Evaluating Strategy Use, Online Awareness and Memory Performance Using the Contextual Memory Test Version 2 (CMT-2) in Healthy Adults.

ObjectiveResting-state EEG (rsEEG) provides insights into neural mechanisms underlying memory by reflecting intrinsic brain activity. This study tested whether rsEEG spectral power and theta-gamma phase-amplitude coupling (PAC) can predict memory performance in healthy adults.MethodsTwenty-four healthy adults participated in two rsEEG recording sessions, followed by memory tests assessing multimodal Working Memory (WM), Immediate Recall (IR), and Delayed Recall (DR). The predictive value of rsEEG spectral power across frequency bands and theta-gamma PAC was analyzed in relation to memory performance.ResultsHigh-gamma (h-γ, 51–100 Hz) power significantly predicted IR and DR, accounting for over 43% of the variance. Temporal and frontal h-γ power positively correlated with memory performance, while posterior h-γ power showed a negative correlation. Temporal low-gamma (30–49 Hz) power positively predicted DR, and posterior and frontal theta power was significantly linked to IR. Other frequency bands showed marginal associations, and theta-gamma PAC had limited predictive value.ConclusionsSpontaneous gamma activity emerged as a key predictor of memory performance in healthy adults, highlighting the role of brain networks in encoding and retrieval processes.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11571-025-10313-2.

To investigate whether the association between APOE-epsilon4 and memory decline is modified by baseline cognition and age in a population-based elderly sample. The study sample consisted of 1,243 subjects, 62 to 85 years old, with a Mini-Mental State Examination (MMSE) score between 21 and 30 and known APOE phenotypes. Memory performance was measured with an abbreviated Auditory Verbal Learning Test (AVLT) at baseline and repeated after 3 years (n = 854). Memory decline was defined as a decrease of at least 1 SD from the mean change score on immediate recall (IR), delayed recall (DR), and retention, based on the AVLT. Multivariate logistic regression analyses showed that APOE-epsilon4 is associated with memory decline in cognitively impaired subjects (MMSE score, 21 to 26) (OR for decline on IR adjusted for age, sex, education, and baseline recall score, 3.8; 95% CI, 1.4 to 10.0; adjusted OR for decline on DR, 2.9; 95% CI, 1.2 to 7.0; adjusted OR for decline on retention, 3.3; 95% CI, 1.1 to 10. 1), but not in cognitively normal subjects (MMSE score, 27 to 30) (adjusted OR for decline on IR, 1.1; 95% CI, 0.6 to 2.0; adjusted OR for decline on DR, 1.0; 95% CI, 0.6 to 1.8; adjusted OR for decline on retention, 1.5; 95% CI, 0.7 to 3.0). In particular, cognitively impaired epsilon4 carriers older than 75 years were at high risk of memory decline (adjusted OR for decline on IR, 4.5; 95% CI, 1.4 to 13.8; adjusted OR for decline on DR, 3.6; 95% CI, 1.2 to 10.8; adjusted OR for decline on retention, 6.6; 95% CI, 1.5 to 29.7). APOE-epsilon4 was associated with memory decline in subjects with cognitive impairment, but not in normally functioning subjects. Contrary to AD studies, our study suggests that the risk of APOE-epsilon4 on memory decline does not decrease at higher ages.

