Subjective memory loss in age-associated memory impairment: Family history and neuropsychological correlates

Abstract

Empiricist and rationalist approaches to data-quality control in meta-analyses are discussed, and a compromise approach advocated by Strube and Hartmann (1983) for theoretically driven meta-analyses is applied to Laver and Burke's (1993) data sets. When older adults' response times (RTs) and semantic priming effects (SPEs) are regressed on young adults' RTs and SPEs, the slopes of the regression lines are approximately 1.5 as long as the age difference is held constant and performance is reasonably accurate. Both increases and decreases in RTs following unrelated and related primes, relative to RTs following baseline primes, were analyzed. The results, like those regarding RTs and SPEs, support the hypothesis that, compared with young adults who are 50 years younger, older adults take approximately 50% longer to process lexical information     

Subtyping obsessive-compulsive disorder: neuropsychological correlates

We administered neuropsychological measures considered sensitive to prefrontal dysfunction (both orbitofrontal and dorsolateral prefrontal neocortex) to obsessive-compulsive disorder (OCD) patients and control subjects. OCD subjects exhibited performance deficits, in comparison to community controls, on three measures sensitive to orbitofrontal neocortex dysfunction. Contrary to expectation, OCD patients also exhibited performance deficits on measures sensitive to dorsolateral prefrontal neocortex dysfunction. However, distinct neurocognitive profiles emerged when we examined the impact of comorbid schizotypal personality features on neuropsychological test performance. Primary OCD patients displayed impaired performance on measures sensitive to orbitofrontal dysfunction; however, they did not differ from control subjects on tests of dorsolateral function. OCD subjects presenting with schizotypal personality features performed poorly not only on tests sensitive to orbitofrontal dysfunction, but also on tests sensitive to dorsolateral dysfunction. Findings suggest that OCD can be subdivided into clinical subtypes, and distinct prefrontal subsystems may be differentially involved in these subtypes.     

Mild cognitive impairment: a neuropsychological perspective

Mild cognitive impairment (MCI) is a clinical diagnosis in which deficits in cognitive function are evident but not of sufficient severity to warrant a diagnosis of dementia. For the majority of patients, MCI represents a transitional state between normal aging and mild dementia, usually Alzheimer's disease. Multiple subtypes of MCI are now recognized. In addition to presentations featuring memory impairment, symptoms in other cognitive domains (eg, executive function, language, visuospatial) have been identified. Neuropsychological testing can be extremely useful in making the MCI diagnosis and tracking the evolution of cognitive symptoms over time. A comprehensive test battery includes measures of baseline intellectual ability, attention, executive function, memory, language, visuospatial skills, and mood. Informant-based measures of neuropsychiatric symptoms, behaviors, and competency in instrumental activity are also included. Careful assessment can identify subtle deficits that may otherwise elude detection, particularly in individuals of superior baseline intellectual ability. As we move closer to disease-modifying therapy for Alzheimer's disease, early identification becomes critical for identifying patients who have an opportunity to benefit from treatment.     

The neuropsychological correlates of cognitive insight in healthy participants

Cognitive insight is the ability to monitor and correct one's own erroneous convictions. The Beck Cognitive Insight Scale (BCIS) assesses two sub‐dimensions of cognitive insight: self‐reflectiveness (SR), which is the attitude of questioning one's own judgments; and self‐certainty (SC), which is the unwillingness to modify and correct one's own convictions. There is little information about cognitive insight in healthy participants (HP). Here we investigated the socio‐demographic and neuropsychological correlates of cognitive insight in 50 HP who were administered the BCIS and a comprehensive neuropsychological battery. The global BCIS R‐C index correlated positively with age and WCST perseverative errors. SR correlated positively with age. These data support the hypothesis that a less self‐reflective and more self‐confident style is cognitively functional in HP. Thus, what has been found malfunctioning in mental illnesses is adaptive in HP. Future studies should consider a wider range of factors that might affect this complex construct. Copyright © 2011 John Wiley & Sons, Ltd.     

A study of neuropsychological impairment among school-indentified learning-disabled students

This investigation examined the proportion of school-identified learning-disabled (LD) students who scored in the impaired range on the Halstead Reitan Neuropsychological Battery for Children (HNBC) over a 20-year period. A difference was noted in findings for periods before and after the passage of federal legislation (Public Law 94-142); specifically, the proportion of LD students who scored in the impaired range on neuropsychological tests was significantly higher prior to than after this law. A similar pattern of impaired performance across the different tests was noted before and after the legislation. The implications of these results for theorists and practitioners are discussed.     

