Auditory Verbal Learning Test Performance Research Articles

Methods for assessment of rey auditory verbal learning test performance in memory clinic patients and healthy adults - at the cross-roads of learning theory and clinical utility

Background: Knowledge is still lacking regarding the preferred method for evaluation of learning in the Rey Auditory Verbal Learning Test (RAVLT). Validity of different methods was examined by the effect size in differentiating diagnostic stages in memory clinic patients versus healthy adults and the strength of association between RAVLT performance and brain atrophy. Method: The study included individuals with dementia (n = 247), Mild Cognitive Impairment (MCI, n = 709), Subjective Cognitive Impairment (SCI, n = 175) and cognitively unimpaired adults serving as healthy controls (HC, n = 102). All patients went through a comprehensive clinical examination and neuropsychological assessment of cognition including episodic memory gauged with RAVLT and brain imaging of medial temporal atrophy, cortical atrophy, and white matter hyperintensity. Results: The standard method for evaluation of learning in RAVLT (summed score over five trials) together with the late learning method (mean of trials 4 and 5) were the two most powerful methods according to group differentiation (discriminant validity). Both methods also showed considerable association with medial temporal atrophy (construct validity). The initial RAVLT performance represented by results on trial 1 and the constant in regression analysis with the power function provided information regarding attention that was important for the separation of SCI and HC. Conclusions: The most favorable clinical utility was indicated by discriminant and construct validity by total learning (standard method) including both attention- and learning-related parts and late learning of RAVLT performance, while theoretical understanding of mental processes involved in RAVLT performance was provided by the distinction between initial versus the subsequent learning performance.

3 Stricker Learning Span criterion validity: remote self-administration of a computer adaptive word list memory test shows similar ability to differentiate PET-defined biomarker groups as in-person Rey Auditory Verbal Learning Test performance in cognitively unimpaired individuals on the Alzheimer’s continuum

Objective:The Stricker Learning Span (SLS) is a computer-adaptive word list memory test specifically designed for remote assessment and self-administration on a web-based multi-device platform (Mayo Test Drive). Given recent evidence suggesting the prominence of learning impairment in preclinical Alzheimer’s disease (AD), the SLS places greater emphasis on learning than delayed memory compared to traditional word list memory tests (see Stricker et al., Neuropsychology in press for review and test details). The primary study aim was to establish criterion validity of the SLS by comparing the ability of the remotely-administered SLS and inperson administered Rey Auditory Verbal Learning Test (AVLT) to differentiate biomarkerdefined groups in cognitively unimpaired (CU) individuals on the Alzheimer’s continuum.Participants and Methods:Mayo Clinic Study of Aging CU participants (N=319; mean age=71, SD=11; mean education=16, SD=2; 47% female) completed a brief remote cognitive assessment (∼0.5 months from in-person visit). Brain amyloid and brain tau PET scans were available within 3 years. Overlapping groups were formed for 1) those on the Alzheimer’s disease (AD) continuum (A+, n=110) or not (A-, n=209), and for 2) those with biological AD (A+T+, n=43) vs no evidence of AD pathology (A-T-, n=181). Primary neuropsychological outcome variables were sum of trials for both the SLS and AVLT. Secondary outcome variables examined comparability of learning (1-5 total) and delay performances. Linear model ANOVAs were used to investigate biomarker subgroup differences and Hedge’s G effect sizes were derived, with and without adjusting for demographic variables (age, education, sex).Results:Both SLS and AVLT performances were worse in the biomarker positive relative to biomarker negative groups (unadjusted p’s<.05). Because biomarker positive groups were significantly older than biomarker negative groups, group differences were attenuated after adjusting for demographic variables, but SLS remained significant for A+ vs A- and for A+T+ vs A-T- comparisons (adjusted p’s<.05) and AVLT approached significance (p’s .05-.10). The effect sizes for the SLS were slightly better (qualitatively, no statistical comparison) for separating biomarker-defined CU groups in comparison to AVLT. For A+ vs A- and A+T+ vs A-T- comparisons, unadjusted effect sizes for SLS were -0.53 and -0.81 and for AVLT were -0.47 and -0.61, respectively; adjusted effect sizes for SLS were -0.25 and -0.42 and for AVLT were -0.19 and -0.26, respectively. In secondary analyses, learning and delay variables were similar in terms of ability to separate biomarker groups. For example, unadjusted effect sizes for SLS learning (-.80) was similar to SLS delay (.76), and AVLT learning (-.58) was similar to AVLT 30-minute delay (-.55) for the A+T+ vs AT- comparison.Conclusions:Remotely administered SLS performed similarly to the in-person-administered AVLT in its ability to separate biomarker-defined groups in CU individuals, providing evidence of criterion validity. The SLS showed significantly worse performance in A+ and A+T+ groups (relative to A- and A-T-groups) in this CU sample after demographic adjustment, suggesting potential sensitivity to detecting transitional cognitive decline in preclinical AD. Measures emphasizing learning should be given equal consideration as measures of delayed memory in AD-focused studies, particularly in the preclinical phase.