Verbal memory is typically studied using immediate recall (IR) and delayed recall (DR) scores, although DR is dependent on IR capability. Separating these components may be useful for deciphering the genetic variation in age-related memory abilities. This study was conducted to (a) construct individual trajectories in IR and independent aspects of delayed recall, or residualized-DR (rDR), across older adulthood; and (b) identify genetic markers that contribute to four estimated phenotypes: IR and rDR levels and changes after age 60. A cognitively intact sample (N = 20,650 with 125,164 observations) was drawn from the U.S. Health and Retirement Study, a nationally representative study of adults aged 50 and older. Mixed effects regression models were constructed using repeated measures from data collected every two years (1996–2012) to estimate level at age 60 and change in memory post-60 in IR and rDR. Genome-wide association scans (GWAS) were conducted in the genotypic subsample (N = 7,486) using ~1.2 million single nucleotide polymorphisms (SNPs). One SNP (rs2075650) in TOMM40 associated with rDR level at the genome-wide level (p = 5.0x10-08), an effect that replicated in an independent sample from the English Longitudinal Study on Ageing (N = 6,898 with 41,328 observations). Meta-analysis of rDR level confirmed the association (p = 5.0x10-11) and identified two others in TOMM40 (rs71352238 p = 1.0x10-10; rs157582 p = 7.0x10-09), and one in APOE (rs769449 p = 3.1 x10-12). Meta-analysis of IR change identified associations with three of the same SNPs in TOMM40 (rs157582 p = 8.3x10-10; rs71352238 p = 1.9x10-09) and APOE (rs769449 p = 2.2x10-08). Conditional analyses indicate GWAS signals on rDR level were driven by APOE, whereas signals on IR change were driven by TOMM40. Additionally, we found that TOMM40 had effects independent of APOE e4 on both phenotypes. Findings from this first U.S. population-based GWAS study conducted on both age-related immediate and delayed verbal memory merit continued examination in other samples and additional measures of verbal memory.

This study investigated the classification accuracy of alternative cutoffs for three Medical Symptom Validity Test (MSVT) indices, Immediate Recall (IR), Delayed Recall (DR), and Consistency (CNS). Study 1 included 83 college students randomized into two simulated ADHD groups (Incentivized simulator n = 25; Non-incentivized simulator n = 28) and one control group (n = 30). Study 2 included cross-sectional data from 114 ADHD referrals at a university-based clinic (n = 91 valid group; n = 23 invalid group) who completed the MSVT and at least two additional performance validity tests. Receiver Operator Characteristic (ROC) curves in study 1 revealed significant areas under the curve for IR, DR, and CNS (AUC = .81 − .86), high to perfect specificity (.93 − .10), and moderate to high sensitivity (.45 − .75) using cutoffs of ≤85, ≤90, and ≤95. ROC curve analyses in study 2 yielded significant areas under the curve for IR (AUC = .73), DR (AUC = .74), and CNS (AUC = .78). An optimal cut score of ≤90 across all three subtests yielded modest sensitivity (.35 − .52) while still maintaining adequate specificity (.91 − .96). The manual-recommended cutoff for invalidity (IR, DR, or CNS ≤85) demonstrated high specificity (95%) but only modest sensitivity (35%) whereas the modified cutoff (IR, DR, or CNS ≤90) increased sensitivity substantially (56%) while maintaining adequate specificity (90%). This study provides preliminary support for alternative MSVT cutoffs in adult ADHD assessments. However, additional research is warranted before utilizing these alternative cutoffs in clinical contexts.

A-024 The Relationship Between Levels of Insight and Memory Performance in Patients with Dementia