CT scan and neuropsychological correlates of Alzheimer's disease and Huntington's disease

"Cortical" and "subcortical" dementia syndromes differ in areas of primary neuropathology and clinical characteristics. Conventional CT scan interpretation, visual inspection of pictures, has not been useful in studying dementia. Recent studies of the digitally stored CT attenuation values have found systematic variations with normal aging and aphasia subtypes. In this study of numerical CT scan information in four Alzheimer's Disease and two Huntington's Disease patients, a double dissociation of frontal and temporal lobe density values was found, and a significant correlation was found between left temporal lobe density and verbal ability measures in the Alzheimer's Disease patients.     

Adult attention-deficit/hyperactivity disorder: neuropsychological correlates and clinical presentation

We compared the neuropsychological test performance of adult ADHD patients to the neurocognitive profiles of control subjects recruited from the general population. We administered a neuropsychological test battery consisting of measures considered sensitive to either orbitofrontal or dorsolateral-prefrontal (DLPF) dysfunction. Orbitofrontal hypoarousal is associated with behavioral disinhibition and a relative indifference to punishment. The DLPF region may function as a central executive system. Indeed, DLPF dysfunction may underlie many of the cardinal symptoms associated with ADHD. We tested the following hypotheses: (1) adult subjects meeting DSM-IV criteria for ADHD, predominantly hyperactive-impulsive type, would display neuropsychological deficits on tasks sensitive to orbitofrontal dysfunction; (2) adult subjects meeting DSM-IV criteria for ADHD, predominantly inattentive type, would perform poorly on measures sensitive to DLPF dysfunction; and (3) adult subjects meeting DSM-IV criteria for ADHD, combined type, would exhibit performance deficits on orbitofrontal measures and on DLPF tasks. Results partially confirmed our hypotheses. Subtyping ADHD patients revealed important group differences. Distinct neurocognitive and clinical profiles were observed.     

Brainstem correlates of temporal auditory processing in children with specific language impairment

Deficits in identification and discrimination of sounds with short inter-stimulus intervals or short formant transitions in children with specific language impairment (SLI) have been taken to reflect an underlying temporal auditory processing deficit. Using the sustained frequency following response (FFR) and the onset auditory brainstem responses (ABR) we evaluated if children with SLI show abnormalities at the brainstem level consistent with a temporal processing deficit. To this end, the neural encoding of tonal sweeps, as reflected in the FFR, for different rates of frequency change, and the effects of reducing inter-stimulus interval on the ABR components were evaluated in 10 4–11-year-old SLI children and their age-matched controls. Results for the SLI group showed degraded FFR phase-locked neural activity that failed to faithfully track the frequency change presented in the tonal sweeps, particularly at the faster sweep rates. SLI children also showed longer latencies for waves III and V of the ABR and a greater prolongation of wave III at high stimulus rates (>30/sec), suggesting greater susceptibility to neural adaptation. These results taken together appear to suggest a disruption in the temporal pattern of phase-locked neural activity necessary to encode rapid frequency change and an increased susceptibility to desynchronizing factors related to faster rates of stimulus presentation in children with SLI.     

Affective and neuropsychological correlates of children's rituals and compulsive-like behaviors: continuities and discontinuities with obsessive-compulsive disorder

This study explored the relations among ritualistic and compulsive-like behavior, fears, and neuropsychological performance in typically developing children between the ages of four and eight years. Forty-two children were administered a battery of neuropsychological tasks assessing response inhibition and set-shifting. Two parent-report questionnaires assessed the intensity of children's fears and compulsive-like behaviors ("just right" perceptions and repetitive behaviors). For younger children (72 months), set-shifting and response inhibition accounted for significant variance in their ritualistic, compulsive-like behaviors. For older children (>72 months), a combination of neuropsychological (response inhibition) and affective (animal fears and social anxiety) factors predicted compulsive-like behaviors. These findings suggest that common neuropsychological mechanisms underlie compulsive, ritualistic behavior exhibited in normal development and in obsessive-compulsive disorder.     

