Serial position effects differ between Alzheimer's and vascular features in mild cognitive impairment.

Russell Jude Chander,Simon Ting,Juan Zhou,Shahul Hameed,Heidi Foo,Levinia Lim,Tingting Yong,Adeline Ng,Nagaendran Kandiah,Ming-Ching Wen,Jayne Tan

doi:10.18632/aging.101678

Abstract

Individuals with mild cognitive impairment (MCI) exhibit varying serial position effect (SPE) performances. The relationship between SPE performance in word list recall and clinical, genetic, and neuroimaging features of MCI requires elucidation. 119 MCI and 68 cognitively normal (CN) participants underwent cognitive assessment, apolipoprotein E (ApoE) genotyping, and volumetric MRI brain scans processed via voxel-based morphometry. A 10-word recall task was used to assess SPE performance in relation to recency and primacy recall. MCI participants were classified as having Good SPE performance (high primacy and recency, Good SPE) or Poor SPE performance (low primacy only, LP-SPE; low recency only, LR-SPE; or both low, Low SPE). Poor SPE participants had reduced grey matter (GM) volumes and increased white matter hyperintensities (WMH) volumes. Participants with LP-SPE demonstrated reduced hippocampal GM volumes and were more likely to be ApoE ε4 carriers. LR-SPE was associated with higher WMH volumes. Presence of both greater WMH volumes and ApoE ε4 resulted in Low SPE. LP-SPE MCI participants had features typical of Alzheimer’s disease. LR-SPE MCI was associated with increased WMH volumes, likely representing vascular pathology. SPE profiles are associated with distinct clinical patterns of MCI pathophysiology and could have potential as a clinical marker.

Highlights

The serial position effect (SPE) [1,2] is a well-established psychological phenomenon of free recall
The current study cohort comprised of the remaining 187 participants, of whom 177 were right handed. 68 participants were classified as cognitively normal (CN) and 119 were classified as mild cognitive impairment (MCI) (Figure 1)
CN and MCI participants did not differ in terms of gender (55.9% vs. 48.7% female; p=0.347) or race (94.1% vs. 89.9% Han Chinese; p=0.652; remainder of participants were a mix of Malay, Indian, Eurasian, and others)

Summary

Introduction

The serial position effect (SPE) [1,2] is a well-established psychological phenomenon of free recall. The ready recall of the first few items is known as the primacy effect, and the recency effect refers to the ready recall of the last few items This effect can be seen even in individuals with normal cognition, and assumes no other method is used to facilitate memorization (e.g. via chunking or mnemonics). Participants with Alzheimer’s disease dementia (AD) exhibit a characteristic SPE pattern of reduced primacy effect recall with relatively preserved recency effect.[3] More recent studies have focused mainly on the primacy effect and have consistently found impaired primacy function in participants with AD.[4,5] This “AD phenotype” of SPE having a greater recency performance over primacy has been said to indicate a more passive learning approach,[6] and is consistent with functional MRI studies in young adults finding an association between recognition for primacy items and increased activation of www.aging-us.com long-term memory pathways, [7] pathways understood to be deficient in AD

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