Mayo normative studies: A conditional normative model for longitudinal change on the Auditory Verbal Learning Test and preliminary validation in preclinical Alzheimer's disease.

IntroductionThe aim of this study was to develop a conditional normative model for Rey's Auditory Verbal Learning Test (AVLT) that accounts for practice effects.MethodsIn our normative sample, robust conditional norms were derived from 1001 cognitively unimpaired (CU) adults ages 50 to 89 who completed the AVLT up to eight times. Linear mixed‐effects models adjusted for baseline performance, prior test exposures, time, demographics, and interaction terms. In our preliminary validation, mean performance on conditional and typical normative scores across two to four completed follow‐up tests in preclinical Alzheimer's disease participants at baseline with positive amyloid and tau positron emission (n = 27 CU amyloid [A]+tau[T]+) was compared to biomarker negative individuals (n = 269 CU A–T–).ResultsAVLT performance using typical norms did not differ across A+T+ and A–T– groups. Conditional norms z‐scores were lower in the A+T+ relative to the A–T– group for 30‐minute recall (P = .033) and sum of trials (P = .030).DiscussionConditional normative methods that account for practice effects show promise for identifying longitudinal cognitive decline.

CHANGE IN VERBAL LEARNING TEST PERFORMANCE STRATIFIED BY BASELINE FLORBETAPIR PET STATUS OVER A SIX-MONTH INTERVAL IN THE ADNI-GO/ADNI2 DATASETS

As most longitudinal studies administer cognitive tests annually, there is a paucity of data with tests of episodic memory to plan ≤6 month-duration proof-of-concept clinical studies with novel therapeutics that would be expected to impact episodic memory function. ADNI-GO and ADNI2 provided an opportunity to generate such information, as they administered the Rey's Auditory Verbal Learning Test (AVLT) six months after enrollment and obtained baseline PET scans. Permission was obtained from LONI and ADNI2/ADNI-GO cognitive test and florbetapir PET scan results were downloaded. An early AD cohort was created by including subjects from these two datasets that had baseline MMSE scores between 21 and 26 (inclusive), baseline PET results, and baseline and six-month AVLT5 (total of 5 immediate recall trials) results. 67 subjects were identified; 23 of whom had baseline florbetapir global SUVR < 1.1 (PET- subjects) and 43 of whom had baseline SUVR ≥1.1(PET+ subjects). At baseline, mean MMSE was 25.3(SD=1.3) in PET- and 24.6(1.5) in PET+ (p=0.02 vs. PET-). Mean AVLT5 was 32.4(8.5) in PET- and 28.2(9.7) in PET+ (p=0.04 vs. PET-). At six months, the change in z-score of AVLT5 was -0.22(95% CI: +0.07 to -0.51) in PET- and −0.19 (95% CI: +0.05 to -0.43) in PET+ subjects. Sample size calculations indicated that assuming a z-score decline at six-months of −0.2 in a control arm, there would be 90% power to show a treatment effect if a therapeutic would be expected to improve AVLT performance by a z-score of 0.3. Practice/learning effects appear to be minimal at six months with a word list-based verbal learning test to evaluate episodic memory, thereby providing an opportunity to show a treatment effect if the therapeutic showed at least a modest effect of improving episodic memory function. A six-month trial would be of insufficient duration if the expected treatment effect were limited to slowing of decline in episodic memory function. Amyloid PET status had limited impact on level of decline in verbal learning performance. However, selecting PET+ subjects could potentially limit ceiling effects for improvement, as it would select subjects with worse performance at baseline.

