Prospective memory function predicts future cognitive decline and incident dementia

OBJECTIVES

This study aimed to test whether prospective memory (PM) was an early cognitive marker of future cognitive decline and incident dementia using longitudinal data spanning eight years from the Sydney Memory and Ageing Study.

METHODS

121 participants aged 72-91 years were tested in PM at baseline using a validated PM task, Virtual Week, which included time- and event-based tasks presented with varying regularity. Responses were scored "Correct" if completed accurately and "Missed' if the target was not remembered at any time. Measures of cognition were taken at baseline and two-year intervals over eight years. Dementia diagnoses were made by expert consensus panels using DSM-IV criteria. Linear mixed models and Cox proportional hazards regression models were used to analyse the data, controlling for potential confounds.

RESULTS

Both decreased PM accuracy and missed PM responses were associated with rate of cognitive decline measured by MMSE over eight years and global cognitive decline over four years. Risk of incident dementia increased with poorer baseline PM ability and missed responses. These effects remained significant after controlling for baseline cognition and were strongest for event-based and regular PM tasks.

DISCUSSION

PM is a sensitive early marker of future cognitive decline and risk of incident dementia. PM tasks supported by spontaneous retrieval (event-based) and those with lower retrospective memory demands (regular tasks) function as particularly sensitive predictors. In other words, deficits in performing less effortful PM tasks best predicted cognitive decline. These findings may encourage clinicians to incorporate PM tasks in clinical assessments.

Dual-Task Performance in Right- and Left-Handed Adults: A Finger-Tapping and Foot-Tapping Study

The dual-task paradigm has been used extensively to study laterality, with concurrent verbalization interfering with right finger-tapping in right handers. Only a few studies have used this paradigm to study interference patterns in left handers and have found inconsistent results. The dual-task paradigm has not been used to study interference effects with concurrent verbalization and foot-tapping. The objective of this study was to use this paradigm to assess whether verbal interference produces different effects on finger- and foot-tapping rate for right handers as compared to left handers. 12 right-handed and 12 left-handed men were studied, each with uncrossed hand and foot dominance, i.e., all individuals were either right handed and right footed or left handed and left footed. Subjects performed finger- and foot-tapping tasks with and without verbal interference. A significant relationship was found between handedness and finger and foot-tapping rate; individuals with a stronger right-hand preference tended to tap at a higher rate on the right side and vice-versa. Analogous relationships were not found when participants were tapping and speaking concurrently. With verbal interference, both right and left handers had a significant asymmetric effect with a decremental response in right finger-tapping rate and a facilitative effect on left finger-tapping rate. In contrast, there was a bilateral decremental response in foot-tapping with verbal interference in both right and left handers. The implications of these findings are discussed with reference to cerebral laterality of language systems and to the differential organization and integration of the motor representations of the hand and the foot.

Morphology of the frontal operculum: a volumetric magnetic resonance imaging study of the pars triangularis

OBJECTIVE

Broca's area, which includes the pars triangularis (PTR), is a neuroanatomical region important in speech and language production. Linear measures of the PTR have been found to be asymmetric, with the direction of the asymmetry correlating with language dominance determined by Wada testing. It is unclear, however, whether these linear measurements correlate with volumetric measures, and it is also unknown whether white matter and/or gray matter contribute differentially to these asymmetries. To investigate these issues, volumetric magnetic resonance imaging methodologies were used to measure the PTR in a group of healthy right-handed men (n = 12). There was a significant leftward asymmetry of the PTR using linear and volumetric measures. Linear measures of the left and right hemispheres were highly correlated with volumetric measures. Underlying gray and white matter both contributed to PTR asymmetry. Anatomical boundaries and four configurations (V, U, Y, and J) are discussed with reference to potential interhemispheric differences.

Using music during childbirth

BACKGROUND

The application of music in pain management has become popular in the past two decades. This article describes the responses of primiparas to the use of music therapy during the births of their children.

METHOD

Eleven women who attended childbirth education classes in Brantford, Ontario, Canada, volunteered to participate in a music therapy exercise. During pregnancy each participant selected preferred music, listened to it daily, and received instruction about focused listening. Within 72 hours after birth they were interviewed about their use of music as a coping strategy during labor.

RESULTS

Women selected the combination of music and labor support as a helpful coping strategy during labor. All women used the music during labor to help distract them from the pain or their current situation.

CONCLUSION

The planned use of music by mothers and caregivers can be an aid to prenatal preparation and an important adjunct in pain and stress management during labor and birth.

