Auditory Verbal Learning Test Scores Research Articles

Neuropsychological profile of Alzheimer’s disease based on amyloid biomarker findings results from a South American cohort

Objective Increased life expectancy and exponential growth of adults suffering from Alzheimer’s disease (AD) worldwide, has led to biomarkers incorporation for diagnosis in early stages. Use of neuropsychological testing remains limited. This study aimed to identify which neuropsychological tests best indicated underlying AD pathophysiology. Methods One hundred and forty-one patients with MCI (Mild Cognitive Impairment) were studied. A neuropsychological test battery based on the Uniform Data Set (UDS) from the Alzheimer’s Disease Centers program of the National Institute on Aging (NIA) was performed and amyloid markers recorded; according to presence or absence of amyloid identified by positive PIB-PET findings, or low CSF Aβ42 levels, patients were separated into MCI amyloid–(n:58) and MCI amyloid + (n = 83) cases. Results Statistical differences were found in all memory tests between groups. Delayed recall score at thirty minutes on the Rey Auditory Verbal Learning Test (AVLT) was the best predictor of amyloid pathology presence (AUC 0.68), followed by AVLT total learning (AUC 0.66) and AVLT Recognition (AUC 0.59) scores, providing useful cut off values in the clinical setting. Conclusions Use of neuropsychological testing, specifically AVLT scores with cutoff values, contributed to the correct diagnosis of MCI due to AD in this SouthAmerican cohort.

Study on the white matter neuronal integrity in amnestic mild cognitive impairment based on automating fiber-tract quantification

Objective: To analyze the pattern of the change in cerebral white matter tract in amnestic mild cognitive impairment (aMCI) patients based on the automating fiber-tract quantification (AFQ). Methods: A total of 20 aMCI patients,9 males,11 females, the mean age was (67±9) years, and 22 patients with naMCI, 8 males,14 females, the mean age was (64±10) years, and 23 normal control subjects, 10 males, 13 females, with a mean age of (65±9) years were enrolled from the Affiliated Drum Tower Hospital of Nanjing University Medical School from January 2018 to March 2019. All of them underwent 3.0 T MRI scan, which include DTI and 3D T(1)WI sequence.Two tract profiles, fractional anisotropy (FA) and mean diffusivity (MD), were extracted to evaluate the white matter integrity at 100 locations along each of 20 fiber tracts based on the AFQ. Results: In a pointwise comparison of FA profiles,the aMCI patients showed FA reduction in the middle part of right corticospinal tract (t=-4.023, P<0.01, FWE corrected) relative to the naMCI patients. There was a positive correlation between the decreased FA value and the auditory verbal learning test score (P=0.039). In a pointwise comparison of MD profiles, the aMCI patients showed extensive MD elevation in the middle part of the left cingulum hippocampus (t=2.408,P=0.037,FWE corrected) relative to the naMCI patients. The aMCI patients showed MD elevation in the posterior part of the left inferior longitudinal fasciculus (t=-2.919, P=0.006, FWE corrected) and the middle part of the left cingulum hippocampus (t=-3.878, P=0.002, FWE corrected) relative to the NC subjects. And the elevated MD in left inferior longitudinal fasciculus showed negative correlation with MoCA (P=0.039) and auditory verbal learning test score (P=0.015). There was also a negative correlation between the elevated MD value in the left cingulum hippocampus and the auditory verbal learning test score (P=0.033). Conclusions: Disruption is found in specific part along the white matter tract in the aMCI group. Furthermore, the pattern of white matter abnormalities is different across neuronal fiber tracts. These findings will have an impact on the further specific study of the white matter tract in aMCI patients.

Women can bear a bigger burden: ante- and post-mortem evidence for reserve in the face of tau.

