A rehabilitative program for central executive deficits after traumatic brain injury

Deficits affecting Central Executive System (CES) of working memory (WM) are the main neuropsychological outcome after traumatic brain injury (TBI) and can also explain deficits in other domains, like divided attention, executive functions and long-term memory. For this reason we developed a rehabilitative program based on CES functions and we expected to find an improvement in WM as well as in those cognitive functions controlled by the CES.The experimental group was composed by 9 TBIs, selected for WM deficits, whereas the control group was composed by 6 TBIs, without WM deficits, but with speed processing deficits. All patients performed a cognitive training, based on PASAT (Gronwall & Wrightson, 1981)and two new versions of this task.The results showed in the experimental group an improvement in WM and in the cognitive functions controlled by the CES, whereas control patients did not show any improvement after the cognitive training.     

Regional cortical volume and cognitive functioning following traumatic brain injury

There has been limited examination of the effect of brain pathology on subsequent function. The current study examined the relationships between regional variation in grey matter volume, age and cognitive impairment using a semi-automated image analysis tool. This study included 69 individuals with mild-to-severe TBI, 41 of whom also completed neuropsychological tests of attention, working memory, processing speed, memory and executive functions. A widespread reduction in grey matter volume was associated with increasing age. Regional volumes that were affected also related to the severity of injury, whereby the most severe TBI participants displayed the most significant pathology. Poorer retention of newly learned material was associated with reduced cortical volume in frontal, parietal, and occipital brain regions. In addition, poorer working memory and executive control performance was found for individuals with lower cortical volume in temporal, parietal, and occipital regions. These findings are largely in line with previous literature, which suggests that frontal, temporal, and parietal regions are integral for the encoding of memories into long-term storage, memory retrieval, and working memory. The present study suggests that automated image analysis methods may be used to explore the relationships between regional variation in grey matter volume and cognitive function following TBI.     

Modeling a cascade of effects: the role of speed and executive functioning in preterm/full-term differences in academic achievement

This study identified deficits in executive functioning in pre-adolescent preterms and modeled their role, along with processing speed, in explaining preterm/full-term differences in reading and mathematics. Preterms (< 1750 g) showed deficits at 11 years on a battery of tasks tapping the three basic executive functions identified by Miyake - updating/working memory, inhibition, and shifting. Confirmatory factor analysis showed that these executive functions, though correlated, were distinct from one another and from processing speed, which later proved to account for much of the intercorrelation among executive functions. In the best-fitting structural equation model, the negative effects of prematurity on achievement were completely mediated by the three executive functions and speed in a cascade of effects: prematurity → slower processing speed → poorer executive functioning (working memory) → lower achievement in math and reading.     

Verbal Declarative Memory Dysfunction in Schizophrenia: From Clinical Assessment to Genetics and Brain Mechanisms

The recent literature on the neuropsychology of schizophrenia has emphasized memory deficits as a key area of impairment. Abnormalities in the medial temporal lobe, a brain region crucial for long-term memory formation, have also consistently been reported. We conducted a comprehensive review of verbal declarative memory (VDM) in schizophrenia with the aim of systematically addressing the nature of this impairment. We conclude that verbal declarative memory is significantly impaired in schizophrenia and is largely accounted for by deficits in the encoding stage. Subtle impairments in increased rates of forgetting are present, but are mild compared with those in amnestic disorders. Impairment in other cognitive domains studied thus far (e.g., attention), medication effects, or fluctuations in symptoms do not completely account for the deficit. VDM is among the most impaired neurocognitive domains in schizophrenia (along with attention and executive functions). Milder encoding deficits are present in high-risk subjects and non-psychotic relatives of individuals with schizophrenia suggesting that components of the deficit are associated with a genetic vulnerability to the illness, and are independent of the frank psychotic illness. Furthermore, VDM is observed in individuals experiencing their first-psychotic episode and it remains fairly consistent over time. Preliminary imaging studies and other work suggest abnormalities in prefrontal-hippocampal processing networks. Future work should emphasize delineating specific information processing components contributing to the deficit. This would allow imaging studies to determine which brain regions contribute to specific information processing deficits in schizophrenia.     

