Concordance Between Logical Memory and Craft Story 21 in Community-Dwelling Older Adults: The Role of Demographic Factors And Cognitive Status

OBJECTIVE

Episodic memory loss, a hallmark symptom of Alzheimer's Disease, is frequently quantified by story memory performance. The National Alzheimer's Coordinating Center Uniform Data Set Neuropsychological Battery (UDSNB) replaced Logical Memory with Craft Story 21 in UDSNB Version 3. The concordance between these story memory tasks is poorly characterized in demographically diverse older adults, possibly jeopardizing the integrity of longitudinal data in aging cohorts.

METHOD

Einstein Aging Study participants (n = 298; Mage = 76.6; Meducation = 15; 66.4% women; 43.3% Non-Hispanic White) completed UDSNB measures, including Craft Story and Logical Memory. Classification as normal cognition (n = 206) or mild cognitive impairment (n = 90) was based on Jak/Bondi criteria. Analyses included correlations, linear regression, and equipercentile equating methods to characterize the relationship between Logical Memory and Craft Story. Multivariate linear mixed effects models explored the association of covariates and practice effects over follow-up, stratified by cognitive status and race/ethnicity.

RESULTS

Immediate (r = 0.54) and delayed (r = 0.56) versions of Logical Memory and Craft Story were moderately correlated. Age, education, depression, and female sex were associated with Logical Memory, while age, education, cognitive status, and male sex were associated with Craft Story. Significant differential effects of sex on story memory were observed.

CONCLUSIONS

We demonstrated that Logical Memory and Craft Story may be used largely interchangeably; however, memory may be enhanced for stories with a protagonist of the same sex as the participant. Craft Story was somewhat more associated with mild cognitive impairment in the overall sample, but especially in non-Hispanic Black participants. We discuss how results inform test selection considerations.

Rivastigmine for Cognitive Impairment in Multiple Sclerosis: A Prospective Randomized Open Label study with Blinded End-Point Assessment

Background and Objective

Nearly 40-65% patients with MS develop cognitive impairment during the disease. There is no treatment clearly effective in improving the cognitive deficits. To evaluate the efficacy and safety of Rivastigmine in cognitively impaired MS patients.

Materials and Methods

This was a parallel group randomized open label study with blinded end-point assessment. The patient allocation to treatment and control arm was done by telephonic contact with an independent statistician who used a computer to generate a random sequence of allocation using permuted block randomization (varying block size of 4 and 6) in 1:1 ratio. The outcome assessor was blinded to this allocation. A total of 60 patients were in included in the study (30 in each arm). Primary outcome was improvement in memory functions (using logical memory subset of Wechsler Memory Scale III, India) assessed after 12 weeks. Secondary outcomes included fatigue, depression, and safety.

Results

In modified intention to treat analysis (N = 22), treatment arm showed statistically significant improvement in memory function with mean difference of 7.56 [95% CI (0.67,14.46), p 0.032] as compared to control arm. There was no statistically significant difference in outcomes such as fatigue and depression. Vomiting was the most common side effect. No major adverse events were observed in either group.

Conclusion

Rivastigmine is safe and effective in improving memory functions in cognitively impaired MS patients. However, our study has a small sample size and tested only a single domain. Larger studies with a validated single comprehensive neuropsychological test are needed.

The story of memory and executive functions in obsessive-compulsive disorder: a case-control study

OBJECTIVE

Neuropsychological findings in obsessive-compulsive disorder (OCD) are mainly clustered around the role of memory and executive functions. However, outcomes vary across different OCD populations. In addition, the extent to which each of these factors can distinguish patients with OCD (PwOCD) from healthy individuals remains uncertain and attracts great attention. The present study aims to investigate the above issues.

METHOD

This was a cross-sectional study of 182 individuals (90 PwOCD and 92 matched healthy controls). After screening for inclusion and exclusion criteria, the participants were administered neuropsychological tests including, the Wechsler Memory Scale-III (WMS-III), the Wisconsin Card Sorting Test (WCST), and the Stroop Color-Word Test (SCWT). Data were analyzed to test the study hypotheses using comparison of means and regression analysis methods.

RESULTS

The results showed that PwOCD had poorer performance than the control group in Immediate Memory, General Memory, and Working Memory and also according to response inhibition indexes. The results also showed that General Memory and Reaction Time2 from the SCWT index could be predictive variables for discriminating between PwOCD and controls.

CONCLUSION

The findings of this study support the prior assumptions that PwOCD would have impaired memory dimensions and response inhibition, but did not support worse set-shifting performance. We also present an initial model for the predictive role of these neuropsychological variables in discriminating OCD from healthy individuals and increasing diagnostic accuracy.