In this study, we aimed to assess whether women are able to withstand more tau before exhibiting verbal memory impairment. Using data from 121 amyloid-β-positive Alzheimer’s Disease Neuroimaging Initiative participants, we fit a linear model with Rey Auditory Verbal Learning Test score as the response variable and tau-PET standard uptake value ratio as the predictor and took the residuals as an estimate of verbal memory reserve for each subject. Women demonstrated higher reserve (i.e. residuals), whether the Learning (t = 2.78, P = 0.006) or Delay (t = 2.14, P = 0.03) score from the Rey Auditory Verbal Learning Test was used as a measure of verbal memory ability. To validate these findings, we examined 662 National Alzheimer’s Coordinating Center participants with a C2/C3 score (Consortium to Establish a Registry for Alzheimer’s Disease) at autopsy. We stratified our National Alzheimer’s Coordinating Center sample into Braak 1/2, Braak 3/4 and Braak 5/6 subgroups. Within each subgroup, we compared Logical Memory scores between men and women. Men had worse verbal memory scores within the Braak 1/2 (Logical Memory Immediate: β = −5.960 ± 1.517, P < 0.001, Logical Memory Delay: β = −5.703 ± 1.677, P = 0.002) and Braak 3/4 (Logical Memory Immediate: β = −2.900 ± 0.938, P = 0.002, Logical Memory Delay: β = −2.672 ± 0.955, P = 0.006) subgroups. There were no sex differences in Logical Memory performance within the Braak 5/6 subgroup (Logical Memory Immediate: β = −0.314 ± 0.328, P = 0.34, Logical Memory Delay: β = −0.195 ± 0.287, P = 0.50). Taken together, our results point to a sex-related verbal memory reserve.

Orthostatic blood pressure reduction as a possible explanation for memory deficits in dialysis patients.

Cognitive impairment is prevalent in patients with chronic kidney disease (CKD), but its underlying mechanisms are obscure. Here, we test the hypothesis that exaggerated orthostatic blood pressure reduction mediates the effects of renal failure on global cognition and memory. A total of 160 study subjects were recruited, including 80 dialysis patients and 80 controls. Global cognition was evaluated using the Montreal Cognitive Assessment (MoCA), and episodic memory was evaluated using the auditory verbal learning test (AVLT). Autonomic function was evaluated via the low-frequency to high-frequency ratio (LF/HF) through heart rate variability analysis. Compared with the controls, the dialysis patients had significantly lower MoCA and AVLT scores (including learning memory, short recall memory, and delayed recall memory) (all p < 0.001). They also showed exaggerated orthostatic systolic blood pressure reductions (all p ≤ 0.001). The maximum orthostatic systolic blood pressure reduction was independently and negatively associated with short (β = -0.05, p = 0.029) and delayed (β = -0.05, p = 0.035) recall memory in dialysis patients but not in controls. Mediation analysis demonstrated that maximum orthostatic systolic blood pressure reduction mediates 13.8% of the effect of end-stage renal disease (ESRD) on short recall memory (p = 0.04). After adjustment for LF/HF, the negative association between maximum orthostatic blood pressure reduction and short recall score remained significant (p = 0.049), while the association between maximum orthostatic blood pressure reduction and delayed recall score became nonsignificant, with a marginal p value of 0.062. Our study reveals that exaggerated orthostatic blood pressure reduction is a possible explanation for ESRD-associated memory deficits.

The Relationship Between Subjective Memory Complaints and Objective Memory Performance, Depression and Anxiety Levels in Patients Under 55 Years of Age

Psychiatric differential diagnosis is often ignored in young patients with memory complaints, even if no neurological or physical illnesses were evident. In this study, we aimed to determine the relationship between subjective memory complaints and objective memory impairment, depression and anxiety levels in young patients with memory complaints. METHOD: The study was carried out with 56 patients under the age of 55 who applied to the psychiatry, neurology and internal medicine outpatient clinics with memory complaints and 55 healthy volunteers. All participants completed the Subjective Memory Complaints Questionnaire (SMCQ), the Montreal Cognitive Assessment (MoCA), the Auditory Verbal Learning Test (AVLT), the Benton Visual Memory Test (BVMT), the Digit Span Test (DST), the Verbal Fluency Test (VFT), the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). RESULTS: Significant differences were observed in the scores of SMCQ, MoCA, AVLT, BVMT, DST, VFT, BDI and BAI in individuals with memory complaints compared to the controls, which could not be ascribed to any neurological or physical disease. Depression and anxiety levels were significantly higher than those of the control group. CONCLUSION: Differential diagnosis of memory complaints has to be made in young patients. Subjective memory complaints may be indicative of depression and anxiety disorders. It is necessary to evaluate the cognitive impairment that may develop over time in young patients with subjective memory disturbances via longitudinal studies.

