The power of the written word: Comparing word meaning inferencing from auditory and written modalities throughout grade school

Previous research indicates that word learning from auditory contexts may be more effective than written context at least through fourth grade. However, no study has examined contextual differences in word learning in older school-aged children when reading abilities are more developed. Here we examined developmental differences in children's ability to deduce the meanings of unknown words from the surrounding linguistic context in the auditory and written modalities and sought to identify the most important predictors of success in each modality. A total of 89 children aged 8-15 years were randomly assigned to either read or listen to a narrative that included eight novel words, with five exposures to each novel word. They then completed three posttests to assess word meaning inferencing. Children across all ages performed better in the written modality. Vocabulary was the only significant predictor of success on the word inferencing task. Results indicate support for written stimuli as the most effective modality for novel word meaning deduction. Our findings suggest that the presence of orthographic information facilitates novel word learning even for early, less proficient readers.

Development of Gamma Oscillation during Sentence Processing in Early Adolescence: Insights into the Maturation of Semantic Processing

Children's ability to retrieve word meanings and incorporate them into sentences, along with the neural structures that support these skills, continues to evolve throughout adolescence. Theta (4-8 Hz) activity that corresponds to word retrieval in children decreases in power and becomes more localized with age. This bottom-up word retrieval is often paired with changes in gamma (31-70 Hz), which are thought to reflect semantic unification in adults. Here, we studied gamma engagement during sentence processing using EEG time-frequency in children (ages 8-15) to unravel the developmental trajectory of the gamma network during sentence processing. Children heavily rely on semantic integration for sentence comprehension, but as they mature, semantic and syntactic processing units become distinct and localized. We observed a similar developmental shift in gamma oscillation around age 11, with younger groups (8-9 and 10-11) exhibiting broadly distributed gamma activity with higher amplitudes, while older groups (12-13 and 14-15) exhibited smaller and more localized gamma activity, especially over the left central and posterior regions. We interpret these findings as support for the argument that younger children rely more heavily on semantic processes for sentence comprehension than older children. And like adults, semantic processing in children is associated with gamma activity.

The digital mobile assessment of cognition as a quick comprehensive cognitive test for primary care

BACKGROUND

The uniform standardized neuro-cognitive test is a challenge for the primary care physician due to time constraints, interpretation, and clinical use in the daily practice for dementia care.

METHOD

The DMAC was given to 318 patients presenting with memory loss in the disease group and 33 patients in the control group. The DMAC was given between 35-55 minutes after the pre-screening test. Each domain test was bundled to give a comprehensive average score of each domain in percentage: as the person's ability to recruit neurons in the neural circuit to perform the cognitive task. The test was given individually. The domains tested include visual, auditory, delayed recall, attention, executive, number recall, disinhibition, and working memory.

RESULTS

Statistical analysis with a series of t-Tests showed the diseased group (n-318) had significantly lower scores than the control group (c-33) with confidence interval of 95% in the following domains: visual (p < 0.001), auditory (p < 0.001), delayed recall ( p < 0.001), disinhibition (p < 0.001), attention (p < 0.001), executive function (p < 0.001), numerical recall ( p < 0.001), and working memory (p < 0.001). The average sensitivity of the DMAC across these eight domains was 84.75% while the average specificity was 59.56%.

DISCUSSION

Neuropsychological test batteries have limitations as it takes 4 to 6 hours, which is not possible for the dementia group due to a short attention span and score interpretation is a challenge due to t-score and z-score reporting and selection bias of test battery. In an effort to create a comprehensive, reliable, and simple test for cognitive evaluation by a primary care physician under a controlled environment, we have created a digital mobile cognitive assessment test (DMAC) for memory loss patients with 8 common domains with simple interpretation and guidance to cognitive therapy within one software package. The DMAC has an inbuilt prescreening questionnaire to eliminate and standardize the patient selection.

CONCLUSION

The DMAC is an ideal cognitive test in an outpatient primary care setting as the results are also translated into cognitive therapy & training in simple digital media.