Modifying the minimum criteria for diagnosing amnestic MCI to improve prediction of brain atrophy and progression to Alzheimer\u2019s disease

Mild cognitive impairment (MCI) is a heterogeneous condition with variable outcomes. Improving diagnosis to increase the likelihood that MCI reliably reflects prodromal Alzheimer’s Disease (AD) would be of great benefit for clinical practice and intervention trials. In 230 cognitively normal (CN) and 394 MCI individuals from the Alzheimer’s Disease Neuroimaging Initiative, we studied whether an MCI diagnostic requirement of impairment on at least two episodic memory tests improves 3-year prediction of medial temporal lobe atrophy and progression to AD. Based on external age-adjusted norms for delayed free recall on the Rey Auditory Verbal Learning Test (AVLT), MCI participants were further classified as having normal (AVLT+, above −1 SD, n = 121) or impaired (AVLT -, −1 SD or below, n = 273) AVLT performance. CN, AVLT+, and AVLT- groups differed significantly on baseline brain (hippocampus, entorhinal cortex) and cerebrospinal fluid (amyloid, tau, p-tau) biomarkers, with the AVLT- group being most abnormal. The AVLT- group had significantly more medial temporal atrophy and a substantially higher AD progression rate than the AVLT+ group (51% vs. 16%, p < 0.001). The AVLT+ group had similar medial temporal trajectories compared to CN individuals. Results were similar even when restricted to individuals with above average (based on the CN group mean) baseline medial temporal volume/thickness. Requiring impairment on at least two memory tests for MCI diagnosis can markedly improve prediction of medial temporal atrophy and conversion to AD, even in the absence of baseline medial temporal atrophy. This modification constitutes a practical and cost-effective approach for clinical and research settings.

Childhood trauma and diagnosis of major depression: Association with memory and executive function

Cognitive function is often impaired in patients with major depressive disorder (MDD). Childhood trauma is a risk factor for developing MDD and is also associated with cognitive impairments in later life. We aimed to investigate the effects of childhood trauma on cognitive function in MDD. 68 medication-free MDD patients and 75 healthy controls (HC) participated. We tested cognitive function with the Autobiographical Memory Test, Auditory Verbal Learning Test (AVLT), Trail Making Test A and B, Rey–Osterrieth/Taylor Complex Figure Test, and Digit Span Backward. Childhood trauma was assessed with the Childhood Trauma Questionnaire (CTQ). Patients and HC did not differ with respect to age, sex, education. Mean CTQ sum scores differed significantly for depressed and HC with mean 47.8 (19.2) and 31.0 (6.8), respectively. Depressed patients and HC (without taking childhood trauma into account) differed only in AVLT performance. When childhood trauma was considered, this group difference disappeared. Subsequent regression analyses revealed that higher CTQ scores but not a diagnosis of MDD were associated with less specific autobiographical memories. Associations of CTQ with other cognitive domains failed significance after correction for multiple testing. Our results suggest that cognitive function is influenced by childhood trauma in MDD. However, the effects are small.

NIH Toolbox Picture Sequence Memory Test for Assessing Clinical Memory Function: Diagnostic Relationship to the Rey Auditory Verbal Learning Test.

The NIH Cognitive Toolbox Picture Sequence Memory Test (PSMT) was developed as a measure of learning ability. PSMT use in clinical populations is only beginning to be investigated. PSMT performance was analyzed in a retrospective series of 221 patients referred to either the Deep Brain Stimulation Clinic (n = 128) for presurgical evaluation, or to the Cognitive Screening Clinic (n = 93). Patients were also administered the Rey Verbal Auditory Verbal Learning test (AVLT). In addition to correlation between measures, classification agreement was examined based upon performance ratings of normal (>16th percentile), borderline (5-16th percentile), or impaired (<5th percentile). Correlation between measures was significant (r = 0.48, p < .0001), with classification agreement of 62% (weighted Kappa = 0.43). For patients with valid PVT scores (n = 147), correlation between tests was 0.67 (p < .0001) with a classification agreement of 72% (weighted Kappa = 0.44). Multiple level likelihood ratios (LRs) relating PSMT to various dichotomous AVLT learning classifications were modest, with the largest group LR obtained for impaired PSMT increasing the likelihood of obtaining impaired AVLT by 7.62 (95% CI = 3.54-16.42). Despite significant correlations between measures, the NIH Toolbox PSMT and AVLT learning score often generate different interpretive results. Impaired PSMT appears better at predicting impaired AVLT performance rather than predicting combined borderline/impaired AVLT performance. Ultimately, individual clinicians will need to determine whether the PSMT can be used independently without other memory tests in the clinical environment in which they practice while further validation studies are performed.