DNA Hypomethylation in Blood Links B3GALT4 and ZADH2 to Alzheimer's Disease.

Differentially methylated positions (DMPs) between persons with and without late-onset Alzheimer's disease (LOAD) were observed at 477 of 769,190 loci in a plurality of genes. Of these, 17 were shared with DMPs identified using clinical LOAD markers analyzed independently as continuous variables comprising Rey Auditory Verbal Learning Test scores, cerebrospinal fluid total tau (t-tau) and phosphorylated tau 181 (p-tau181) levels, and t-tau/Aβ1-42 (Aβ42), p-tau181/Aβ42, and Aβ42/Aβ1-40 (Aβ40) ratios. In patients with LOAD, 12 of the shared 17 DMPs were hypomethylated in B3GALT4 (Beta-1,3-galatcosyltransferase 4) (EC 2.4.1.62), and 5 were hypomethylated in ZADH2 (Prostaglandin reductase 3) (EC 1.3.1.48).

Corrigendum: Evaluation of Metformin on Cognitive Improvement in Patients With Non-dementia Vascular Cognitive Impairment and Abnormal Glucose Metabolism.

[This corrects the article DOI: 10.3389/fnagi.2018.00227.].

Cognitive effects of transcranial direct current stimulation combined with working memory training in fibromyalgia: a randomized clinical trial

Cognitive dysfunction in fibromyalgia has been reported, especially memory. Anodal transcranial direct current stimulation (tDCS) over the dorsolateral prefrontal cortex (DLPFC) has been effective in enhancing this function. We tested the effects of eight sessions of tDCS and cognitive training on immediate and delayed memory, verbal fluency and working memory and its association with brain-derived neurotrophic factor (BDNF) levels. Forty females with fibromyalgia were randomized to receive eight sessions of active or sham tDCS. Anodal stimulation (2 mA) was applied over the DLPFC and online combined with a working memory training (WMT) for 20 minutes. Pre and post-treatment neurocognitive tests were administered. Data analysis on deltas considering years of education and BDNF as covariates, indicated active-tDCS + WMT significantly increased immediate memory indexed by Rey Auditory Verbal Learning Test score when compared to sham. This effect was dependent on basal BDNF levels. In addition, the model showed active stimulation increased orthographic and semantic verbal fluency scores (Controlled Oral Word Association Test) and short-term memory (Forward Digit Span). The combination of both techniques seemed to produce effects on specific cognitive functions related to short-term and long-term episodic memory and executive functions, which has clinical relevance for top-down treatment approaches in FM.

Evaluation of Metformin on Cognitive Improvement in Patients With Non-dementia Vascular Cognitive Impairment and Abnormal Glucose Metabolism.

Objective: Recent studies have suggested that metformin can penetrate the blood–brain barrier, protecting neurons via anti-inflammatory action and improvement of brain energy metabolism. In this study, we aim to investigate the effect of metformin on cognitive function in patients with abnormal glucose metabolism and non-dementia vascular cognitive impairment (NDVCI).Methods: One hundred patients with NDVCI and abnormal glucose metabolism were randomly allocated into two groups: metformin and donepezil (n = 50) or acarbose and donepezil (n = 50). The neuropsychological status, glucose metabolism, and common carotid arteries intima–media thickness (CCA-IMT) before and after a year of treatment, were measured and compared between the groups.Results: Ninety four patients completed all the assessment and follow-up. After a year of treatment, there was a decrease in Alzheimer’s disease Assessment Scale-Cognitive Subscale scores and the duration of the Trail Making Test in the metformin-donepezil group. Furthermore, these patients showed a significant increase in World Health Organization–University of California–Los Angeles Auditory Verbal Learning Test scores after treatment (all P < 0.05). However, there was no obvious improvement in cognitive function in the acarbose-donepezil group. We also observed a significant decrease in the level of fasting insulin and insulin resistance (IR) index in the metformin-donepezil group, with a lower CCA-IMT value than that in the acarbose-donepezil group after a year of treatment (P < 0.05).Conclusion: We conclude that metformin can improve cognitive function in patients with NDVCI and abnormal glucose metabolism, especially in terms of performance function. Improved cognitive function may be related to improvement of IR and the attenuated progression of IMT.Trial Registration: ChiCTR-IPR-17011855.

