Normative data beyond the total scores: a process score analysis of the Rey's 15 word test in healthy aging and Alzheimer's Disease

BACKGROUND

The Rey's 15 words test is currently the most frequently used task in Italy to detect memory deficits in AD. The current standardised version is however quite outdated and lacks some cognitive indexes which may highlight problems in recall or encoding processes. The aim of the study was to update the normative data of the test and to consider some variables which were not accounted for in the original study, that is, recognition, learning rate and forgetfulness. We also adopted the process scores approach to ascertain the effects of serial position (primacy and recency).

METHODS

Three hundred ninety-six healthy participants were recruited. To detect any variables useful for intercepting the early stages of dementia, a group of 208 patients in the very early stage of AD was also recruited. Linear models were used to calculate the corrections scores for age, education, and gender, and ROCs were used to calculate cut-offs based on the maximum sum of sensitivity and specificity and the positive and negative predictive values.

RESULTS

All main indexes showed excellent Area Under the Curve (0.90-1), strong sensitivity and PPVs for distinguishing between the HCs and AD participants. However, the Intrusions index performed poorly in all parameters.

CONCLUSION

The study provides updated, normative data which may be reliably used as a cognitive marker to detect early AD. The strength of the study is the large sample size and the number of indexes which make it possible to explore the utility of memory test process scores.

Oscillatory delta and theta frequencies differentially support multiple items encoding to optimize memory performance during the digit span task

The human brain has limited storage capacity often challenging the encoding and recall of a long series of multiple items. Different encoding strategies are therefore employed to optimize performance in memory processes such as chunking where particular items are 'grouped' to reduce the number of items to store artificially. Additionally, related to the position of an item within a series, there is a tendency to remember the first and last items on the list better than the middle ones, which calls the "serial position effect". Although relatively well-established in behavioral research, the neuronal mechanisms underlying such encoding strategies and memory effects remain poorly understood. Here, we used event-related EEG oscillation analyses to unravel the neuronal substrates of serial encoding strategies and effects during the behaviorally controlled execution of the digit span task. We recorded EEG in forty-four healthy young-adult participants during a backward digit span (ds) task with two difficulty levels (i.e., 3-ds and 5-ds). Participants were asked to recall the digits in reverse order after the presentation of each set. We analyzed the pattern of event-related delta and theta oscillatory power in the time-frequency domain over fronto-central and parieto-occipital areas during the item (digit) list encoding, focusing on how these oscillatory responses changed with each subsequent digit being encoded in the series. Results showed that the development of event-related delta power evoked by digits in each series matched the 'serial position curve', with higher delta power being present during the first, and especially last, digits as compared to digits presented in the middle of a set, for both difficulty levels. Event-related theta power, in contrast, rather resembled a neural correlate of a chunking pattern where, during the 5-ds encoding, a clear change in event-related theta occurred around the third/fourth positions, with decreasing power values for later digits. This suggests that different oscillatory mechanisms linked to different frequency bands may code for the different encoding strategies and effects in serial item presentation. Furthermore, recall-EEG correlations suggested that participants with higher fronto-central delta responses during digit encoding showed also higher recall scores. The here presented findings contribute to our understanding of the neural oscillatory mechanisms underlying multiple item encoding, directly informing recent efforts towards memory enhancement through targeted oscillation-based neuromodulation.

Predicting Early Mild Cognitive Impairment With Free Recall: The Primacy of Primacy

OBJECTIVES

Serial position effects have been found to discriminate between normal and pathological aging, and to predict conversion from Mild Cognitive Impairment (MCI) to Alzheimer's disease (AD). Different scoring methods have been used to estimate the accuracy of these predictions. In the current study, we investigated delayed primacy as predictor of progression to early MCI over established diagnostic memory methods. We also compared three serial position methods (regional, standard and delayed scores) to determine which measure is the most sensitive in differentiating between individuals who develop early MCI from a baseline of cognitively intact older adults.