Effects of Demographic Variables on the Auditory Verbal Learning Test Performance

Abstract Objectives. The present study aimed to demonstrate the psychometric robustness of the Auditory Verbal Learning Test (AVLT) on Turkish samples. In the context of the test’s normalization, the study first aimed to show the effect of the demographic variables (age, education and sex) on learning, recall (free recall, recognition) and interference scores of AVLT. The second aim was to contribute to the validity studies on AVLT. In this respect, the relations between AVLT performance and fluid intelligence and the relations between age and interference scores were studied. Method: Sample consisted of a total of 48 healthy adult volunteers. There were 24 young adult (20-25 years of age) and 24 elderly (60-70 years of age) participants in the sample. In each age group, participants were evenly distributed to levels of education and sex (5-8 years, 9-11 years, 12 yearsand above; male, female, respectively). Measurement tools were AVLT and Raven Standart Progresive Matrices (RSPM). Results:According to analysis of variance and analysis of covariance (common variable: fluid intelligence), AVLT scores were significantly affected by age. The effect of education and sex were not significant. Age had a significant effect on only retroactive interference. There were significant correlations (low to medium) between all AVLT scores and the RSPM score; and between all AVLT scores and retroactive interference score. Discussion:The findings on the effect of demographic variables on AVLT performance were consistent with the literature; this points to the validity of AVLT on Turkish samples. Literature findings about the effect of age on interference scores are inconsistent; however, both types of interferences are explained as deficits of working memory and both types are represented in overlapping brain areas. In the present study, AVLT performance was related to only retroactive interference score and age affect was obtained for only retroactive interference. The effect of age on interference should be investigated in controlled studies that use appropriately larger samples. Keywords: Auditory Verbal Learning Test, Normalization, Validity, Interference Effect

Inter-trial Reliability, Cardio and Demographic Markers of Rey Auditory Verbal Learning Test Performance in Young Adult Sample from Nigeria

Objectives: The current study examines the inter-trial reliability as well as cardio and demographic markers of Rey Auditory Verbal Learning Test (RAVLT) performances in Nigeria young adult sample. Methods: Young adults between the ages of 22 – 40, were enrolled for the study. They included healthy controls (HC, n = 102) and psychiatric group (PG, n = 25) who completed the serial test protocols of RAVLT as well few indices of cardio status: Blood pressure (systolic/diastolic) and pulse rate. Results: Correlation analysis showed significant positive inter-trial correlations among trials 1 – 5 of RAVLT. When the immediate post interference and delayed trials were built into the analysis, positive significant relationships were also found. However no significant relationships were found on time taken to complete each trials of RAVLT except on few trials. Regression analyses showed low predictive strength of systolic and diastolic pressures and pulse rate on total performance score of RAVLT (Trials 1 – 5) as well as the delayed trial score. However the pulse rate showed strong predictor of Recall Word List (RWL) trial of RAVLT. Analysis of covariance showed significant group differences in all trials of RAVLT except the distraction trial. Equally gender differences were found on total trial, distraction trial and delayed trial respectively. Conclusion: The study was the first to examine some psychometric properties of RAVLT in Nigeria sample and highlights good inter-trial reliability and discriminant validity of the test. It further highlights the possible roles of cardio variables on episodic memory in young adults and may have implications for treatment among this group.