An investigation of the mechanism of dexmedetomidine in improving postoperative cognitive dysfunction from the perspectives of alleviating neuronal mitochondrial membrane oxidative stress and electrophysiological dysfunction.

The aim of this study was to investigate the mechanism of dexmedetomidine in improving postoperative cognitive dysfunction from the perspectives of alleviating neuronal mitochondrial membrane oxidative stress and electrophysiological dysfunction. A total of 120 patients undergoing elective surgery under general anesthesia from June 2013 to May, 2016 were selected as the subjects of the study and randomly divided into the propofol + remifentanil and dexmedetomidine groups. The Rey Auditory Verbal Learning Test (AVLT) and Beck Depression Inventory (BDI) were performed at day 1 before operation and at day 1, 3, 5 and 15 after operation. The mitochondrial membrane potential was detected using a flow cytometer after staining and labeling for mitochondria in leukocytes via JC-1 fluorescence staining using a fluorescence probe at day 1 before operation and at day 1, 3, 5 and 15 after operation. The activities of mitochondrial respiratory chain complexes at day 1 before and after operation were detected via enzyme-linked immunosorbent assay (ELISA). The results showed that there were no statistically significant differences in the comparisons of general conditions (age, body weight, sex ratio, body mass index, anesthesia time, operation time, and length of stay in the ICU and hospital) for the dexmedetomidine and propofol + remifentanil groups (P>0.05). At day 3 and 5 after operation, the National Institutes of Health Stroke Scale (NIHSS) scores and AVLT scores in the two groups were decreased in different degrees, but the decrease range in the dexmedetomidine group was smaller than that in the propofol + remifentanil group, and the differences were statistically significant (P<0.05). At day 3, 5 and 15 after operation, the BDI scores of the two groups were increased in different degrees, but the increase range in the dexmedetomidine group was smaller than that in the propofol + remifentanil group, and the differences were statistically significant (P<0.05). At day 1, 3 and 5 after operation, the mitochondrial membrane potentials of the two groups were decreased in different degrees, but the decrease range in the dexmedetomidine group was smaller than that in the propofol + remifentanil group, and the differences were statistically significant (P<0.05). The mitochondrial membrane potentials of the two groups returned to the preoperative levels at day 15 after operation. The activities of mitochondrial respiratory chain complex I–IV in the propofol + remifentanil group at day 1 after operation were significantly decreased compared with those before operation, and the differences were statistically significant (P<0.05). The decrease in activities of mitochondrial respiratory chain complex I–IV in the propofol + remifentanil group at day 1 after operation was more significant than that in the dexmedetomidine group, and the difference was statistically significant (P<0.05). The results suggest that dexmedetomidine can relieve neuronal damage that may be caused by mitochondrial membrane oxidative stress, alleviate the damage to mitochondrial related enzyme system activity, and reduce the damage to the activities of mitochondrial respiratory chain enzyme complex I, II, III and IV, ultimately improving the postoperative cognitive dysfunction of patients.

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

Rey's Auditory Verbal Learning Test scores can be predicted from whole brain MRI in Alzheimer's disease.