6-9岁儿童工作记忆的发展研究

以Baddeley工作记忆模型为基础考察儿童语音环路、视觉空间模板、中央执行的发展及其与复杂广度的关系。225名6-9岁被试完成9个任务,分别测量听力广度及工作记忆三个子系统的功能。发现工作记忆各个子成分的功能在6-9岁期间发展速度不同;中央执行与语音环路和视觉空间模板的联系随年龄增长加强;结构方程模型分析发现中央执行和语音环路功能对儿童听力广度都有显著的直接影响,表明言语复杂广度任务既涉及中央执行功能也涉及语音环路的存贮功能。     

Pantomimes are special gestures which rely on working memory

The case of a patient is reported who presented consistently with overt deficits in producing pantomimes in the absence of any other deficits in producing meaningful gestures. This pattern of spared and impaired abilities is difficult to reconcile with the current layout of cognitive models for praxis. This patient also showed clear impairment in a dual-task paradigm, a test taxing the co-ordination aspect of working memory, though performed normally in a series of other neuropsychological measures assessing language, visuo-spatial functions, reasoning function, and executive function. A specific working memory impairment associated with a deficit of pantomiming in the absence of any other disorders in the production of meaningful gestures suggested a way to modify the model to account for the data. Pantomimes are a particular category of gestures, meaningful, yet novel. We posit that by their very nature they call for the intervention of a mechanism to integrate and synthesise perceptual inputs together with information made available from the action semantics (knowledge about objects and functions) and the output lexicon (stored procedural programmes). This processing stage conceived as a temporary workspace where gesture information is actively manipulated, would generate new motor programmes to carry out pantomimes. The model of gesture production is refined to include this workspace.     

Association between biological markers of sickle cell disease and cognitive functioning amongst Cameroonian children

Background: Some of the major complications of sickle cell disease (SCD) occur in the brain and apart from overt stroke, patients also present with cognitive impairments. We sought to evaluate the prevalence of cognitive deficits as well as their biological predicting factors in young SCD patients in Cameroon.

Methods: The cognitive performances of Cameroonian SCD young patients were evaluated using a neuropsychological test battery assessing four domains of cognitive functioning (executive functions, attention, memory, and sensory-motor skills) previously adapted and normalized on healthy subjects in Yaoundé.

Findings: Up to 37.5% of the 96 SCD patients aged 6 to 24 years (M?=?13.5, SD?=?4.9) had mild-to-severe cognitive deficits. The cognitive deficits tend to increase with age. There was a significant effect of SCD on executive functions and attention, whereas SCD patients performed as well as controls on memory and sensory-motor skills tests. Structural equation models showed a significant association between (a) severe anemia and lower executive functioning, (b) low fetal hemoglobin levels and lower executive functioning and attention, (c) history of cerebrovascular accidents and lower performances in executive functioning, sensory-motor skills, and memory, (d) pathological electroencephalogram and lower attention, and (e) abnormal Transcranial Doppler and lower memory.

Conclusion: SCD patients in Cameroon presented a very high prevalence of cognitive deficits, with a specific impairment of executive functions and attention. Routine neuropsychological evaluation for early detection of cognitive deficits in SCD patients could represent a cost-effective tool to implement in resource-limited contexts such as in sub-Saharan Africa.     

The Executive Decline Hypothesis of Cognitive Aging: Do Executive Deficits Qualify as Differential Deficits and Do They Mediate Age-Related Memory Decline?

This paper reports the results of two studies which investigated whether aging is associated with a differential deficit in executive function, compared with deficits in general cognitive ability (Wechsler Adult Intelligence Scale-Revised performance). Further, the studies investigated the specificity of the executive decline hypothesis of memory and aging by examining whether declines in executive function mediate age-related memory decline over and above the variance in memory accounted for by general cognitive ability. The results of Study 1 showed no consistent evidence of a differential decline in executive function among a sample of participants aged between 18 and 75 years. The results of Study 2 indicated a differential decline in one indicator of executive function, the Modified Card Sorting Test, among an older sample aged between 60 and 89 years. Both studies demonstrated that measures of executive function accounted for age-related variance in free recall, recognition, and serial recall, even after controlling for general cognitive ability. However, in Study 1, once variance attributed to speed of processing was taken into account, executive function did not contribute further to the age-related variance.     