APOE Genotypes Associate With Cognitive Performance but Not Cerebral Structure: Diabetes Heart Study MIND

Dementia is a debilitating illness with a disproportionate burden in patients with type 2 diabetes (T2D). Among the contributors, genetic variation at the apolipoprotein E locus (APOE) is posited to convey a strong effect. This study compared and contrasted the association of APOE with cognitive performance and cerebral structure in the setting of T2D. European Americans from the Diabetes Heart Study (DHS) MIND (n = 754) and African Americans from the African American (AA)-DHS MIND (n = 517) were examined. The cognitive battery assessed executive function, memory, and global cognition, and brain MRI was performed. In European Americans and African Americans, the APOE E4 risk haplotype group was associated with poorer performance on the modified Mini-Mental Status Examination (P < 0.017), a measure of global cognition. In contrast to the literature, the APOE E2 haplotype group, which was overrepresented in these participants with T2D, was associated with poorer Rey Auditory Verbal Learning Test performance (P < 0.032). Nominal associations between APOE haplotype groups and MRI-determined cerebral structure were observed. Compared with APOE E3 carriers, E2 and E4 carriers performed worse in the cognitive domains of memory and global cognition. Identification of genetic contributors remains critical to understanding new pathways to prevent and treat dementia in the setting of T2D.

False-Positive Error Rates for Reliable Digit Span and Auditory Verbal Learning Test Performance Validity Measures in Amnestic Mild Cognitive Impairment and Early Alzheimer Disease

The objective is to examine failure on three embedded performance validity tests [Reliable Digit Span (RDS), Auditory Verbal Learning Test (AVLT) logistic regression, and AVLT recognition memory] in early Alzheimer disease (AD; n = 178), amnestic mild cognitive impairment (MCI; n = 365), and cognitively intact age-matched controls (n = 206). Neuropsychological tests scores were obtained from subjects participating in the Alzheimer's Disease Neuroimaging Initiative (ADNI). RDS failure using a ≤7 RDS threshold was 60/178 (34%) for early AD, 52/365 (14%) for MCI, and 17/206 (8%) for controls. A ≤6 RDS criterion reduced this rate to 24/178 (13%) for early AD, 15/365 (4%) for MCI, and 7/206 (3%) for controls. AVLT logistic regression probability of ≥.76 yielded unacceptably high false-positive rates in both clinical groups [early AD = 149/178 (79%); MCI = 159/365 (44%)] but not cognitively intact controls (13/206, 6%). AVLT recognition criterion of ≤9/15 classified 125/178 (70%) of early AD, 155/365 (42%) of MCI, and 18/206 (9%) of control scores as invalid, which decreased to 66/178 (37%) for early AD, 46/365 (13%) for MCI, and 10/206 (5%) for controls when applying a ≤5/15 criterion. Despite high false-positive rates across individual measures and thresholds, combining RDS ≤ 6 and AVLT recognition ≤9/15 classified only 9/178 (5%) of early AD and 4/365 (1%) of MCI patients as invalid performers. Embedded validity cutoffs derived from mixed clinical groups produce unacceptably high false-positive rates in MCI and early AD. Combining embedded PVT indicators lowers the false-positive rate.

Auditory Verbal Learning Test in a Large Nonclinical Portuguese Population

This study aimed to produce adjusted normative data for the Portuguese version of the Auditory Verbal Learning Test (AVLT). The study included 1,068 community-dwelling individuals (736 women, 332 men) aged 18 to 93 years old (Mage = 56 years, SD = 18) who had educational backgrounds ranging from 0 to 24 years (M = 9.8 years, SD = 5.3). The results showed that sex, age, and education were significantly associated with AVLT performance. These demographic characteristics accounted for 24% to 35% of the variance of direct recall trials and for 8% to 39% of the variance of derived recall scores. The normative data for direct and derived recall scores are presented as regression-based algorithms to adjust for sex, age, and education with subsequent correspondence between adjusted scores and percentile distribution. The norms for the recognition correct score are presented as algorithms to estimate the recognition scores for 5th, 10th, and 18th percentiles for each combination of the variables sex, age, and education.

Correlation of hippocampal volume and cognitive performances in patients with either mild cognitive impairment or Alzheimer's disease.