METHOD

Data were analyzed with binary logistic regression and with receiver-operating characteristic (ROC). Baseline serial position scores were collected using the Rey's Auditory Verbal Learning Test and used to predict conversion to early MCI. The diagnosis of early MCI was obtained through statistical algorithm and consequent consensus conference. One hundred and ninety-one participants were included in the analyses. All participants were aged 60 or above and cognitively intact at baseline.

RESULTS

The binary logistic regression showed that delayed primacy was the only predictor of conversion to early MCI, when compared to total and delayed recall. ROC curves showed that delayed primacy was still the most sensitive predictor of progression to early MCI when compared to other serial position measures.

CONCLUSIONS

These findings are consistent with previous studies and support the hypothesis that delayed primacy may be a useful cognitive marker of early detection of neurodegeneration.

Maradona in our minds: The FIFA World Cup as a way to address collective memory properties

The FIFA World Cup football tournament is one of the most widely watched sporting events in the world. Particularly, the Argentina national football team has appeared in five World-Cup finals and support for this team has been a long-standing tradition in this country. In the present study, we asked whether the FIFA World Cup constructs a significant collective memory and to what extent this informal memory is similar to collective memories acquired in more formal settings. An online memory task was conducted asking a large group of Argentinian adults (N=407) which country was the winner, the runner-up, and the host of each tournament from 1930 to 2014. In addition, participants were asked to rank the emotional content and the response confidence of each tournament. Finally, participants reported a number of keywords associated with each tournament, to measure memory detail. Our results reveal the existence of a robust collective memory for the World Cup events, showing a high degree of memory accuracy and detail with regard to the history of the tournaments. Furthermore, an independent replication study (N=124) confirmed our findings. More specifically, we found evidence for general principles of individual memories in FIFA World-Cup informal collective memories. These results suggest that informal collective memories share common attributes with more formal collective memories such as those found in presidents or wars. Thus, collective memory properties may be independent of the conditions under which their acquisition occurs.

Cognitive and neural mechanisms underlying the mnemonic effect of songs after stroke

Sung melody provides a mnemonic cue that can enhance the acquisition of novel verbal material in healthy subjects. Recent evidence suggests that also stroke patients, especially those with mild aphasia, can learn and recall novel narrative stories better when they are presented in sung than spoken format. Extending this finding, the present study explored the cognitive mechanisms underlying this effect by determining whether learning and recall of novel sung vs. spoken stories show a differential pattern of serial position effects (SPEs) and chunking effects in non-aphasic and aphasic stroke patients (N = 31) studied 6 months post-stroke. The structural neural correlates of these effects were also explored using voxel-based morphometry (VBM) and deterministic tractography (DT) analyses of structural MRI data. Non-aphasic patients showed more stable recall with reduced SPEs in the sung than spoken task, which was coupled with greater volume and integrity (indicated by fractional anisotropy, FA) of the left arcuate fasciculus. In contrast, compared to non-aphasic patients, the aphasic patients showed a larger recency effect (better recall of the last vs. middle part of the story) and enhanced chunking (larger units of correctly recalled consecutive items) in the sung than spoken task. In aphasics, the enhanced chunking and better recall on the middle verse in the sung vs. spoken task correlated also with better ability to perceive emotional prosody in speech. Neurally, the sung > spoken recency effect in aphasic patients was coupled with greater grey matter volume in a bilateral network of temporal, frontal, and parietal regions and also greater volume of the right inferior fronto-occipital fasciculus (IFOF). These results provide novel cognitive and neurobiological insight on how a repetitive sung melody can function as a verbal mnemonic aid after stroke.

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Non-aphasic stroke patients show more stable recall of sung than spoken stories.

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Aphasic patients show larger recency and chunking effects to sung vs. spoken stories.

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The left dorsal pathway mediates better recall of sung stories in non-aphasics.

