Commission error rates on a continuous performance test are related to deficits measured by the Benton Visual Retention Test

Neuropsychological outcomes after frontal lobectomy to treat intractable epilepsy

OBJECTIVE

Frontal lobectomy is often used as a surgical treatment for frontal lobe epilepsy, especially when a large epileptogenic zone in the frontal lobe is inferred from preoperative evaluation. The frontal lobe is important for cognitive functions such as executive functions and verbal fluency, but the neuropsychological outcome after a frontal or prefrontal lobectomy that includes both the dorsolateral prefrontal cortex and ventral prefrontal cortex has not been studied thoroughly. In the present study, we evaluated neuropsychological outcomes after patients with frontal lobe epilepsy received a frontal or prefrontal lobectomy.

METHODS

We retrospectively reviewed the data of patients with frontal lobe epilepsy who underwent a frontal or prefrontal lobectomy that includes both the dorsolateral prefrontal cortex and ventral prefrontal cortex at 16 years or older from October 2004 to December 2014, with a minimum postoperative follow-up of 24 months. We analyzed and compared neuropsychological outcomes, including executive functions, verbal fluency, intelligence, and memory, before and after the operation.

RESULTS

Eighteen patients were 16 years or older and underwent pre- and postoperative (2 years after the operation) neuropsychological evaluations. Patients showed significant deterioration only on the Benton Visual Retention Test. Performance on tests of frontal lobe functions, such as executive function and verbal fluency, showed no significant deterioration.

CONCLUSIONS

Overall cognitive performance, including functions widely thought to depend on the frontal lobe, is stable after a frontal or prefrontal lobectomy to treat frontal lobe epilepsy.

Association Between Auditory and Visual Continuous Performance Tests in Students With ADHD

OBJECTIVE

Continuous Performance Tests (CPTs) are known to measure inattention and impulsivity in students with ADHD. Many CPTs utilize a visual format. It is accepted that auditory tasks reflect attentional demand more closely in the classroom. Thus, the association between deficits found by auditory and visual CPTs needs to be studied. We hypothesized that impulsivity would be dependent on sensory modality and inattention would be a unitary cross-modal construct.

METHOD

Forty-four students with ADHD performed two CPTs (visual and auditory). We analyzed correlations between the variables examined by the two tasks.

RESULTS

There were strong correlations between variables measuring inattention. Correlations between auditory and visual measures of impulsivity were weak.

CONCLUSION

Inattention is partially independent of modality. In contrast, response inhibition is modality-specific. Although ADHD is defined regardless of modality, hyperactive students may exhibit deficits in the auditory modality but not in the visual modality or vice versa.

Assessing Executive Function in Adolescence: A Scoping Review of Existing Measures and Their Psychometric Robustness

Background: There is much research examining adolescents' executive function (EF) but there is little information about tools that measure EF, in particular preference of use, their reliability and validity. This information is important as to help both researchers and practitioners select the most relevant and reliable measure of EF to use with adolescents in their context. Aims: We conducted a scoping review to: (a) identify the measures of EF that have been used in studies conducted among adolescents in the past 15 years; (b) identify the most frequently used measures of EF; and (c) establish the psychometric robustness of existing EF measures used with adolescents. Methods: We searched three bibliographic databases (PsycINFO, Ovid Medline, and Web of Science) using key terms "Adolescents," "Executive Functions," and "measures". The search covered research articles published between 1st January 2002 and 31st July 2017. Results: We identified a total of 338 individual measures of EF from 705 eligible studies. The vast majority of these studies (95%) were conducted in high income countries. Of the identified measures, 10 were the most used frequently, with a cumulative percent frequency accounting for nearly half (44%) the frequency of usage of all reported measures of EF. These are: Digit Span (count = 160), Trail Making Test (count = 158), Behavior Rating Inventory of Executive Function (count = 148), Wisconsin Card Sorting Test (count = 140), Verbal Fluency Tasks (count = 88), Stroop Color-Word Test (count = 78), Classical Stroop Task (count = 63), Color-Word Interference Test from Delis-Kaplan battery (count = 62), Rey-Osterrieth Complex Figure Test (count = 62), and Original Continuous Performance Test (count = 58). In terms of paradigms, tasks from Span (count = 235), Stroop (count = 216), Trails (count = 171), Card sorting (count = 166), Continuous performance (count = 99), and Tower (count = 94) paradigms were frequently used. Only 48 studies out of the included 705 reported the reliability and/or validity of measures of EF used with adolescents, but limited to studies in high income countries. Conclusion: We conclude that there is a wide array of measures for assessing EF among adolescents. Ten of these measures are frequently used. However, the evidence of psychometric robustness of measures of EF used with adolescents remains limited to support the validity of their usage across different contexts.