To evaluate hippocampal volume changes and neuropsychological performances in patients with either amnestic mild cognitive impairment (aMCI) or Alzheimer's disease (AD). Thirty-eight AD dementia, 22 aMCI patients, and 20 healthy controls were enrolled. Bilateral hippocampal volume was measured concurrently with mini-mental state examination (MMSE), auditory verbal learning test (AVLT), Boston naming test (BNT), and activities of daily living (ADL) test. Baseline and two additional follow-up examinations were conducted. Baseline hippocampal volumes were significantly smaller in AD group than that in aMCI and control groups. MMSE, AVLT, ADL, and BNT scores for the AD group were significantly different from that of both aMCI and control groups. Baseline hippocampal volumes were positively correlated with MMSE and AVLT scores in AD and aMCI patients. At follow-up, left hippocampal volume loss was positively correlated with decreased MMSE and AVLT scores both in AD and aMCI groups, while right hippocampal volume loss was positively associated with decreased AVLT performance only in AD group. Increased ADL and decreased BNT scores were positively associated with left hippocampal volume reduction only in the AD group. Current findings provide evidence of a close relationship between hippocampal volume and cognitive performances in patients with AD and aMCI, both at baseline and over follow-up.

Age- and gender-adjusted normative data for the German version of Rey’s Auditory Verbal Learning Test from healthy subjects aged between 50 and 70 years

Rey’s Auditory Verbal Learning Test (AVLT) is widely used to evaluate dysfunctional episodic memory. The current study aimed to provide extended age- and gender-specific norms for the German AVLT for individuals older than 50 years. In 690 subjects, a comprehensive medical examination including a structural 3.0-tesla magnetic resonance imaging scan was administered, as well as extensive neuropsychological tests. After controlling for exclusion criteria, 407 subjects were included in the analysis. AVLT performance decreased with age, and women outperformed men. We present age- and gender-specific normative data for the German AVLT from subjects aged between 50 and 70 years.

Derivation of an Embedded Rey Auditory Verbal Learning Test Performance Validity Indicator

This study derived an embedded performance validity indicator for the Rey Auditory Verbal Learning Test (AVLT) using an archival dataset. Participants aged 20 to 65 (N = 167) who reported traumatic brain injury and completed at least two performance validity tests were included. The group who passed all performance validity measures (n = 68) demonstrated higher scores on all AVLT trials than the group who failed two or more validity indicators (n = 62). Bayesian model averaging was used to identify the optimal combination of AVLT variables for group discrimination; Total Learning and Recognition raw scores were selected. Logistic regression using these variables showed excellent discrimination with an area under the curve of. 85. The resulting AVLT performance validity index demonstrated sensitivity of. 55 with specificity of. 91. Further study of this index is warranted and cross-validation is recommended prior to clinical use.

Reliable Change Indexes for Memory Performance in Schizophrenia as a Means to Determine Drug-Induced Cognitive Decline

Some psychotropic medications frequently prescribed in schizophrenia, especially agents that contain anticholinergic properties, have adverse effects on learning and memory. Given the impact of memory on both functional and symptomatic outcome in schizophrenia, it is important to determine if patients suffer from medication-related memory impairment. This study provides a statistical methodology for identifying medication-related changes in memory functioning. Reliable change estimates were determined for Rey Auditory Verbal Learning Test performance in 38 inpatients with schizophrenia. When an 80% confidence criterion was applied, improvement or decline of 12 words in the total score (sum score: Trials 1-5) cannot be attributed to measurement error. These findings should help clinicians better understand cognitive side effects and facilitate decision making regarding changes to individual patient's psychopharmacotherapy.

Memory Function Related to Hippocampal Imaging Findings.

The Relationship Between Quantitative T2 Relaxometry and Memory in Nonlesional Temporal Lobe Epilepsy Wendel JD, Trenerry MR, Xu YC, Sencakova D, Cascino GD, Britton JW, Lagerlund TD, Shin C, So EL, Sharbrough FW, Jack CR Epilepsia 2001;42:863–868 Purpose We investigated the relationship between preoperative quantitative magnetic resonance imaging (MRI) T2 relaxometry and volumetry of the hippocampi and pre- and postoperative verbal memory in temporal lobectomy patients who had nonlesional temporal lobe epilepsy. Methods Pre- and postoperative memory data based on the Logical Memory (LM) subtest of the Wechsler Memory Scale-Revised (WMS-R) and the 30-min delayed recall trial of the Rey Auditory Verbal Learning Test (AVLT) were obtained from 26 left and 15 right temporal lobectomy patients. Coronal MRI T2 maps were generated for these 41 temporal lobectomy patients as well as 61 control patients. Hippocampal T2 relaxation times and hippocampal volumes, converted to z scores using control group data, were correlated with neuropsychological performance in the patients. Results In left temporal lobe-onset patients, high T2 in the left hippocampal body predicted higher LM performance after surgery. Asymmetrically high T2 in the left hippocampal body (i.e., the right-minus-left difference), compared with the right hippocampal body, also predicted higher LM performance after surgery. In right temporal lobe-onset patients, high T2 in the left hippocampal body predicted relatively lower AVLT performance after surgery. Multiple regression analysis in left temporal-onset patients revealed that high T2 in the left hippocampal body together with higher preoperative LM performance predict higher postoperative LM performance. Conclusions Our findings suggest that elevated (i.e., abnormal) hippocampal T2 signal is associated with memory ability (or hippocampal functional capacity) independent of MRI-determined hippocampal atrophy. Therefore, our findings support the use of quantitative T2 relaxometry as an independent predictor of verbal memory outcome in both left and right TLE patients who are candidates for temporal lobectomy.