Hemispheric and sex-linked differences in Sylvian fissure morphology: a quantitative approach using volumetric magnetic resonance imaging

OBJECTIVE

In a sample of right-handed adults, volumetric magnetic resonance imaging (MRI) was used to reinvestigate hemispheric and sex-linked differences in Sylvian fissure (SF) morphology.

BACKGROUND

Asymmetries of the SF exist with a predominant leftward asymmetry consistently reported in postmortem studies. These anatomic asymmetries may reflect asymmetric allocation of adjacent opercula, with some investigators positing a relationship with planum temporale asymmetries, as the postcentral SF is more asymmetric than the anterior segment. Sex-related differences have also been reported with reduced asymmetries in women relative to men.

METHOD

Using in vivo MRI surface renderings, SF asymmetries were studied in a group of consistently right-handed men (n = 12) and women (n = 12). Anterior and postcentral SF lengths were measured.

RESULTS

Overall, there was a significant leftward asymmetry of the horizontal SF (anterior and postcentral) in men and women. Whereas there was a significant leftward asymmetry of the postcentral SF, there was no significant asymmetry of the anterior SF. There was an increase in the parietal operculum anterior to the posterior ascending ramus (PAR) in the left hemisphere and posterior to the PAR in the right hemisphere when SF asymmetries were leftward, with the length of the anterior parietal operculum positively correlated with postcentral SF length.

CONCLUSIONS

These findings demonstrate that the SF is asymmetric but that clear sex-related effects do not exist in consistently right-handed subjects.

Age-related changes of the insular cortex and lateral ventricles: conventional MRI volumetric measures

Preliminary data suggest that the insular region may be atrophied in patients with Alzheimer's disease when compared with healthy, age-matched control subjects. Therefore, normative data on age-related changes of the insular cortex were gathered and compared with age-related changes in the bodies of the lateral ventricles, which have been studied previously. Cerebrospinal fluid (CSF) volume of the lateral ventricles and insular cortical regions were measured on T1-weighted axial magnetic resonance images in 93 healthy subjects (age 21 to 84 years). Age-related changes were found in the lateral ventricles (r = 0.57, p < 0.0001) and in the CSF insular space (r = 0.42, p < 0.0001). Increasing age accounted for a significant amount of the variance for the lateral ventricle (pc = 0.45, p < 0.0001), but not for the insula (pc = 0.15, p = 0.14). Although there was a continuous linear increase in lateral ventricular volume with age, the CSF insular space increased linearly until the fourth decade, then plateaued until the seventh decade, with a linear increase thereafter. These data suggest that age-related changes occur in the region of the insular cortex, but differ from age-related changes of the lateral ventricles.

Construction of an Infant Neurological International Battery (Infanib) for the assessment of neurological integrity in infancy

In this article, we describe the construction of an instrument for the assessment of the neurological integrity of infants. In a follow-up program for infants from the neonatal intensive care unit, 365 evaluations of 308 infants were made by using a 32-item battery with items from four methods. Factor analyses were used for data analyses, which yielded a 20-item instrument with five factors. We named the instrument the Infant Neurological International Battery (Infanib). The Infanib has sufficient reliability for clinical and research purposes. We have formed scoring sheets, which permit clinical use of the instrument. Cut points are recommended for the separation of infants with normal, transiently abnormal, and abnormal neurologic development. The quantified scoring system enables comparison of infants on item scores, subscores (factor scores), and total scores. It also permits entry of these scores in the computer so that more complex descriptions are possible of the relationship of the neurological assessment of infants both to earlier (eg, birth) and later variables (eg, cerebral palsy, cognitive function, and school performance).

Development of a scoring system for the Milani-Comparetti and Gidoni method of assessing neurologic abnormality in infancy

This article reports the results of using a scoring system designed for the Milani-Comparetti and Gidoni method of neurologic examination of infants. The system was used in the assessment of 999 infants from the neonatal intensive care units affiliated with the Medical College of Wisconsin. The sample included all neonates who spent more than five days in the units from 1975 to 1978. Full assessments were conducted at 6 months and at 15 to 16 months corrected gestational age; additional assessments were scheduled by the physical therapists. For data analyses, the scores from the Milani-Comparetti and Gidoni method were summed; infants were subdivided into normal, transiently abnormal, and abnormal on the basis of the summed scores. Abnormal infants were further categorized on the basis of all information available. Several data analyses were performed to test the contribution of each item in separating normal, transiently abnormal, and abnormal infants and in distinguishing one type of abnormality from another. We conclude that the scoring system is useful in quantifying the degree of abnormality, in separating normality from abnormality, and in distinguishing among types of abnormality.