studies have independently shown associations of working memory and degree of handedness with episodic memory retrieval. The current study takes a step ahead by examining whether handedness and working memory independently predict episodic memory. In agreement with past studies, there was an inconsistent-handed advantage for episodic memory; however, this advantage was absent for working memory tasks. Furthermore, regression analyses showed handedness, and complex working memory predicted episodic memory performance at different times. Results are discussed in light of theories of episodic memory and hemispheric interaction.

A Review of the Neuropsychological Dimensions of Tourette Syndrome

Neurocognitive functioning in Tourette syndrome (TS) has been the subject of intensive research in the past 30 years. A variety of impairments, presumably related to frontal and frontostriatal dysfunctions, have been observed. These impairments were found in various domains, such as attention, memory, executive functions, language, motor and visuomotor functions, among others. In line with contemporary research, other neurocognitive domains have recently been explored in TS, bringing evidence of altered social reasoning, for instance. Therefore, the aims of this review are to give an overview of the neuropsychological dimensions of TS, to report how neuropsychological functions evolve from childhood to adulthood, and to explain how various confounding factors can affect TS patients' performance in neuropsychological tasks. Finally, an important contribution of this review is to show how recent research has confirmed or changed our beliefs about neuropsychological functioning in TS.

Neuropsychological Functioning in Adults With ADHD and Adults With Other Psychiatric Disorders

OBJECTIVE

The aim was to investigate how well neuropsychological measures can discriminate between adults with ADHD and those with other psychiatric disorders.

METHOD

Adults with ADHD and a clinical control group ( n = 110) were included. Neuropsychological functioning was investigated using measures of inhibition, working memory, set shifting, planning, fluency, reaction-time variability, and delay aversion.

RESULTS

Adults with ADHD performed more poorly compared with clinical controls with regard to all constructs. The effects of verbal memory, inhibition, set shifting, fluency, and delay aversion remained significant when controlling for IQ. However, when controlling for basic cognitive functions, only the effects of inhibition, fluency, and delay aversion were significant. Sensitivity ranged between 64% and 75%, and specificity between 66% and 81%.

CONCLUSION

Neuropsychological tests have a relatively poor ability to discriminate between adults with ADHD and clinical controls, but they may be used to identify individuals at particularly high risk for poor daily functioning.