Clinicians’ Perspectives on the Validity of Neuropsychological Memory Tests for Use in Aotearoa New Zealand

The vulnerability of several neuropsychological memory tests--the Wechsler Memory Scale--Revised, Complex Figure Test, Auditory Verbal Learning Test, and Rey Memory Test--to faked deficits was evaluated. Subjects were randomly assigned to one of three conditions: Control (n = 28), Malingering with a financial incentive (n = 30), and Malingering without a financial incentive (n = 28). Overall, the performance of the Malingering Groups was not significantly different from one another, but both groups were significantly poorer than Controls. Discriminant functions with a reduced set of predictors correctly classified about 75% of cases in both the Control and the combined Malingering Groups on cross-validation. The results suggest that neuropsychological memory tests are vulnerable to faked deficits, and that recognition tasks are disproportionately affected. The use of incentives in simulation research is also discussed.

Visual and verbal learning in a genetic metabolic disorder

ABSTRACTIntroduction: Motor slowness (bradykinesia) is a core feature of Parkinson’s disease (PD). It is often assumed that patients show mental slowness (bradyphrenia) as well; however, evidence for this is debated. The aims of this study were to determine whether PD patients show mental slowness apart from motor slowness and, if this is the case, to what extent this affects their performance on neuropsychological tests of attention, memory, and executive functions (EF). Method: Fifty-five nondemented PD patients and 65 healthy controls were assessed with a simple information-processing task in which reaction and motor times could be separated. In addition, all patients and a second control group (N = 138) were assessed with neuropsychological tests of attention, memory, and EF. Results: While PD patients showed significantly longer reaction times than healthy controls, their motor times were not significantly longer. Reaction and motor times were only moderately correlated and were not related to clinical measures of disease severity. PD patients performed significantly worse on tests of attention and EF, and for the majority of neuropsychological tests 11–51% of the patients showed a clinically impaired performance. Reaction times did not, however, predict patients’ test performance, while motor times were found to have a significant negative influence on tests of attention. Conclusions: PD patients show mental slowness, which can be separated from motor slowness. Neuropsychological test performance is not influenced by mental slowness; however, motor slowness can have a negative impact. When interpreting neuropsychological test performance of PD patients in clinical practice, motor slowness needs to be taken into account.

Although problems with remembering significant events from the past (e.g. holidays, weddings, etc.) have been reported previously in patients with transient epileptic amnesia (TEA), to date there have been no detailed studies of autobiographical memory in patients with this disorder. To investigate this issue, a 68-year-old right-handed man (R.G.) who suffered from TEA and reported significant autobiographical memory problems was tested on a battery of neuropsychological tests of anterograde and remote memory. Tests of autobiographical memory revealed that R.G. was unable to evoke detailed autobiographical recollections from a substantial part of his life. By contrast, he performed well on tests of new learning and general knowledge and possessed good personal semantic information about his past. In summary, a distinct form of autobiographical amnesia, which is characterized by loss of experiential remembering of significant events, may be associated with TEA. It is proposed that the autobiographical memory deficit seen in the disorder may result from the progressive erasure of cortically based memory representations. This case adds to growing evidence for a dissociation between mechanisms subserving anterograde memory and those required to evoke remote episodic memories.

Neuropsychological tests were used to evaluate different memory systems in the three subgroups of adult Attention Deficit Hyperactivity Disorder (ADHD) (n = 105) using analysis of means, factor analysis, and GLM analysis with covariance of gender, estimated IQ, and level of anxiety and depression measured with the Hospital anxiety and depression scale. A higher IQ level was found in the neuropsychological background tests for the predominantly inattentive subtype (ADD). In the memory tests the dual-task memory/simultaneous capacity tests “Brown-Peterson” Consonant Trigram and Benton Visual Retention Test (BVRT) were the most sensitive and were severely reduced in all three subgroups, but only the BVRT revealed a difference between the three ADHD groups. In learning and delayed recall measured with Rey Auditory Verbal learning test and modified Diagnosticum für Cerebralschädigung (mDCS), the Attention Deficit Disorder subgroup had the best learning and delayed capacity of the three groups. A good agreement was found between the interviewed DSM-IV-TR criteria, Conners CAARS S:S scale, and Wender WURS 25-item scales. Despite the difference in number of ADHD criteria for the three ADHD subgroups, the results in the neuropsychological memory tests indicate a severe reduction in all three subgroups of adult ADHD in simultaneous capacity.