Lesion-behaviour mapping reveals multifactorial neurocognitive processes in recognition memory for unfamiliar faces

Face recognition abilities, which play a critical role in social interactions, involve face processing and identifying familiar faces, but also remembering one-off encounters with previously unfamiliar faces. Previous functional imaging and lesion studies have found evidence for temporal, frontal, and parietal contributions to episodic recognition memory for previously unfamiliar faces. However, the functional contributions of these regions remain unclear. We, therefore, conducted a systematic group analysis of this memory function using lesion-behavior mapping. 95 first-event stroke patients (53 with right- and 42 with left-hemisphere damage) in the sub-acute phase performed the Wechsler Memory Scale (WMS-III) face recognition memory subtest. We analyzed their performance relative to 75 healthy controls, using signal detection measures. To identify brain lesions specifically implicated in face recognition deficits, we used voxel-based lesion-behavior mapping (VLBM; an analysis comparing the performance of participants with and without damage affecting a given voxel). Behavioral analysis disclosed a pronounced impairment in the performance of patients with right hemisphere damage. Frontal damage was associated with an increased amount of false alarms (i.e., failed rejection of new face items) and overly liberal criterion setting, without affecting the recognition of studied faces. In contrast, parietal damage was associated with impaired recognition of studied faces, which was more pronounced in immediate than in delayed retrieval. These findings suggest the existence of multifactorial neurocognitive processes in recognition memory for unfamiliar faces.

Assessment of verbal and visuospatial working memory in mild cognitive impairment and Alzheimer's dementia

In addition to episodic memory impairment, working memory may also be compromised in mild cognitive impairment (MCI) or Alzheimer's dementia (AD), but standard verbal and visuospatial span tasks do not always detect impairments.

Confirmatory Factor Analysis of the Dutch Version of the Wechsler Memory Scale-Fourth Edition (WMS-IV-NL)

The latent factor structure of the Dutch version of the Wechsler Memory Scale-Fourth Edition (WMS-IV-NL) was examined with a series of confirmatory factor analyses. As part of the Dutch standardization, 1,188 healthy participants completed the WMS-IV-NL. Four models were tested for the Adult Battery (16-69 years; N = 699), and two models were tested for the Older Adult Battery (65-90 years; N = 489). Results corroborated the presence of three WMS-IV-NL factors in the Adult Battery consisting of Auditory Memory, Visual Memory, and Visual Working Memory. A two-factor model (consisting of Auditory Memory and Visual Memory) provided the best fit for the data of the Older Adult Battery. These findings provide evidence for the structural validity of the WMS-IV-NL, and further support the psychometric integrity of the WMS-IV.

Assessing cognition, depression and anxiety in hospitalized patients during pre and post-Bone Marrow Transplantation

OBJECTIVE

Bone Marrow Transplantation is considered one of the main procedures used in the treatment of both malignant and non-malignant diseases. Psychological factors after Bone Marrow Transplantation have an important role in the survival of the patients undergoing this procedure.

METHOD

In the present study, some parameters including depression, anxiety and cognition were assessed during both pre and post-transplantation in patients undergoing Bone Marrow Transplantation. The evaluations were performed by utilizing several questionnaires including Hospital Anxiety and Depression Scale and Wechsler Memory Scale within 72 hours after hospitalization (pre-transplantation) and one month after transplantation (post-transplantation). All patients received intensive chemotherapy during the first 72 hours after hospitalization. Paired t test was used to compare pre and post values. SPSS (version 18) was used to analysis the data. The significance level was defined as p < 0.05.

RESULTS

Twenty one patients who were not receiving any antianxiety agents at least for two weeks prior to and during this study were included. It was noted that anxiety was significantly less at post-transplantation compared to its pre-transplantation level (P = 0.008). However, no significant difference was found between pre and post-transplantation depression. Memory function was significantly improved at post-transplantation compared to pre-transplantation (P = 0.001).

CONCLUSION

The authors suggest that the improvement of anxiety and memory status of the patients one month after the bone marrow transplantation is expected even in the absence of consumption of any antianxiety agents. However, antidepressants may be needed to help those patients who undergo bone marrow transplantation.

A computational language approach to modeling prose recall in schizophrenia

Many cortical disorders are associated with memory problems. In schizophrenia, verbal memory deficits are a hallmark feature. However, the exact nature of this deficit remains elusive. Modeling aspects of language features used in memory recall have the potential to provide means for measuring these verbal processes. We employ computational language approaches to assess time-varying semantic and sequential properties of prose recall at various retrieval intervals (immediate, 30 min and 24 h later) in patients with schizophrenia, unaffected siblings and healthy unrelated control participants. First, we model the recall data to quantify the degradation of performance with increasing retrieval interval and the effect of diagnosis (i.e., group membership) on performance. Next we model the human scoring of recall performance using an n-gram language sequence technique, and then with a semantic feature based on Latent Semantic Analysis. These models show that automated analyses of the recalls can produce scores that accurately mimic human scoring. The final analysis addresses the validity of this approach by ascertaining the ability to predict group membership from models built on the two classes of language features. Taken individually, the semantic feature is most predictive, while a model combining the features improves accuracy of group membership prediction slightly above the semantic feature alone as well as over the human rating approach. We discuss the implications for cognitive neuroscience of such a computational approach in exploring the mechanisms of prose recall.