Objective:Assessment of performance validity during neuropsychology evaluation is essential to reliably interpret cognitive test scores. Studies (Webber et al., 2018; Wisdom, et al., 2012) have validated the use of abbreviated measures, such as Trial 1 (T1) of the Test of Memory Malingering (TOMM), to detect invalid performance. Only one study (Bauer et al., 2007) known to these authors has examined the utility of Green’s Word Memory Test (WMT) immediate recall (IR) as a screening tool for invalid performance. This study explores WMT IR as an independent indicator of performance validity in a mild TBI (mTBI) veteran population.Participants and Methods:Participants included 211 (Mage = 32.1, SD = 7.4; Medu = 13.1, SD = 1.64; 94.8% male; 67.8% White) OEF/OIF/OND veterans with a history of mTBI who participated in a comprehensive neuropsychological evaluation at one of five participating VA Medical Centers. Performance validity was assessed using validated cut scores from the following measures: WMT IR and delayed recall (DR); TOMM T1; WAIS-IV reliable digit span; CVLT-II forced choice raw score; Wisconsin Card Sorting Test failure to maintain set; and the Rey Memory for Fifteen Items test, combo score. Sensitivity and specificity were calculated for each IR score compared with failure on DR. In addition, sensitivity and specificity were calculated for each WMT IR score compared to failure of at least one additional performance validity measure (excluding DR), two or more measures, and three or more measures, respectively.Results:Results indicated that 46.8% participants failed to meet cut offs for adequate performance validity based on the standard WMT IR cut score (i.e., 82.5%; M = 81.8%, SD = 17.7%); however, 50.2% participants failed to meet criteria based on the standard WMT DR cut score (M = 79.8% SD = 18.6%). A cut score of 82.5% or below on WMT IR correctly identified 82.4% (i.e., sensitivity) of subjects who performed below cut score on DR, with a specificity of 94.2%. Examination of IR cutoffs compared to failure of one or more other PVTs revealed that the standardized cut score of 82.5% or below had a sensitivity of 78.2% and a specificity of 72.4%; whereas, a cut score of 65% or below had a sensitivity of 41% and a specificity of 91.3%. Similarly, examination of IR cutoffs compared to failure of two or more additional PVTs revealed that the cut score of 60% or below had a sensitivity of 45.7% and specificity of 93.1% ; whereas, a cut score of 57.5% or below had a sensitivity of 57.9% and specificity of 90.9% when using failure of three or more PVTs as the criterion.Conclusions:Results indicated that a cut score of 82.5% or below on WMT IR may be sufficient to detect invalid performance when considering WMT DR as criterion. Furthermore, WMT IR alone, with adjustments to cut scores, appears to be a reasonable way to assess symptom validity compared to other PVTs. Sensitivity and specificity of WMT IR scores may have been adversely impacted by lower sensitivity of other PVTs to independently identify invalid performance.

Background and PurposeThe Mini Mental State Examination, 2nd edition: Expanded version (MMSE-2: EV) involves an immediate recall (IR) of story memory (SM). A full version of SM has been developed and standardized; it includes delayed recall (DR) and recognition tests in addition to IR to increase its clinical utility as an independent story recall test. This study was conducted to provide norms for the full version of SM in the Korean version of MMSE-2: EV for clinical use.MethodsA total of 1,168 participants (496 males and 672 females) were included in the study. The ages ranged from 19 to 90 years, and the education level ranged from illiterate to post-graduate. Regression analysis was used to evaluate the relative contributions of demographic variables (age, education, and sex) on the SM measures.ResultsWe stratified age into 11 groups, and categorized the education level into 6 groups. It was found that the IR, DR, and recognition scores of SM were affected by age, education level, and sex. We provided corrected means and standard deviations of the IR, DR, and recognition scores of the SM for the demographic variables.ConclusionsThe results indicate the importance of considering demographic variables in interpreting the full version of SM measures. The normative data we have provided in this study should be useful in clinical and research settings for detecting the impairment in verbal memory.

Background and PurposeThe Korean version of Story Memory (SM) in the Korean-Mini Mental State Examination, 2nd Edition: Expanded Version (K-MMSE-2: EV) was developed. Based on the SM, we additionally developed a full version of SM including delayed recall (DR) and recognition adding to immediate recall (IR). This study aimed to examine the reliabilities and validities of the newly developed SM in the K-MMSE-2: EV and its full version.MethodsNinety-five healthy elderly individuals (HE), 90 patients with amnestic mild cognitive impairment (aMCI), and 53 patients with dementia of the Alzheimer's type (DAT) participated in the study. They were administered the full version of SM with the Seoul Verbal Learning Test-Elderly's version (SVLT-E) and Rey Complex Figure Test (RCFT). In addition, the SM was re-administered to 51 participants after a 5-week interval. Two clinical neuropsychologists independently rated the performance of 50 participants.ResultsThe test-retest reliabilities of the IR, DR, and recognition of the SM were statistically significant. The inter-rater reliabilities (Cohen's kappa) were high (0.87–1.00) for all the measures. The IR, DR, and recognition of SM had significant positive correlations with those of the SVLT-E and RCFT. Significant group differences in IR and DR of SM were found among the HE, aMCI, and DAT groups. The recognition scores were significantly different between the aMCI and DAT groups, but not between the HE and aMCI groups.ConclusionsThe newly developed full version of SM in the K-MMSE-2: EV was proven to be a reliable and valid memory measure for clinical use.