Electrophysiological correlates of rapid auditory and linguistic processing in adolescents with specific language impairment

Brief tonal stimuli and spoken sentences were utilized to examine whether adolescents (aged 14;3-18;1) with specific language impairments (SLI) exhibit atypical neural activity for rapid auditory processing of non-linguistic stimuli and linguistic processing of verb-agreement and semantic constraints. Further, we examined whether the behavioral and electrophysiological indices for rapid auditory processing were correlated with those for linguistic processing. Fifteen adolescents with SLI and 15 adolescents with normal language met strict criteria for displaying consistent diagnoses from kindergarten through the eighth grade. The findings provide evidence that auditory processing for non-linguistic stimuli is atypical in a significant number of adolescents with SLI compared to peers with normal language and indicate that reduced efficiency in auditory processing in SLI is more vulnerable to rapid rates (200ms ISI) of stimuli presentation (indexed by reduced accuracy, a tendency for longer RTs, reduced N100 over right anterior sites, and reduced amplitude P300). Many adolescents with SLI displayed reduced behavioral accuracy for detecting verb-agreement violations and semantic anomalies, along with less robust P600s elicited by verb-agreement violations. The results indicate that ERPs elicited by morphosyntactic aspects of language processing are atypical in many adolescents with SLI. Additionally, correlational analyses between behavioral and electrophysiological indices of processing non-linguistic stimuli and verb-agreement violations suggest that the integrity of neural functions for auditory processing may only account for a small proportion of the variance in morphosyntactic processing in some adolescents.     

Recollection and familiarity in recognition memory: adult age differences and neuropsychological test correlates

Dual process theories account for age-related changes in memory by proposing that old age is associated with deficits in recollection together with invariance in familiarity. The authors evaluated this proposal in recognition by examining recollection and familiarity estimates in young and older adults across 3 process estimation methods: inclusion/exclusion, remember/know, and receiver operating characteristics (ROC). Consistent with a previous literature review (Light, Prull, LaVoie, & Healy, 2000), the authors found age invariance in familiarity when process estimates were derived from the inclusion/exclusion method, but the authors found age differences favoring the young when familiarity estimates were derived from the remember/know and ROC methods. Recollection estimates were lower for older adults in all 3 methods. Recollection and familiarity had variable relationships with frontal- and temporal-lobe measures of neuropsychological functioning in older adults, depending on which method was used to generate process estimates. These data suggest that although recollection deficits appear to be the rule in aging, not all estimates of familiarity show age invariance.     

The relationship of neuropsychological impairment to conduct disorder in adolescence: A conceptual review

This review is an attempt to expand the understanding of the neuropsychological mechanisms that may influence the expression of violent or aggressive behavior in adolescents. Although a relative large literature of adult studies examining the relation of neuropsychological impairment and aggression exists, the research literature investigating this relationship in adolescents is much smaller. With a few exceptions, the delinquent literature suffers from methodological problems, including biased sampling methods, small numbers of subjects, failing to objectively diagnose conduct disorder, incorrect use of specific statistical procedures, and lacking of appropriate control groups. In general, a mixed pattern of neuropsychological deficits are displayed across studies, depending on the sampling method, methodological design, statistics employed, control groups, and assessment tools that were utilized. Verbal deficits have been frequently displayed across the literature, while evidence for executive dysfunction varies, depending on the specific construct being evaluated (e.g., attention, cognitive flexibility, concept formation, planning abilities) and the specific population. Relatively inconsistent findings have been observed for visuospatial, sensory, and motor deficits. This article provides a critical review of this literature and discusses the varying impact that any neurological insult will have, depending on premorbid personality and cognitive functioning, location of the lesion, age at which the injury occurred, child's pre- and postinjury environment, and ability of the brain to adapt to acquired deficits as the result of the insult. On the basis of this review and neuropsychological theory, four subgroups within this population are proposed (i.e., adolescents with subcortical injuries, dominant hemisphere temporal-parietal injuries, nondominant hemisphere temporal-parietal injuries, and injuries to the prefrontal regions), which may better explain the neuropsychological and behavioral outcomes exhibited by this heterogeneous population. Recommendations for future research are offered.     

Autobiographical memory impairment in chronic schizophrenia: Significance and clinical correlates