Rey's Auditory Verbal Learning Test (RAVLT) is a powerful neuropsychological tool for testing episodic memory, which is widely used for the cognitive assessment in dementia and pre-dementia conditions. Several studies have shown that an impairment in RAVLT scores reflect well the underlying pathology caused by Alzheimer's disease (AD), thus making RAVLT an effective early marker to detect AD in persons with memory complaints. We investigated the association between RAVLT scores (RAVLT Immediate and RAVLT Percent Forgetting) and the structural brain atrophy caused by AD. The aim was to comprehensively study to what extent the RAVLT scores are predictable based on structural magnetic resonance imaging (MRI) data using machine learning approaches as well as to find the most important brain regions for the estimation of RAVLT scores. For this, we built a predictive model to estimate RAVLT scores from gray matter density via elastic net penalized linear regression model. The proposed approach provided highly significant cross-validated correlation between the estimated and observed RAVLT Immediate (R = 0.50) and RAVLT Percent Forgetting (R = 0.43) in a dataset consisting of 806 AD, mild cognitive impairment (MCI) or healthy subjects. In addition, the selected machine learning method provided more accurate estimates of RAVLT scores than the relevance vector regression used earlier for the estimation of RAVLT based on MRI data. The top predictors were medial temporal lobe structures and amygdala for the estimation of RAVLT Immediate and angular gyrus, hippocampus and amygdala for the estimation of RAVLT Percent Forgetting. Further, the conversion of MCI subjects to AD in 3-years could be predicted based on either observed or estimated RAVLT scores with an accuracy comparable to MRI-based biomarkers.

Pork and Chicken Meals Similarly Impact on Cognitive Function and Strength in Community-Living Older Adults: A Pilot Study

ABSTRACTA pilot quasi-experimental study investigated whether provision of pork, a rich source of thiamin, as the main protein source in meals four times/week for 12 weeks resulted in improved muscle mass, body strength, and cognitive function in community-living older adults compared to similar meals containing chicken. Retirement villages were randomized to receive pre-prepared frozen meals containing either pork or chicken. Dietary intake was assessed by three-day food records and cognitive domains assessed using validated tests. Hand grip strength was measured and lower extremity performance assessed by the sit-to-stand test, get-up-and-go test and six-minute walk test. Forty-eight volunteers participated (78.2 ± 6.2 y). In linear mixed models, controlling for baseline physical activity and dietary protein and energy intake, no differences were found between pork (n = 19) and chicken (n = 12) groups. The chicken group had improved Rey Auditory Verbal Learning test scores (verbal learning and memory) at six weeks (p < 0.001). Provision of four pork meals a week did not result in improvements in cognitive function, nor measures of strength or physical function, compared to those receiving chicken meals in healthy older adults. This suggests that merely changing the type of dietary protein provided by meat does not impact physical or cognitive function.

Subbands analysis of amplitude of low-frequency fluctuations in type 2 diabetes mellitus patients: a resting-state functional MRI study

Objective To investigate changes of spontaneous brain activity in patients with type 2 diabetes mellitus (T2DM) by fractional amplitude of low-frequency fluctuations (fALFF) on subbands, and the possible relationship between these changes and cognitive impairment caused by T2DM. Methods Twenty-two T2DM patients and twenty-three healthy control subjects were involved in this study between December 2013 and June 2014 and the demographic and clinical data (fasting plasma glucose and HbA1c level) were obtained in all subjects. General cognition was assessed by MMSE in all subjects, and memory performance was assessed by Auditory Verbal Learning Test (AVLT) in T2DM group. 3D-T1 structural and resting-state functional MRI data were collected by MR scanner. Then fALFF value on slow-5 (0.010-0.027 Hz) and slow-4 (0.027-0.073 Hz) were calculated respectively using DPARSF V2.3. Intra-group and inter-group t-tests were conducted by REST V1.8. Partial correlation among fALFF values extracted from significantly different brain regions, clinical data and AVLT score of T2DM patients were calculated , using age as covariate. Results Compared to the healthy controls, T2DM patients showed increased fALFF values in bilateral anterior cingulate gyrus (cluster=130, t=4.4487, P<0.05) and partial left cerebelum areas (cluster= 89, t=3.8409,P<0.05) in frequency band slow-5. Moreover, the T2DM patients showed decreased fALFF values in bilateral middle occipital gyrus and precuneus (Left: cluster=102,t=-3.4806. Right: cluster=151,t=- 5.1355. All P<0.05) in frequency band slow-5. While in frequency band slow-4, the T2DM patients showed increased fALFF values in left inferior temporal gyrus (cluster=104, t=4.8631, P<0.05), and decreased fALFF values in right lingual gyrus (cluster=91, t=- 3.7146, P<0.05). There was positive correlation between fALFF values of middle occipital gyrus and precuneus and AVLT immediate memory score (r=0.456 , P=0.038). Conclusions T2DM patients exhibit abnormal spontaneous activity among brain regions associated with cognition, including brain regions related to default mode network on slow-5, and brain regions related to semantic cognition and visual information processing on slow-4. The abnormal regions exhibit different spatial patterns depending on the subbands of low-frequency fluctuations. Key words: Diabetes mellitus, type 2; Magnetic resonance imaging; Cognitive science