BackgroundCognitive remediation has been associated with enhanced cognition and psychosocial functioning in schizophrenia (SCZ). We present the preliminary results of a naturalistic study using a Cognitive Rehabilitation Programme (CRP) in Athens, Greece. The programme includes 40 individual hourly sessions, having a frequency of at least 2 sessions per week. It has a cognitive exercises and a social cognition module and aims at improving social functioning through cognitive enhancement. The CRP is implemented at a specialized Unit of the Greek National Health Service which is located in the centre of Athens for patients with SCZ living in the community.MethodsWe analyzed the CRP effects on verbal learning and memory, for the first 47 patients with SCZ referred to the Unit who took part in a naturalistic study. We compared these effects with those from a control group of 8 patients with SCZ undergoing occupational therapy. We conducted seven linear regression analyses investigating the effects of the CRP on verbal learning parameters using the Hopkins Verbal Learning Test (HVLT) (immediate total recall-ITR, immediate recall at the three learning trials (IRLT1, IRLT2, IRLT3), delayed recall (DR), retention (RT), recognition (RC) controlling for the duration of illness (DOI). In these analyses the relevant HVLT post-treatment scores were the dependent variables and CRP (receipt or not) and DOI were the independent variables controlling for the effects of baseline HVLT scores.Results47 patients with SCZ completed the CRP (15 women and 32 men, mean age=42.34 years-standard deviation/SD=11.69, mean DOI=18.27-SD=10.88). 8 patients (5 women and 3 men, mean age=54.5 years, SD=8.14, mean DOI=26.25, SD=10.63) participated in occupational therapy sessions of the same duration. Baseline HVLT scores strongly correlated with post-treatment scores in all analyses. CRP was associated with increased post-treatment HVLT total immediate recall scores (B=3.35, 95% Confidence Interval-CI=0.66, 6, t=2.5, df=49, p=0.016). DOI was associated with decreased post-treatment HVLT total immediate recall scores (B=-0.11, 95%CI=-0.2, -0.02, t=-0.25, df=49, p=0.015). Further analysis of the subjects’ performance in the three IRLTs revealed that the effect of CRP approached statistical significance in the IRLT1 (B=1.21, 95% CI=-0.04, 2.46, t=1.95, df=47, p=0.058). DOI was negatively associated with IRLT1 scores (B=-0.05, 95%CI= -0.09, -0.004, t=-2.23, df=49, p=0.023) and IRLT3 scores (B=-0.05, 95%CI=-0.1, -0.007, t=-2.3, df=48, p=0.026). The association of CRP and DOI with IRLT2 scores was not significant. DOI was negatively correlated with DR scores (B=-0.11, 95%CI=-0.16, -0.06, t=-4.38, df=49, p<0.001). Similarly, DOI was negatively associated with RT scores (B=-1, 95%CI=-1.67, -0.35, df=49, p=0.004). We failed to find any effect of CRP on DR and RT scores. The ANOVA Model for RC scores was not significant.DiscussionWe presented preliminary results of an ongoing naturalistic study. CRP was associated with improved immediate recall, after controlling for the effects of the DOI. However, we failed to find any association of CRP with other verbal learning and memory measures. DOI negatively affected immediate and delayed verbal memory and learning. Although the naturalistic design of our study supports its external validity, it also limits the interpretation of our findings. Due to its preliminary character, our study was underpowered. A future blind randomized trial recruiting more subjects could shed more light onto the effect of CRP on cognition and functioning in schizophrenia.