Previous studies of autobiographical memory (AM) in schizophrenia yielded a reduction of specificity, richness of details and conscious recollection, which indicate both, quantitative and qualitative AM changes. However, their associations with psychopathological symptoms and neuropsychological deficits were not resolved. Therefore, we sought to investigate AM with respect to psychopathology and neuropsychology in patients with chronic schizophrenia to rule out the influence of different courses of the disease. AM of four lifetime periods was examined in 75 patients and 50 healthy controls by using a semi-structured interview. The recalled episodes were rated for memory specificity. Subsequently, one single event of each period of life was rated for details and experiential aspects of reliving (originality, vividness/visual imagery, emotional re-experiencing and emotional valence). When contrasted with healthy controls, patients recalled a significantly reduced number of episodes and personal semantic facts; moreover, memory specificity of AM was significantly lower in patients than controls. While the richness of details calculated for single events showed only minor, non-significant group differences, vividness and emotional re-experiencing were significantly less pronounced in the patient group. Along with this, AM performance correlated significantly with negative symptoms including apathy as well as verbal memory and executive functions. Our results underline the significance of overgenerality as a key feature of AM in schizophrenia as well as a dissociation between intact number of details of single events and reduced vividness and emotional re-experiencing. The extent of negative symptoms including apathy and impairments of verbal memory/executive functions may explain AM deficits in chronic schizophrenia.     

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.     

HIV-related neuropsychological impairment and immunodeficiency. CD8+ lymphocytes and neopterin are related to HIV-encephalopathy

The relationship between neuropsychological test performance and immunological parameters was studied in 52 HIV-positive patients within different stages of the infection. All subjects were neuropsychologically tested, the CD4 + and CD8 4- lymphocyte count were measured in peripheral blood, and the concentration of neopterin and HIV-p24 antigen were measured in serum. Ten patients with AIDS were defined as neuropsychologically impaired. The CD8 + cell count was the only immunological parameter that could significantly discriminate between AIDS patients with and without neuropsychological impairment. For the total group, significant positive correlations were found between neuropsychological test results and the number of CD8 + and CD4 + lymphocytes, and significant negative correlations were observed between serum concentration of neopterin and neurocognitive function. Regression analyses showed that up to 51% of the variance in test performance could be explained by CD8 + cells and neopterin concentration. The possible role of CD8 + lymphocytes and neopterin in the pathogenesis of HIV-related CNS-dysfunction is discussed.     

Sources of openness/intellect: cognitive and neuropsychological correlates of the fifth factor of personality

We characterize Openness/Intellect as motivated cognitive flexibility, or cognitive exploration, and develop a neuropsychological model relating it to dopaminergic function and to the functions of the prefrontal cortex (PFC). Evidence is reviewed for sources of Openness/Intellect shared with Extraversion and sources unique to Openness/Intellect. The hypothesis that the cognitive functions of the dorsolateral PFC are among the latter was tested using standard measures of cognitive ability and a battery of tasks associated with dorsolateral PFC function (N=175). Dorsolateral PFC function, as well as both fluid and crystallized cognitive ability, was positively related to Openness/Intellect but no other personality trait. Additionally, facet level analysis supported the characterization of Openness/Intellect as a primarily cognitive trait.     

Changes in the neuropsychological correlates of clinical dimensions between the acute and stable phase of schizophrenia

This study was designed to investigate whether the neuropsychological correlates of the symptom dimensions of schizophrenia vary with the clinical state in patients followed from the acute to stable the phase of the illness. Fifteen patients were assessed for symptoms (SAPS-SANS) and undergone a complete neuropsychological assessment at two sessions. The first session (S1) was carried out within six days after admission, i.e., acute phase and the second (S2) at least two month after hospitalization, i.e., stable phase. The data were analyzed using stepwise regression models in which neuropsychological scores were in entered to predict each dimensional score. This analysis was applied on the S1 and S2 data as well as on the S2-S1 difference to assess the neuropsychological predictors of clinical changes. Generally, the results replicate the previous associations between neuropsychological and dimensional measures found in stable patients. In addition, this study shows if each dimension appears to rely on a key structure, symptom variations seems to involve changes in the spread of the dysfunction and/or changes in the connectivity between the key and other regions. The results also suggest that functional changes related to some symptoms dimensions occur to compensate for the dysfunction associated with other symptoms.     

Early neuropsychological correlates of later clock drawing and clock copying abilities among school aged children.

Although widely used in empirical study and bedside neuropsychological evaluation of geriatric populations, there is little literature on clock copying and drawing among children. However, existing research suggests that clock drawing tests (CDTs) may be effective and efficient tools for assessing neurocognitive development in children. This paper reports data on clock drawing on demand (CDT-D) and clock drawing to copy (CDT-C) among a non-clinical sample of elementary school aged children and identifies predictive relationships between earlier measures of executive function, visuo-construction, and visual-motor coordination and CDT performance 3 years later. Similar to findings with adult samples, analyses revealed better performance on copying than on drawing. Longitudinal analyses indicate that general intelligence significantly predicted performance on both tasks. Visual-motor coordination only predicted performance on the drawing on demand subtest of the CDT.