Digit Span Backward Test Research Articles

The potential mechanisms underlying the effect of acute alcohol use on duration perception.

Acute alcohol consumption has been found to cause duration perception distortions, but the directions of these distortions are not consistent. The mechanisms underlying this effect are also unclear. The present study seeks to elucidate the effect of acute alcohol consumption on duration perception and the mechanisms involved. Forty-one participants in the placebo group and 40 in the alcohol group completed time bisection tasks, attentional network tests, digit span backward tests and arousal reports to evaluate their duration perception, attentional network, working memory capacity and arousal. The results showed that the alcohol group overestimated duration compared to the placebo group. The alcohol group also showed increased arousal, impaired executive control of attention and reduced working memory capacity. Arousal mediated the effect of acute alcohol consumption on duration perception, whilst working memory capacity masked this effect. The findings are discussed based on the Scalar Timing Model and the Cognitive Resource Allocation Model.

The Role of Hearing Aids in Improving Dual-Task Gait Performance in Older Adults With Presbycusis: A Cognitive and Motor Analysis.

Cognitive decline is a common challenge faced by older individuals with presbycusis; their performance on dual-task (DT) activities is generally lower compared to those without hearing loss. However, the influence of hearing aids on nonauditory cognitive decline in this population remains unclear. This study aims to investigate the effect of hearing aids on nonauditory DT performance in older adults with presbycusis. This study included older people with presbycusis who used hearing aids (P&HA group), those with presbycusis who did not use hearing aids (PoHA group), and a control group of healthy adults. Forward and backward digit span tests and timed up and go test (TUG) were administered to all individuals. TUG and motor and cognitive (forward and backward digit span) tasks were applied simultaneously to evaluate the participants' DT performance. The study comprised 60 individuals with presbycusis (19 females, 41 males; mean age: 73.23±6.49years) and 30 healthy adults (15 females, 15 males; mean age: 35.93±8.57years). Healthy adults performed better than the P&HA and PoHA groups in all the administered tests (p<0.05). There was a moderate negative relationship between the severity of hearing loss and the forward and backward digit span test performances (p<0.05). The P&HA group performed better than the PoHA group on the DT cognitive forward and backward digit span tests. The use of hearing aids and their proper fitting are important not only for improving communication skills and reducing listening effort but also for supporting nonauditory cognitive functions, minimizing the risk of falls during DT activities, and enhancing the overall quality of life.

Effectiveness of Korean medicine treatments in improving cognitive function and prefrontal cortex activity in older individuals with mild cognitive impairment: retrospective observational study.

Mild cognitive impairment (MCI) is a growing concern among older adults, with limited effective pharmacological treatments available. Despite the potential of herbal medicine and acupuncture in managing MCI, there is a lack of research on their long-term effects on cognitive function and brain activity in clinical practice settings. This study aimed to address this gap by exploring the effects of a community-based program integrating herbal medicine and acupuncture on cognitive function and neural responses in older individuals with MCI. Nineteen individuals were enrolled from a pool of 250 individuals registered in the 2021 Busan Dementia Prevention & Care Program. Participants with MCI received herbal medicine, acupuncture, and pharmacopuncture treatments over a 6-month period. The Montreal Cognitive Assessment (MoCA) was administered at baseline and after 3 and 6 months to evaluate cognitive function. Functional near-infrared spectroscopy (fNIRS) was used to measure prefrontal cortex activity during cognitive task performance, including verbal fluency, Stroop color and word, and digit span backward tests. Seventeen participants (13 female; mean age, 69.5 years) with MCI completed the study. Following the 6-month intervention, they exhibited a significant increase in the MoCA total score over time [F(2.32) =10.59, p < 0.0001]. Additionally, the deoxygenated hemoglobin beta coefficient in the left frontopolar prefrontal cortex significantly decreased during the Stroop task after the intervention. The Dementia Prevention & Care Program, which integrates herbal medicine and acupuncture, may enhance cognitive function in individuals with MCI. Moreover, the observed changes in prefrontal cortex activity after completion of the program suggest a need for further investigation of the underlying mechanisms.

Large-scale structural covariance networks changes relate to executive function deficit in betel quid-dependent chewers.