A new screening test for detecting mild cognitive impairment (MCI) with higher sensitivity that can easily be administered at the bedside is necessary. In this study, we proposed the delayed recall task using the word booklet of Alzheimer's Disease Assessment Scale-cognitive component-Japanese version (ADAS-Jcog) and compared the score of the task in patients with MCI with that of cognitive normal elderly (NE) and patients with AD. Thirty six patients with MCI, 13 very mild AD, 104 mild AD, 13 moderate AD, and age- and education-matched 19 NE, recruited from the memory clinic of Nagoya University Hospital, were evaluated by the ADAS-Jcog word recall task which consisted of immediate recall (IR), a classical method on ADAS-Jcog, and delayed recall (DR) that has been newly introduced. Compared with controls, patients with MCI were significantly impaired on both IR and DR. On the other hand, DR is more sensitive than IR for distinguishing MCI from NE. The highest sensitivity (94.4%) and specificity (68.4%) were achieved when the results of IR were combined with those of DR. The result suggests that the delayed word recall task using the word booklet of ADAS-Jcog may be a useful tool as a screening method for the detection of MCI.

While the neural correlates of age-related decline in episodic memory have been the subject of much interest, the spontaneous functional architecture of the brain for various memory processes in elderly adults, such as immediate recall (IR) and delayed recall (DR), remains unclear. The present study thus examined the neural correlates of age-related decline of various memory processes. A total of 66 cognitively normal older adults (aged 60–80 years) participated in this study. Memory processes were measured using the Auditory Verbal Learning Test as well as resting-state brain images, which were analyzed using both regional homogeneity (ReHo) and correlation-based functional connectivity (FC) approaches. We found that both IR and DR were significantly correlated with the ReHo of these critical regions, all within the default mode network (DMN), including the parahippocampal gyrus, posterior cingulate cortex/precuneus, inferior parietal lobule, and medial prefrontal cortex. In addition, DR was also related to the FC between these DMN regions. These results suggest that the DMN plays different roles in memory retrieval across different retention intervals, and connections between the DMN regions contribute to memory consolidation of past events in healthy older people.

To observe the effect of electronic moxibustion on memory function in the patients with amnestic mild cognitive impairment (aMCI). A total of 59 aMCI patients were randomized into an electronic moxibustion group (30 cases) and a placebo moxibustion group (29 cases). In the electronic moxibustion group, the electronic moxibustion was applied to Baihui (GV 20), Dazhui (GV 14), Mingmen (GV 4) and Taixi (KI 3), 45 ℃ in temperature, 20 min each time. The treatment was given once a day, 5 times a week. The treatment for 4 weeks was as one course and 2 courses were required totally. In the placebo moxibustion group, the moxa-free patch was used, 38 ℃ in temperature. The acupoint selection and the treatment frequency were same as the electronic moxibustion group. Before and after treatment, Rivermead behavior memory test (RBMT) was adopted to evaluate the global memory function of the patients in the two groups and the N-back task test was adopted to evaluate working memory function separately. Additionally, the mini-mental state examination (MMSE) and its immediate memory, Montreal cognitive assessment (MoCA) and its delay recall were adopted to evaluate the global cognitive function and memory function. In the electronic moxibustion group, after treatment, RBMT score, N-back accuracy rates, MMSE and MoCA scores and the scores of immediate memory and delay recall were improved significantly as compared with those before treatment (P<0.01). In the placebo moxibustion group, the accuracy rates of 1-back and 2-back task and the scores of immediate memory and delay recall were improved obviously as compared with those before treatment (P<0.05, P<0.01). After treatment, the improvements of RBMT score, the accuracy rates of N-back task and MMSE and MoCA scores in the electronic moxibustion group were higher than those in the placebo moxibustion group (P<0.05). Electronic moxibustion improves memory function in the patients with amnestic mild cognitive impairment.

B - 135 Wisconsin Card Sorting Test 64-Card Computer Version (WCST-64-CV) Failure to Maintain Set (FMS) as an Embedded Performance Validity Indicator in a Mixed Clinical Sample

Diffusion tensor imaging of the hippocampus in chronic cigarette smokers

CORRELATION BETWEEN COGNITIVE IMPAIRMENT AND THE REY AUDITORY-VERBAL LEARNING TEST IN A POPULATION WITH ALZHEIMER DISEASE