CONSTRUCT VALIDITY OF AUDITORY VERBAL LEARNING TEST

Auditory Verbal Learning Test (AVLT) is frequently used in neuropsychology literature to comprehensively assess the memory. The test measures verbal learning as immediate and delayed free recall, recognition, and retroactive and proactive interference. Adaptation of AVLT to the Turkish society has been completed, whereas research and development studies are still underway. The purpose of the present study is to investigate the construct validity of the test in order to contribute to the research and development process. In line with this purpose, the research data were obtained from 78 healthy participants aged between 20 and 69. The exclusion criteria included neurological and/or psychiatric disorders as well as untreated auditory/visual disorders. AVLT was administered to participants individually by two trained psychologists. Principal component analysis that is used to investigate the components represented by the AVLT scores consisted of learning, free recall and recognition, in line with the construct of the test. Distractors were also added to these two components in structural equation model. Analyses were carried out on descriptive level to establish the relatioships between age, education, gender and AVLT scores. These findings, which are consistent with the literature indicating that memory is affected by the developmental process, suggest that learning/free recall, recognition, and distractor scores of the AVLT demonstrate a component pattern consistent with theoretical knowledge. This conclusion suggests that AVLT is a valid measurement test for the Turkish society.

Glycemia and Cognitive Function in Metabolic Syndrome and Coronary Heart Disease

ObjectiveHigher hemoglobin A1c (HbA1c) is associated with lower cognitive function in type 2 diabetes. To determine whether associations persist at lower levels of dysglycemia in patients who have established cardiovascular disease, cognitive performance was assessed in the Targeting INflammation Using SALsalate in CardioVascular Disease (TINSAL-CVD) trial. MethodsThe age-adjusted relationships between HbA1c and cognitive performance measured by the Mini-Mental State Examination, Digit Symbol Substitution Test, Rey Auditory Verbal Learning Test, Trail Making Test, and Categorical Verbal Fluency were assessed in 226 men with metabolic syndrome and established stable coronary artery disease. ResultsOf the participants, 61.5% had normoglycemia, 20.8% had impaired fasting glucose, and 17.7% had type 2 diabetes. HbA1c was associated with cognitive function tests of Digit Symbol Substitution Test, Rey Auditory Verbal Learning Test, Trail Making Test, and Categorical Verbal Fluency (all P < .02), but not the Mini-Mental State Examination. In an age-adjusted model, a 1% (11 mmol/mol) higher HbA1c value was associated with a 5.9 lower Digit Symbol Substitution Test score (95% confidence interval [CI], −9.58 to −2.21; P < .0001); a 2.44 lower Rey Auditory Verbal Learning Test score (95% CI, −4.00 to −0.87; P < .0001); a 15.6 higher Trail Making Test score (95% CI, 5.73 to 25.6; P < .0001); and a 3.71 lower Categorical Verbal Fluency score (95% CI, −6.41 to −1.01; P < .02). In a multivariate model adjusting for age, education, and cardiovascular covariates, HbA1c remained associated with cognitive function tests of Rey Auditory Verbal Learning Test (R2 = 0.27, P < .0001), Trail Making Test (R2 = 0.18, P < .0001), and Categorical Verbal Fluency (R2 = 0.20, P < .0001), although association with the Digit Symbol Substitution Test was reduced. ConclusionsHigher HbA1c is associated with lower cognitive function performance scores across multiple domain tests in men with metabolic syndrome and coronary artery disease. Future studies may demonstrate whether glucose lowering within the normative range improves cognitive health.

