Integrating cognitive function screening and assessment into the routine care of multiple sclerosis patients

Cognitive dysfunction, a common feature of multiple sclerosis (MS), frequently leads to impaired activities of daily living, social skills deficits, diminished social support, and unemployment. There is growing evidence indicating that cognitive impairment is amenable to the effects of medication and behavioral counseling. Unfortunately, routine neuropsychological testing is rare in MS clinics because screening is ineffective and testing strategies are often too cumbersome or expensive. Recent research supports the reliability of a brief screening test called the Multiple Sclerosis Neuropsychological Screening Questionnaire as well as a minimal neuropsychological battery called the Minimal Assessment of Cognitive Function in Multiple Sclerosis. Data indicate that the Multiple Sclerosis Neuropsychological Screening Questionnaire has excellent split-half and test-retest reliability, and that it predicts neuropsychological deficiency with good sensitivity and specificity. Recently acquired data also show that the Minimal Assessment of Cognitive Function in Multiple Sclerosis tests have good test-retest reliability, discriminate MS patients from normal controls, and predict unemployment in MS patients. Thus, these or similar methods should be employed for the routine monitoring of cognitive functioning of MS patients.     

When does word meaning affect immediate serial recall in semantic dementia?

Patients with semantic dementia can show superior immediate recall of words that they still understand relatively well, as compared with more semantically degraded words, suggesting that conceptual knowledge makes a major contribution to phonological short-term memory. However, a number of studies have failed to show such a recall difference, challenging this view. We examined the effect of several methodological factors on the recall of known and degraded words in 4 patients with semantic dementia, in order to investigate possible reasons for this discrepancy. In general, our patients did exhibit poorer recall of the degraded words and made more phonological errors on these items. In addition, set size affected the magnitude of the recall advantage for known words. This finding suggests that semantic degradation influenced the rate of learning in the immediate recall task when the same items were presented repeatedly. The methods used to select known and degraded items also impacted on the recall difference. List length, however, did not affect the advantage for known words. The coherence of items in phonological short-term memory was affected by their semantic status, but not by the length of the material to be retained. The implications of these findings for the role of semantic and phonological representations in verbal short-term memory are discussed.     

An analysis of initial acquisition and maintenance of sight words following picture matching and copy cover, and compare teaching methods

This study compared the copy, cover, and compare method to a picture-word matching method for teaching sight word recognition. Participants were 5 kindergarten students with less than preprimer sight word vocabularies who were enrolled in a public school in the Pacific Northwest. A multielement design was used to evaluate the effects of the two interventions. Outcomes suggested that sight words taught using the copy, cover, and compare method resulted in better maintenance of word recognition when compared to the picture-matching intervention. Benefits to students and the practicality of employing the word-level teaching methods are discussed.     

Predicting risk sensitivity in humans and lower animals: risk as variance or coefficient of variation

This article examines the statistical determinants of risk preference. In a meta-analysis of animal risk preference (foraging birds and insects), the coefficient of variation (CV), a measure of risk per unit of return, predicts choices far better than outcome variance, the risk measure of normative models. In a meta-analysis of human risk preference, the superiority of the CV over variance in predicting risk taking is not as strong. Two experiments show that people's risk sensitivity becomes strongly proportional to the CV when they learn about choice alternatives like other animals, by experiential sampling over time. Experience-based choices differ from choices when outcomes and probabilities are numerically described. Zipf's law as an ecological regularity and Weber's law as a psychological regularity may give rise to the CV as a measure of risk.     

Temporal coding in conditioned inhibition: analysis of associative structure of inhibition

Two experiments with rats as subjects were conducted to investigate the associative structure of temporal control of conditioned inhibition through posttraining manipulation of the training excitor-unconditioned stimulus (US) temporal relationship. Experiment 1 found that following simultaneous Pavlovian inhibition training (i.e., A --> US/XA-no US) in which a conditioned stimulus (CS A) was established as a delay excitor, maximal inhibition was observed on a summation test when CS X was compounded with a delay transfer CS. Furthermore, posttraining shifts in the A-US temporal relationship from delay to trace resulted in maximal inhibition of a trace transfer CS. Experiment 2 found complementary results to Experiment 1 with an A-US posttraining shift from serial to simultaneous. These results suggest that temporal control of inhibition is mediated by the training excitor-US temporal relationship.     