Context-processing deficits in schizotypal personality disorder

Research suggests that schizotypal personality disorder (SPD) is a part of the spectrum of schizophrenia-related illnesses. This article hypothesizes that a deficit in the representation and maintenance of context is a core cognitive disturbance in schizophrenia and that SPD individuals should demonstrate context-processing deficits. To test this hypothesis, the authors administered 3 versions of their AX-CPT task, designed to assess context processing, to 35 healthy controls and 26 individuals with DSM-IV SPD. They also administered working memory and selective attention tasks. SPD individuals displayed context representation deficits similar to those found in schizophrenia but did not show the same additional deficits in context maintenance. Context processing was strongly associated with working memory and selective attention performance in the SPD individuals.     

Cognitive Effects of HIV-1 Infection

The major neurological complication of human immunodeficiency virus type 1 (HIV-1) infection is cognitive impairment, which can range in severity from a mild subclinical cognitive inefficiency to a severe dementing illness. Mild to moderate cognitive impairment is identified primarily by neuropsychological tests. The prevalence and severity of cognitive impairment associated with HIV-1 infection increases as the disease progresses. Deficits in attention, information processing speed, memory, and motor abilities can occur early in the course of HIV-1 infection, with deficits in abstraction and executive functions observed in later stages of infection. The nature of the cognitive impairment observed is thought to reflect the effects of HIV-1 infection on the integrity of subcortical or frontostriatal brain systems. Issues related to the detection of subclinical to severe cognitive impairment are discussed, along with the clinical significance of mild cognitive impairment as a significant risk factor for mortality in HIV-1 infection. The need to control for possible confounding factors that can influence test performance is also reviewed.     

Cognitive deficits presenting as psychiatric symptoms in a patient with Moyamoya disease

The case of a middle-aged man who had intraventricular hemorrhages secondary to Moyamoya disease (MMD), and initially, presented with psychiatric symptoms which did not respond to treatment is described. Neuropsychological assessment showed underlying significant cognitive deficits, mostly of complex attention and speed of information processing, visuospatial and constructional abilities, verbal and nonverbal memory, and executive functions. These deficits remained stable or slightly improved in follow-up assessments. Cognitive dysfunction should be suspected in case of psychiatric or psychiatric-related symptoms in MMD patients. This case study in Greece highlights the range of preserved and impaired cognitive functions in adult MMD by means of repeated neuropsychological evaluations in which a broad range of cognitive abilities were assessed.     

Effects of emotional content on working memory capacity

Emotional events tend to be remembered better than neutral events, but emotional states and stimuli may also interfere with cognitive processes that underlie memory performance. The current study investigated the effects of emotional content on working memory capacity (WMC), which involves both short term storage and executive attention control. We tested competing hypotheses in a preregistered experiment (N?=?297). The emotional enhancement hypothesis predicts that emotional stimuli attract attention and additional processing resources relative to neutral stimuli, thereby making it easier to encode and store emotional information in WMC. The emotional impairment hypothesis, by contrast, predicts that emotional stimuli interfere with attention control and the active maintenance of information in working memory. Participants completed a common measure of WMC (the operation span task; Turner, M. L., &; Engle, R. W. [1989]. Is working memory capacity task dependent? Journal of Memory and Language, 28, 127–154) that included either emotional or neutral words. Results revealed that WMC was reduced for emotional words relative to neutral words, consistent with the emotional impairment hypothesis.     