: This research examined whether the presence of a stressor affected performance on neuropsychological tests of attention and memory, and whether a distraction could ameliorate these potential effects. Distraction has previously been shown to reduce perceptions of tension and pain. It was hypothesized that acute stress would negatively affect performance, but that distraction would lessen these effects. These hypotheses were explored by crossing the presence of a stressor (combat surgery film/nature film) with the presence of a distraction (written essay/no essay). Seventy two subjects participated in one ninety minute session. Subjects blood pressure and heart rate were automatically monitored every three to five minutes throughout the session. Subjects filled out background information, mood, distraction, life events and perceived stress inventories, and a battery of neuropsychological tes ts before the film. Subjects then either remained quiet, or were administered the essay distraction manipulation for 15 minutes following the film. Subjects were then administered the final battery of neuropsychological tests, and mood and distraction questionnaires. Results did not support the stress hypothesis, but because results of the stress manipulation were equivocal, definitive conclusions cannot be drawn. One neuropsychological test showed a significant difference, but in the opposite direction predicted: number of errors on the Trails B Test, an attention test, were slightly higher in the no stress-no distraction condition than in the stress-no distraction condition. The distraction hypothesis was not supported by this research, but because of the unclear results of the stress manipulation, further research is necessary. Perceived stress did not affect performance on the tests, and life events affected these tests in an unexpectedly positive fashion: more life events was associated with better performance.

The Patient-Reported Outcomes Measurement Information System Cognitive Function-Concerns® (PROMIS®-CF-Concerns) assesses self-reported cognitive complaints. Construct validity data for the CF-Concerns are few. To add to the literature, an analysis of criterion validity for cognitive complaints (European Organisation for Research and Treatment of Cancer-Cognitive Functioning subscale [EORTC-CF]) and cognitive performance (neuropsychological tests of memory [NIH Toolbox Auditory Verbal Learning Test] and verbal fluency [Controlled Oral Word Association Test]) and discriminant validity (self-reports of negative emotions of anxiety, depression, negative mood) are provided. A two-group comparison design was used. Forty-four patients with chronic lymphocytic leukemia (CLL) and 44 age- and gender-matched noncancer controls completed self-report measures and neuropsychological tests. Spearman's rank correlations (rs) and independent-samples t tests were used. Regarding criterion validity, PROMIS®-CF-Concerns significantly correlated with the EORTC-CF (rs = 0.77, p < .001), although not with tests of memory (-0.19) or verbal fluency (0.16). As expected, patients with CLL performed lower than did controls on neuropsychological tests (ps < .05) yet did not differ from controls on PROMIS®-CF-Concerns. PROMIS®-CF-Concerns was reliably and significantly correlated with negative emotions, with rs ranges across measures of -0.42 to -0.69 for the CLL group and -0.53 to -0.78 for controls. PROMIS®-CF-Concerns exhibited high internal consistency. Criterion validity was evidenced for cognitive complaints though not for cognitive performance as assessed here. In summary, the analysis supports the criterion validity of PROMIS®-CF-Concerns for cognitive complaints. It also covaries with self-reports of co-occurring anxiety, depression, and negative mood. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Investigating the role of future thinking in a case of highly superior autobiographical memory