The relationship between quantitative T2 relaxometry and memory in nonlesional temporal lobe epilepsy.

We investigated the relationship between preoperative quantitative magnetic resonance imaging (MRI) T2 relaxometry and volumetry of the hippocampi and pre- and postoperative verbal memory in temporal lobectomy patients who had nonlesional temporal lobe epilepsy. Pre- and postoperative memory data based on the Logical Memory (LM) subtest of the Wechsler Memory Scale-Revised (WMS-R) and the 30-min delayed recall trial of the Rey Auditory Verbal Learning Test (AVLT) were obtained from 26 left and 15 right temporal lobectomy patients. Coronal MRI T2 maps were generated for these 41 temporal lobectomy patients as well as 61 control patients. Hippocampal T2 relaxation times and hippocampal volumes, converted to z scores using control group data, were correlated with neuropsychological performance in the patients. In left temporal lobe-onset patients, high T2 in the left hippocampal body predicted higher LM performance after surgery. Asymmetrically high T2 in the left hippocampal body (i.e., the right-minus-left difference), compared with the right hippocampal body, also predicted higher LM performance after surgery. In right temporal lobe-onset patients, high T2 in the left hippocampal body predicted relatively lower AVLT performance after surgery. Multiple regression analysis in left temporal-onset patients revealed that high T2 in the left hippocampal body together with higher preoperative LM performance predict higher postoperative LM performance. Our findings suggest that elevated (i.e., abnormal) hippocampal T2 signal is associated with memory ability (or hippocampal functional capacity) independent of MRI-determined hippocampal atrophy. Therefore, our findings support the use of quantitative T2 relaxometry as an independent predictor of verbal memory outcome in both left and right TLE patients who are candidates for temporal lobectomy.

Rey Auditory Verbal Learning Test performance of a Federal corrections sample with acquired immunodeficiency syndrome.

The Rey Auditory-Verbal Learning Test (AVLT) was administered to 30 inmates from three United States Federal corrections facilities. Fifteen were HIV seropositive and carried a diagnosis of AIDS; 15 were seronegative controls. The groups were comparable in age, education, sex, estimated premorbid IQ, and ethnic make-up. Both groups learned across trials, and produced similar acquisition curves. They also showed equivalent registration, but controls performed significantly better than subjects with AIDS on AVLT Trials II, IV, V, Recognition, and sum of I through V. AIDS subjects made significantly more intrusion errors than controls, suggesting that seropositive inmates performed more poorly, at least in part, because they experienced difficulty discriminating relevant from irrelevant responses during recall. Evaluation of serial position effects suggested that AIDS subjects experienced recall problems only with the middle segment of the word list. This finding may be unique to persons with AIDS and is consistent with the view that distinct clinical groups produce different recall patterns.

Rey auditory-verbal learning test: Performance of English and French children aged 5 to 16

Abstract Performance on the Rey Auditory-Verbal Learning Test (AVLT) was investigated for 252 patients aged 5 to 16 who underwent neuropsychological assessment. There was a high positive correlation between age and AVLT performance. Intelligence quotient (IQ) scores correlated moderately with AVLT scores. Rey's (1964) norms were demonstrated to be too high for current use. Males and females did not perform differently on the AVLT. French subjects did less well compared to English subjects, but IQ was a confounding variable. A current French version is included. The AVLT is recommended for clinical use with children.