The neuropsychological profile of vascular cognitive impairment not demented: A meta‐analysis

The most common cause of vascular cognitive impairment not demented (VCIND) is cerebral small vessel disease leading to diffuse subcortical white matter lesions. While many studies indicate that the core cognitive features of VCIND are executive dysfunction and impaired processing speed, this finding is not always consistent, and may be partially dependent on the comparison group applied. Hence, we undertook two systematic meta‐analytic reviews on neuropsychological test performance across eight cognitive domains: between VCIND and healthy controls (data from 27 studies), and between VCIND and non‐vascular mild cognitive impairment (nv‐MCI; data from 20 studies). Our quantitative synthesis of the research literature demonstrates that individuals with VCIND show weaknesses across all cognitive domains relative to healthy controls, with the greatest impairment in the domain of processing speed (Md = ?1.36), and the least affected being working memory (Md = ?.48) and visuospatial construction (Md = ?.63). When compared directly with nv‐MCI, individuals with VCIND had significantly greater deficits in processing speed (Md = ?.55) and executive functioning (Md = ?.40), while those with nv‐MCI exhibited a greater relative deficit in delayed memory (Md = .41). Our analyses indicate that disruption to subcortical white matter tracts impairs more cognitive processes than is typically thought to be directly related to the fronto‐subcortical network. The data also suggest that differing brain aetiologies can be responsible for similar cognitive profiles. Although the findings do not evince diagnostic value, they allude to the interconnectivity of disparate cognitive processes and call for further research on the behavioural outcome of network disruption.     

The Impact of Processing Speed Training on Working Memory in Old Adults

Cross-sectional and longitudinal studies have gotten different results as to whether processing speed can explain the aging of cognitive functions. Experimental analyses are needed to develop further evidence. To explore the relationship between speed and working memory in cognitive aging, processing speed intervention is conducted in the present study. Utilizing paper–pencil training, computer training, and a control group, 78 adults aged 58–83?years from Beijing participated in a speed intervention study. After 5?weeks of training, there were substantial training gains on two speed tests in two training groups, but no transfer effect on working memory was found. Discussion: The results fail to support the view that processing speed is a foundation of working memory for aging. The aging of working memory may depend more on an executive attention component.     

Phonological storage and executive function deficits in children with mathematics difficulties

Children with mathematics difficulties suffer from working memory deficits. This study investigated the deficit profile of phonological storage and executive functions in working memory among children with mathematics difficulties. Based on multiple instruments and two assessment points, 68 children were screened out of 805 fifth graders. Of these 68 children, 18 were classified as children with only mathematics difficulties (MD), 20 were classified as children with mathematics and reading difficulties (MDRD), and 30 were typically developing (TD) peers matched on age and general ability. Measures for phonological storage, dual-task performance, inhibition, and updating of verbal and numerical materials were administered individually. Results showed that compared with the TD group, children with MD exhibited storage and inhibition deficits specific to numerical information and dual-task deficits of both verbal and numerical information, whereas children with MDRD showed extensive deficits on phonological storage and executive functions on both verbal and numerical tasks. Moreover, executive function deficits were not confined to phonological storage deficits. Implications of the findings for the working memory deficit profile and working memory training among children with mathematics difficulties were discussed.     

A meta-analysis of the effects of antidepressants on cognitive functioning in depressed and non-depressed samples

A thorough understanding of the cognitive effects of antidepressant medications is essential given their frequency of use. This meta-analysis was conducted to investigate whether antidepressants differentially affect the various domains of cognitive functioning for depressed and non-depressed participants. An electronic search of PsycInfo, Medline and Google Scholar was conducted for all journal articles published between January 1998 and January 2017. Thirty-three studies were included enabling calculation of Hedges’ g using a random effects model for the cognitive domains of divided attention, executive function, expressive language, immediate memory, perceptual motor skills, processing speed, recent memory, sustained attention, visuospatial-constructional skills and working memory. Results revealed that overall, antidepressants have a modest, positive effect on divided attention, executive function, immediate memory, processing speed, recent memory and sustained attention for depressed participants. Selective serotonin reuptake inhibitors (SSRI’s) were found to have the greatest positive effect on cognition for depressed participants, as compared to the other classes of antidepressants analysed. Antidepressants did not significantly affect cognitive function in non-depressed participants.     