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The right ventral pathway mediates better recall of sung stories in aphasics.

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Large-scale bilateral cortical networks are linked to musical mnemonics in aphasia.

Remapping of memory encoding and retrieval networks: insights from neuroimaging in primates

Advancements in neuroimaging techniques have allowed for the investigation of the neural correlates of memory functions in the whole human brain. Thus, the involvement of various cortical regions, including the medial temporal lobe (MTL) and posterior parietal cortex (PPC), has been repeatedly reported in the human memory processes of encoding and retrieval. However, the functional roles of these sites could be more fully characterized utilizing nonhuman primate models, which afford the potential for well-controlled, finer-scale experimental procedures that are inapplicable to humans, including electrophysiology, histology, genetics, and lesion approaches. Yet, the presence and localization of the functional counterparts of these human memory-related sites in the macaque monkey MTL or PPC were previously unknown. Therefore, to bridge the inter-species gap, experiments were required in monkeys using functional magnetic resonance imaging (fMRI), the same methodology adopted in human studies. Here, we briefly review the history of experimentation on memory systems using a nonhuman primate model and our recent fMRI studies examining memory processing in monkeys performing recognition memory tasks. We will discuss the memory systems common to monkeys and humans and future directions of finer cell-level characterization of memory-related processes using electrophysiological recording and genetic manipulation approaches.

Within-word serial order control: Adjacent mora exchange and serial position effects in repeated single-word production

An essential function of language processing is serial order control. Computational models of serial ordering and empirical data suggest that plan representations for ordered output of sound are governed by principles related to similarity. Among these principles, the temporal distance and edge principles at a within-word level have not been empirically demonstrated separately from other principles. Specifically, the temporal distance principle assumes that phonemes that are in the same word and thus temporally close are represented similarly. This principle would manifest as phoneme movement errors within the same word. However, such errors are rarely observed in English, likely reflecting stronger effects of syllabic constraints (i.e., phonemes in different positions within the syllable are distinctly represented). The edge principle assumes that the edges of a sequence are represented distinctly from other elements/positions. This principle has been repeatedly observed as a serial position effect in the context of phonological short-term memory. However, it has not been demonstrated in single-word production. This study provides direct evidence for the two abovementioned principles by using a speech-error induction technique to show the exchange of adjacent morae and serial position effects in Japanese four-mora words. Participants repeatedly produced a target word or nonword, immediately after hearing an aurally presented distractor word. The phonologically similar distractor words, which were created by exchanging adjacent morae in the target, induced adjacent-mora-exchange errors, demonstrating the within-word temporal distance principle. There was also a serial position effect in error rates, such that errors were mostly induced at the middle positions within a word. The results provide empirical evidence for the temporal distance and edge principles in within-word serial order control.

Qualitative aspects of learning, recall, and recognition in dementia

Objective:

To determine whether learning and serial position effect (SPE) differs qualitatively and quantitatively among different types of dementia and between dementia patients and controls; we also wished to find out whether interference affects it.

Materials and Methods:

We administered the Malayalam version of the Rey Auditory Verbal Learning Test (RAVLT) to 30 cognitively unimpaired controls and 80 dementia patients [30 with Alzheimer's disease (AD), 30 with vascular dementia (VaD), and 20 with frontotemporal dementia (FTD)] with mild severity on the Clinical Dementia Rating Scale.

Results:

All groups were comparable on education and age, except the FTD group, who were younger. Qualitatively, the learning pattern and SPE (with primacy and recency being superior to intermediate) was retained in the AD, VaD, and control groups. On SPE in free recall, recency was superior to intermediate in the FTD group (P < 0.01 using Bonferroni correction). On recognition, the AD and VaD groups had more misses (P < 0.01), while the FTD group had more false positives (P < 0.01).

Conclusion:

Quantitative learning is affected by dementia. The pattern of qualitative learning remains unaltered in dementia in the early stages.