BackgroundThe neuropathological hallmarks of Alzheimer’s disease (AD) occur many years prior to the onset of clinical symptoms. Subjective memory decline can occur during this phase, but no standardized, clinically usable neuropsychological tests are currently able to detect such changes. Autobiographical memory (AM) tests tap a brain network affected in “preclinical” AD. The aim of this study was to investigate whether AM test performance was impaired in persons with Subjective Cognitive Decline (SCD) and in persons with Mild Cognitive Impairment (MCI) and mild dementia due to AD.MethodWe included 17 SCD patients diagnosed according to international SCD criteria, 17 amnestic MCI (aMCI) patients, and 17 patients with mild dementia due to AD. A group of 30 healthy controls was also examined. All participants were ≥ 45 years old and had MMSE scores of ≥ 24. AM was assessed using the Columbia Autobiographical Memory Interview – Short Form (CAMI‐SF) and an instrument, which we named the 3 Events Test. Both measure the specificity of AM and the ability to provide details about personal experiences. We also applied cognitive and neuropsychiatric screening tests and a traditional neuropsychological battery.ResultFor the 3 Events Test, a significant effect of group was found. Post‐hoc testing showed that participants with SCD, aMCI, or mild AD produced significantly fewer contextual details than the healthy controls. An ANOVA also showed a significant effect of group for the CAMI‐SF, and post‐hoc testing showed that the aMCI and mild AD groups were able to answer fewer questions or gave less detailed answers compared to the other groups. The total scores on the CAMI‐SF were lower in the SCD group than in the control group, but the difference was not significant.ConclusionAM was compromised in SCD, aMCI, and mild AD, as reflected by lower scores on the 3 Events Test compared to the control group. Thus, AM may be impaired in very early AD – even in the phases where standard episodic memory tests show no decline. AM tests could be useful in the attempt to verify subjective memory problems, and a decline on such a test could indicate later cognitive decline.

In the present investigation, we sought to determine whether glucose could enhance declarative memory in head-injured individuals, as has been shown previously with elderly and Alzheimer’s patients who had preexisting memory impairments. Varsity rugby players, both with and without a history of concussions, were given glucose- or saccharin-sweetened beverages and then tested on a series of neuropsychological tests of attention and memory; their blood-glucose levels were monitored. Beverages and tests were administered in a counterbalanced, crossover design, enabling within-subjects comparisons. Previously concussed participants were found to perform slightly worse than participants with no history of concussions (controls) on the preliminary screening interview tests and tests of memory and divided attention given in the saccharin (placebo) condition. Glucose was shown to enhance performance of the previously concussed participants and impair the performance of controls on tests of long-term declarative memory. The effects of glucose on memory appeared to be related to the participants’ ability to clear glucose from the blood.

This quantitative research is aimed to find out (1) the writing quality of both visual and auditory learners; (2) whether or not the writing quality of auditory learners is significantly different from that of visual learners; and (3) which type of learners has better writing quality. This research applied causal-comparative design in analyzing and comparing the writing skills between the visual and auditory learners. The research participants were the sixth semester students of English Education Department UIN Alauddin Makassar in the academic year of 2017-2018. The data were collected using two kinds of instruments, namely Perceptual Learning Style Inventory and writing test. The results showed that both the visual and auditory learners are in normal criteria of writing quality, and also, there is not any significant difference of writing quality between auditory learners and visual learners. Nevertheless, auditory learners had a tendency to outweigh the visual learners in terms of the total score regardless the insignificancy of the difference. On the other hand, the significant difference of the mean score found from the t-test result underscores the ideas that the learning styles and other contributing factors to writing production to satisfy students’ learning are consistent with the theories used in this study. It proves that every individual’s learning preferences differ significantly, and the stronger the preference, the more important it is to provide compatible learning and teaching strategies which involve students’ strategies, knowledge and purposes.

This paper examines the statistical relationship between a memory screening test (recall of three words after 5 minutes, 3W5M) and an extensive battery of neuropsychological memory tests. Subjects were 142 consecutive referrals for neuropsychological examination and were given 3W5M in addition to measures of memory, language, and intelligence. Performance on 3W5M was categorized as either "impaired" or "unimpaired" in a manner consistent with judgement used in clinical settings. Linear discriminant function analysis was used to predict 3W5M performance from neuropsychological test scores. Results indicated that 3W5M was a relatively good screening measure, but that its sensitivity and utility as a measure of memory was significantly influenced by the nature of the neurological disorder. Significantly higher diagnostic accuracy rates were obtained in patient groups with clinically obvious memory impairment (e.g., dementia, pure amnesia) than in groups with less obvious memory impairment (e.g., closed head injury, psychiatric disorders). Implications for clinical memory testing, and for the relationship between screening and battery approaches to assessment, are discussed.