Processing of temporal duration information in working memory after frontodorsal tumour excisions

This study aimed to test the hypothesis that impairments of temporal duration processing after frontal lobe lesions reflect deficits in executive monitoring functions rather than a domain-specific deficit in the maintenance of duration information in working memory. Patients with frontodorsal lesions, clinical controls with post-central lesions, and healthy controls performed recognition and classification tasks, which should allow for testing maintenance and monitoring functions, respectively. Results showed mild non-selective impairments of the frontal patients on both temporal and spatial recognition tasks, but a marked selective degradation on temporal classification while performance on spatial classification was unimpaired. This suggests that maintenance of duration information in working memory after frontal lesions is basically preserved but that, depending on executive task characteristics, there is a specific deficit in the strategic organization of this type of information.     

Cognitive and motor deficits in older adults with HIV infection: Comparison with normal ageing and Parkinson’s disease

Despite the life-extending success of antiretroviral pharmacotherapy in HIV infection (HIV), the prevalence of mild cognitive impairment in HIV remains high. Near-normal life expectancy invokes an emerging role for age–infection interaction and a potential synergy between immunosenescence and HIV-related health factors, increasing risk of cognitive and motor impairment associated with degradation in corticostriatal circuits. These neural systems are also compromised in Parkinson’s disease (PD), which could help model the cognitive deficit pattern in HIV. This cross-sectional study examined three groups, age 45–79 years: 42 HIV, 41 PD, and 37 control (CTRL) participants, tested at Stanford University Medical School and SRI International. Neuropsychological tests assessed executive function (EF), information processing speed (IPS), episodic memory (MEM), visuospatial processing (VSP), and upper motor (MOT) speed and dexterity. The HIV and PD deficit profiles were similar for EF, MEM, and VSP. Although only the PD group was impaired on MOT compared with CTRL, MOT scores were related to cognitive scores in HIV but not PD. Performance was not related to depressive symptoms, socioeconomic status, or CD4⁺ T-cell counts. The overlap of HIV-PD cognitive deficits implicates frontostriatal disruption in both conditions. The motor-cognitive score relation in HIV provides further support for the hypothesis that these processes share similar underlying mechanisms in HIV infection possibly expressed with or exacerbated by ageing.     

Cognitive training programs for childhood cancer patients and survivors: A critical review and future directions

A robust literature has developed documenting neurocognitive late effects in survivors of leukemia and central nervous system (CNS) tumors, the most frequent cancer diagnoses of childhood. Patterns of late effects include deficits in attention and concentration, working memory, processing speed, and executive function, as well as other domains. As childhood cancer survivors are living longer, ameliorating deficits both in broad and specific neurocognitive domains has been increasingly recognized as an endeavor of paramount importance. Interventions to improve cognitive functioning were first applied to the field of pediatric oncology in the 1990s, based on strategies used effectively with adults who had sustained a traumatic brain injury (TBI). Compilation and modification of these techniques has led to the development of structured cognitive training programs, with the effectiveness and feasibility of such interventions currently an active area of research. Consequently, the purpose of this critical review is to: (1) review cognitive training programs intended to remediate or prevent neurocognitive deficits in pediatric cancer patients and survivors, (2) critically analyze training program strengths and weaknesses to inform practice, and (3) provide recommendations for future directions of clinical care and research.     

Time perception in severe traumatic brain injury patients: A study comparing different methodologies

In this study, we investigated time perception in patients with traumatic brain injury (TBI). Fifteen TBI patients and 15 matched healthy controls participated in the study. Participants were tested with durations above and below 1 s on three different temporal tasks that involved time reproduction, production, and discrimination tasks. Data variables analyzed included amount of errors, relative errors, and coefficient of variation. Both groups completed a neuropsychological battery that included measures of attention, working memory, and executive functions. Results revealed significant differences between groups on the time reproduction and discrimination tasks, whereas groups showed similar performance on the time production task. Correlation analyses showed involvement of attention, working memory and executive functions on the time reproduction and time discrimination tasks, but there was no involvement on the time production task. These findings suggest that TBI does not impact specific temporal function. Rather, impairments in attention, working memory and executive function abilities may explain lower temporal performance in people with TBI.