Association Between Continuous Performance and Response Inhibition Tests in Adults With ADHD

OBJECTIVE

The study of ADHD uses various computerized tests to assess cognitive functions. Uncertainty exists regarding the association between deficits found by different tools testing similar or different cognitive functions (e.g., continuous performance tests [CPT] and response inhibition [RI] tests).We hypothesized that different tools that measure continuous performance will be better correlated between themselves than with a tool that examines RI.

METHOD

Thirty-six adults with ADHD performed two different CPTs and a RI task. We analyzed correlations between different measures examined by the tasks.

RESULTS

There were strong correlations between corresponding measures in the CPTs. Correlations between the results in CPT and the RI task were only minimal.

CONCLUSION

These findings support the specificity of impairments in different cognitive domains (continuous attention vs. RI) beyond the specific test used in the study of ADHD. Also, these findings strengthen the importance of specific discriminative cognitive domains in ADHD.

Atomoxetine in abstinent cocaine users: Sex differences

Data presented are from a sex-differences secondary analysis of a human laboratory investigation of single doses of atomoxetine (40 mg and 80 mg) versus placebo in abstinent individuals with cocaine use disorders (CUD). Subjective drug effects, cognitive performance and cardiovascular measures were assessed. The primary atomoxetine dose analyses (which do not consider sex as a factor) are reported in full elsewhere (DeVito et al., 2017) [1].

Atomoxetine in abstinent cocaine users: Cognitive, subjective and cardiovascular effects

No pharmacotherapies are approved for the treatment of cocaine use disorders (CUD). Behavioral treatments for CUD are efficacious for some individuals, but recovery rates from CUD remain low. Cognitive impairments in CUD have been linked with poorer clinical outcomes. Cognitive enhancing pharmacotherapies have been proposed as promising treatments for CUD. Atomoxetine, a norepinephrine transporter inhibitor, shows potential as a treatment for CUD based on its efficacy as a cognitive enhancer in other clinical populations and impact on addictive processes in preclinical and human laboratory studies. In this randomized, double-blind, crossover study, abstinent individuals with CUD (N=39) received placebo, 40 and 80mg atomoxetine, over three sessions. Measures of attention, response inhibition and working memory; subjective medication effects and mood; and cardiovascular effects were collected. Analyses assessed acute, dose-dependent effects of atomoxetine. In addition, preliminary analyses investigating the modulation of atomoxetine dose effects by sex were performed. Atomoxetine increased heart rate and blood pressure, was rated as having positive and negative subjective drug effects, and had only modest effects on mood and cognitive enhancement.

Age at First Drink Relates to Behavioral Measures of Impulsivity: The Immediate and Delayed Memory Tasks

BACKGROUND

This study examined the relationship between laboratory-measured impulsivity and age at first drink.

METHODS

Using a laboratory behavioral measure of impulsivity [Immediate (IMT) and Delayed Memory Tasks (DMT)], we compared two groups of women differing in their self-reported age at first drink (early-onset drinking, age <18 years, n = 40; late-onset drinking, age > or =21 years, n = 23). It was expected that those who first consumed alcohol before the legal drinking age (i.e., early onset) would perform in a more impulsive manner on the laboratory behavioral measure than the late-onset drinkers.

RESULTS

The main finding was that the early-onset group (IMT: mean, 28.7%; DMT: mean, 30.4%) had increased commission error rates compared with the late-onset group (IMT: mean, 21.2%; DMT: mean, 15.5%) during both the IMT [ANOVA:F (1,61) = 4.30; p = 0.042; f = 0.27] and DMT [F (1,61) = 10.76; p = 0.002; f = 0.42]. Age at first drink was significantly correlated with DMT commission errors (r = -0.23; p = 0.037), although this was only at the trend level for IMT commission errors (r = -0.20; p = 0.062); these correlations are likely to be underestimates because of range restriction of the age variable.

CONCLUSIONS

These results demonstrate that differences in impulsive behavioral responding are distinguishable even between groups of alcohol drinkers who are not experiencing clinically significant problems with alcohol.