As uncertainty remains about whether clinical response influences cognitive function after electroconvulsive therapy (ECT) for depression, we examined the effect of remission status on cognitive function in depressed patients 4 months after a course of ECT. A secondary analysis was undertaken on participants completing a randomised controlled trial of ketamine augmentation of ECT for depression who were categorised by remission status (MADRS ⩽10 v. >10) 4 months after ECT. Cognition was assessed with self-rated memory and neuropsychological tests of anterograde verbal and visual memory, autobiographical memory, verbal fluency and working memory. Patients were assessed through the study, healthy controls on a single occasion, and compared using analysis of variance. At 4-month follow-up, remitted patients (N = 18) had a mean MADRS depression score of 3.8 (95% CI 2.2-5.4) compared with 27.2 (23.0-31.5) in non-remitted patients (N = 19), with no significant baseline differences between the two groups. Patients were impaired on all cognitive measures at baseline. There was no deterioration, with some measures improving, 4-months after ECT, at which time remitted patients had significantly improved self-rated memory, anterograde verbal memory and category verbal fluency compared with those remaining depressed. Self-rated memory correlated with category fluency and autobiographical memory at follow-up. We found no evidence of persistent impairment of cognition after ECT. Achieving remission improved subjective memory and verbal memory recall, but other aspects of cognitive function were not influenced by remission status. Self-rated memory may be useful to monitor the effects of ECT on longer-term memory.

The objectives of this study were to replicate age-related decrements in recollection and source memory, and to determine if repetition lag training improves recollection and whether these effects maintain and transfer to other tasks. Sixteen young adults and 46 healthy older adults participated, the latter of whom comprised hi-old (n = 16) and lo-old (n = 30) based on neuropsychological memory tests. All participants completed memory tests and questionnaires at baseline, and then half of the lo-old underwent nine days of repetition lag training while the other half engaged in a 9-day active control program. The memory tests and questionnaires were repeated immediately after the training or control program, and again three months later. The baseline data replicated well-established age-related decrements in recollection. Repetition lag training improved objective measures of recollection, eliminated the age-related recollection decrement, and these improvements maintained over three months. However, training did not transfer to any other objective test of memory thought to rely on recollection, or to any subjective memory measure. The results demonstrate for the first time that repetition lag training improves objective measures of recollection, eliminates recollection differences between younger and older adults, and that these gains maintain over a 3-month period posttraining. The lack of transfer to other tasks, however, indicates that training one type of recollection (for the studied modality in this case) does not affect other types of recollection (e.g., of an item's recency). We suggest that recollection can be fractionated into many distinct types. (PsycINFO Database Record

Objective: Knowledge of the cognitive performance associated with REM sleep behavior disorder (RBD) in newly diagnosed Parkinson disease (PD) patients is limited. We thus wanted to explore 1) the frequency of RBD in patients with PD at a relatively early stage and 2) cognitive performance associated with RBD in PD. We hypothesized that RBD would be associated with cognitive impairment in PD. Methods: 29 non-demented patients recently diagnosed with PD (disease duration<5 years, Hoehn and Yahr stage <2.5 and no dementia) were recruited. The diagnosis of PD was supported by dopamine transporter SPECT. RBD was diagnosed based on standardized clinical interview and confirmed by polysomnography. Overall cognition was assessed by screening tests including the Mini-Mental State Examination (MMSE), and neuropsychological tests of memory, language, executive, attentional and visuospatial functions tests were performed. Results: 13 patients (45%) had probable RBD. There were no significant differences between PD with and without RBD in any of the neuropsychological tests, but a numerically lower performance was observed in the PD RBD group on memory tests Conclusions: RBD is common even in early PD without dementia, but was not found to be associated significantly with cognition.