Outpatient cognitive therapy can change the course of dementia irrespective of etiology

INTRODUCTION

Neuroplasticity can only occur in an ideal body condition and establish a new synaptic connection with repeated stimulations in weak cognitive domains or circuits.

METHOD

A Two-phase study was planned as a course of memory loss treatment in an outpatient clinic for a period of 3 years. 49 of 72 acquired brain injury and dementia patients completed X≥14 sessions of cognitive therapy intervention within the period of 2-4 months. Patients selected for intervention had mild severe memory loss on MoCA Score [(9-24)/30]. The first phase of intervention was the correction of nutraceutical status and sleep optimization. The second phase of the intervention was individualized cognitive therapy (CT) by trained cognitive therapists after the Digital Mobile Assessment of Cognitive test (DMAC) was given before and after an intervention. The domains included visual, auditory, delayed recall, attention, executive, number recall, disinhibition, language, and working memory.

RESULTS

Statistical analysis of n-49 with confidence interval 95%, series paired t-tests showed in the post-intervention group, on average, scores were higher as follows: Visual domain 4.89% to 13.74% (p < 0.001), Auditory domain 8.35% to 19.72% (p < 0.001), Delayed recall 21.34% to 33.95% (p < 0.001), Disinhibition Frontal domain 6.89% to 21.80% (p < 0.001), Attention domain 9.33%, 26.12% (p < 0.001 ), Executive domain 9.81%, 23.06% ( p < 0.001), Number domain 5.22% to 17.91% (p < 0.001), and Working memory 2.96%, 29.85% (p = 0.01).

DISCUSSION

Dr. Eric Kandel, Nobel Laureate, showed that damaged neurons can synapse after repeated neuron stimulation. Physical therapy is a standard of practice after acquired brain injury, but cognitive impairment evaluation is often ignored. The systematic approach to body optimization for learning and cognitive therapy can change the course of cognitive decline in dementia or acquired brain injury.

CONCLUSION

The significant improvement in mild to severe dementia in short-term memory or patients' ability of memory retention improved 22% to 34% in the intervention group provides statistically significant evidence that a systematic approach to cognitive therapy can reverse the course of cognitive decline.

Hyperhomocysteinemia: A Risk Factor for Cognitive Decline in mTBI Patients

Objective

Our quest was to find an answer for “Why are some people able to recover 100% from a concussion/traumatic brain injury while others tend to have prolonged symptoms after their concussion/traumatic brain injury?”

Background

The prevalence of hyperhomocysteinemia in general is 5%–7% with increasing evidence showing higher prevalence of HHcy as age increases. The prevalence of vitamin D deficiency was 41.6% in the American population. The prevalence of vitamin B-12 deficiency is at least 40% in the patients of the Americas. With recent data, the prevalence of magnesium deficiency is around 10%–30% of the population. Hyperhomocysteinemia due MTHFR gene mutation B-12, B-6, magnesium, and folic acid deficiency is well established.

Design/Methods

A retrospective study involving 45 patients was conducted in order to correlate the persistent symptoms concussion head injury/traumatic brain injury and their bio nutraceutical deficiency.

Results

This data provides evidence that a patient's Homocysteine levels are significantly linearly related with their MoCA scores (t = −5.837, df = 34, p-value = 1.403e-06, [95% CI: −0.8406114 to −0.4936554]). In the mTBI group, for every 1 umol/L increase in Homocysteine levels, there is a 0.54217 decrease in MoCA scores. mTBI patients that had Homocysteine levels greater than 14 umol/L were 76% more likely to experience cognitive decline. The mean MoCA score of mTBI patients is significantly lower than the mean MoCA score of patients in the control group (t = −3.2898, df = 67, p-value = 0.0016, [95% CI: −6.710893 to −1.642642]). The mean Homocysteine levels of mTBI patients are significantly greater than the mean Homocysteine levels of patients in the control group (t = 2.2182, df = 85, p-value = 0.0292, [95% CI: 0.3039847 to 5.5603010]).

Conclusions

mTBI patients should be routinely screened for serum homocysteine, vitamin D, B12, B6 and magnesium levels to know their risk for cognitive decline.