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.

Parallel but not equivalent: Challenges and solutions for repeated assessment of cognition over time

Objective. Analyses of individual differences in change may be unintentionally biased when versions of a neuropsychological test used at different follow-ups are not of equivalent difficulty. This study's objective was to compare mean, linear, and equipercentile equating methods and demonstrate their utility in longitudinal research. Study design and setting: The Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE, N = 1,401) study is a longitudinal randomized trial of cognitive training. The Alzheimer's Disease Neuroimaging Initiative (ADNI, n = 819) is an observational cohort study. Nonequivalent alternate versions of the Auditory Verbal Learning Test (AVLT) were administered in both studies. Results. Using visual displays, raw and mean-equated AVLT scores in both studies showed obvious nonlinear trajectories in reference groups that should show minimal change and poor equivalence over time (ps ≤ .001), and raw scores demonstrated poor fits in models of within-person change (root mean square errors of approximation, RMSEAs > 0.12). Linear and equipercentile equating produced more similar means in reference groups (ps ≥ .09) and performed better in growth models (RMSEAs < 0.05). Conclusion. Equipercentile equating is the preferred equating method because it accommodates tests more difficult than a reference test at different percentiles of performance and performs well in models of within-person trajectory. The method has broad applications in both clinical and research settings to enhance the ability to use nonequivalent test forms.

Efficacy of hippocampal transection for left temporal lobe epilepsy without hippocampal atrophy

We describe a case of left temporal lobe epilepsy without hippocampal atrophy. A 31-year-old woman presented with typical symptoms of complex partial seizures. Magnetic resonance imaging demonstrated slightly obscure internal structures in the left hippocampus. Scalp electroencephalography revealed interictal epileptiform discharges in the left temporal lobe. A Wada test with propofol determined the language-dominant hemisphere to be the left. Intraoperative electrocorticography revealed active epileptic discharges in the hippocampus and the anterior temporal basal area. The hippocampal epileptic area was treated with multiple transection, which led to the complete cessation of epileptic discharges. After surgery, the Rey Auditory Verbal Learning Test score decreased from 12 to 9. However, it returned to the preoperative level 6 months after surgery. We describe this case as a typical example demonstrating the efficacy of hippocampal transection for seizure control and the preservation of verbal memory.

Memory Complaints in Chronic Stroke Patients Are Predicted by Memory Self-Efficacy rather than Memory Capacity

Background: Memory self-efficacy (MSE) is the belief about one’s mastery of memory functioning. In healthy elderly, memory complaints are related to MSE rather than to objectively measured memory capacity. MSE has scarcely been studied in patients that suffered a stroke. The aim of this study was twofold: (1) to examine whether memory capacity and MSE can predict the presence of memory complaints in stroke patients, and (2) to study which variables are the best predictors of MSE. Methods: In a cross-sectional study, 136 stroke patients (>18 months after onset) were recruited from April 2008 to November 2009. MSE was measured using the Metamemory in Adulthood questionnaire. Depression, coping and personality were measured using validated questionnaires, and memory performance was measured using the Rivermead Behavioural Memory Test (RBMT) and the Auditory Verbal Learning Test (AVLT). Patients were divided into a ‘complaints’ and a ‘no complaints’ group. Results: A lower MSE score was an independent predictor of having memory complaints (adjusted odds ratio: 0.422; p = 0.000), adjusted for age and depression. The RBMT and AVLT scores did not predict the presence of memory complaints (p > 0.263). Presence of memory complaints and depression were the strongest predictors of MSE (B = –1.748, p = 0.000; B = –0.054, p = 0.000), followed by word fluency, not having a partner and side of stroke (B = 0.038, p = 0.012; B = –0.517, p = 0.082; B = –0.479, p = 0.088). Conclusions: Memory complaints are predicted by MSE rather than memory capacity. MSE memory training might be an effective training strategy for reducing memory complaints in selected chronic stroke patients.