Trial spacing is a determinant of cue interaction

Four conditioned lick suppression experiments with rats examined the effect of trial spacing on cue interaction. Experiments 1 and 2 found overshadowing to be eliminated with massed compound stimulus-outcome pairings and the usual trial spacing effect to be reversed with compound acquisition trials. Experiment 3 found that whether acquisition compound-outcome pairings were massed or spaced determined the effect of posttraining extinction treatment. Extinction of the overshadowing cue reduced responding following massed training and increased responding following spaced training. Extinction of the context decreased responding following massed training. Experiment 4 found the conditioning and devaluation results to be associative and stimulus specific. These results are in accord with the extended comparator hypothesis (J. C. Denniston, H. I. Savastano, & R. R. Miller, 2001).     

Dissociable neural systems for recognizing emotions

This study tested the hypothesis that the recognition of emotions would draw upon anatomically separable brain regions, depending on whether the stimuli were static or explicitly conveyed information regarding actions. We investigated the hypothesis in a rare subject with extensive bilateral brain lesions, patient B., by administering tasks that assessed recognition and naming of emotions from visual and verbal stimuli, some of which depicted actions and some of which did not. B. could not recognize any primary emotion other than happiness, when emotions were shown as static images or given as single verbal labels. By contrast, with the notable exception of disgust, he correctly recognized primary emotions from dynamic displays of facial expressions as well as from stories that described actions. Our findings are consistent with the idea that information about actions is processed in occipitoparietal and dorsal frontal cortices, all of which are intact in B.'s brain. Such information subsequently would be linked to knowledge about emotions that depends on structures mapping somatic states, many of which are also intact in B.'s brain. However, one of these somatosensory structures, the insula, is bilaterally damaged, perhaps accounting for B.'s uniformly impaired recognition of disgust (from both static and action stimuli). Other structures that are damaged in B.'s brain, including bilateral inferior and anterior temporal lobe and medial frontal cortices, appear to be critical for linking perception of static stimuli to recognition of emotions. Thus the retrieval of knowledge regarding emotions draws upon widely distributed and partly distinct sets of neural structures, depending on the attributes of the stimulus.     

Hindsight bias: how knowledge and heuristics affect our reconstruction of the past

Once people know the outcome of an event, they tend to overestimate what could have been anticipated in foresight. Although typically considered to be a robust phenomenon, this hindsight bias is subject to moderating circumstances. In their meta-analysis, Christensen-Szalanski and Willham (1991) observed that the more experience people have with the task under consideration, the smaller is the resulting hindsight bias. This observation is one benchmark against which the explanatory power of process models of hindsight bias can be measured. Therefore, we used it to put the recently proposed RAFT model (Hoffrage, Hertwig, & Gigerenzer, 2000) to another test. Our findings were consistent with the "expertise effect." Specifically, we observed-using computer simulations of the RAFT model-that the more comprehensive people's knowledge is in foresight, the smaller is their hindsight bias. In addition, we made two counterintuitive observations: First, the relation between foresight knowledge and hindsight bias appears to be independent of how knowledge is processed. Second, even if foresight knowledge is false, it can reduce hindsight bias. We conclude with a discussion of the functional value of hindsight bias.     

A specific role for the human amygdala in olfactory memory

The medial temporal lobe is known to play a role in the processing of olfaction and memory. The specific contribution of the human amygdala to memory for odors has not been addressed, however. The role of this region in memory for odors was assessed in patients with unilateral amygdala damage due to temporal lobectomy (n = 20; 11 left, 9 right), one patient with selective bilateral amygdala damage, and in 20 age-matched normal controls. Fifteen odors were presented, followed 1 h later by an odor-name matching test and an odor-odor recognition test. Signal detection analyses showed that both unilateral groups were impaired in their memory for matching odors with names, these patients were not significantly impaired on odor-odor recognition. Bilateral amygdala damage resulted in severe impairment in both odor-name matching as well as in odor-odor recognition memory. Importantly, none of the patients were impaired on an auditory verbal learning task, suggesting that these findings reflect a specific impairment in olfactory memory, and not merely a more general memory deficit. Taken together, the data provide neuropsychological evidence that the human amygdala is essential for olfactory memory.