Previous studies demonstrate deficits in executive function for betel quid-dependent (BQD) patients. Large-scale structural covariance network (SCN) based on gray matter (GM) morphometry may be able to explore the neural mechanism of executive dysfunction in BQD individuals. This study aims to identify spatial covariance patterns of GM volume and to investigate their association with executive dysfunction in BQD individuals. Sixty-four BQD individuals and 48 sex- and age-matched healthy controls (HCs) underwent T1-weighted structural MRI examination and executive function assessments, including the Backward Digit Span (BDS) test and Stroop Color and Word (SCW) test. Seventy SCNs based on GM volume covariance patterns were defined using independent component analysis. An SCN-based classifier was constructed to differentiate between BQD and HC individuals. Receiver operating characteristic (ROC) curves were applied to evaluate the performance of the SCN-based classifier. Linear regression analyses were performed to investigate the association between SCN network indices and executive function indices. Six SCNs had higher classifications for differentiating between BQD and HC individuals. The area under the ROC curve of the SCN-based classifier was 0.812 in the training set and 0.771 in the testing set. Furthermore, linear regression analyses demonstrated that the network indices in the thalamus were associated with BDS scores adjusted for age, sex, and education. Large-scale SCNs could provide potential imaging markers for differentiating BQD and HC groups. The loss of network index in the thalamus was associated with working memory, indicating that SCNs could reveal executive dysfunction in BQD individuals.

Effect of moderate-intensity aquatic treadmill exercise on cognitive function and cerebral blood flow for healthy older adults

To compare the effect of moderate-intensity aquatic treadmill exercise (ATM) on cerebral blood flow (CBF) and cognitive function in healthy older adults to that of moderate-intensity land-based treadmill exercise (LTM). This randomized controlled trial study was conducted between May 2023 and Oct 2023. Twenty-eight participants aged 60–80 were randomly assigned to either ATM group (N = 14) or LTM group (N = 14). Cognitive function and cerebral blood flow were assessed before and after the exercise. The outcome measures used in this study were the Digit Symbol Substitution Test (DSST) and the Digit Span Test (DST) to assess cognitive performance, and the mean middle cerebral artery blood velocity (MCAvmean) to evaluate CBF. A mixed effects model was used to analyze the within-group and between-group differences in cognitive function and CBF outcomes pre-to-post treadmill by SPSS. The DSST demonstrated a statistically significant improvement within both the ATM [β ± SE: −13.643 ± 2.407, 95 % CI: −18.749, −8.537] and LTM [β ± SE: −19.25 ± 3.66, 95 % CI: −26.424, −12.076] groups, indicating clinical significance in both groups. Both ATM and LTM groups exhibited post-exercise improvements within their respective groups for forward Digit Span Test (FDST) [ATM β ± SE: −0.143 ± 0.362, 95 % CI: −0.92, 0.634; LTM β ± SE: −0.286 ± 0.37, 95 % CI: −1.078, 0.506] and backward Digit Span Test (BDST) (ATM β ± SE: −1.741 ± 5.377, 95 % CI: −13.27, 9.792; LTM β ± SE: −6.729 ± 5.370, 95 % CI: −4.788, 18.24). In terms of MCAvmean, there is a higher improvement of CBF in ATM group [β ± SE: −138.669 ± 67.9217, 95 % CI: −288.164, 10.826] than LTM group [β ± SE: −9.305 ± 70.076, 95 % CI: −153.617, 135.007]. Hence, a single bout of moderate-intensity ATM and LTM can enhance cognitive function and CBF in healthy older adults, suggesting their potential as preventive strategies against age-related declines.

High-density lipoprotein over midlife and future cognition in women: The SWAN HDL ancillary study.

Limited data provides evidence-based insights on the association between comprehensive metrics of high-density lipoproteins (HDL) and cognitive performance, especially in midlife women for whom benefit might be the greatest. To assess the associations of serum HDL metrics including HDL lipid content [HDL cholesterol, phospholipid (HDL-PL), triglyceride], proteins/subclasses [apolipoprotein A-1 (apoA-1); small, medium, large, total HDL particle (HDL-P); and HDL size], and cholesterol efflux capacity with cognitive performance in midlife women. This prospective cohort study was conducted among 503 midlife women (1234 observations) from the Study of Women's Health Across the Nation HDL ancillary study. Joint models were applied to examine associations of HDL metrics assessed at midlife (50.2 ±2.9 years, baseline of the current study) and their changes over midlife (6.1 ±3.9 years of duration) with subsequent cognitive performance [working memory (Digit Span Backward Test), processing speed (Symbol Digit Modalities Test), and episodic memory immediate and delayed recall (East Boston memory test)] assessed repeatedly (maximum 5 times) 1.5 ±1 years later over 7.72 ± 4.10 years of follow up. Higher total HDL-P and smaller HDL size at midlife were associated with a better subsequent immediate recall, delayed recall and/or processing speed. Greater increase in HDL-PL, apoA-1, medium HDL-P, and total HDL-P and less increase in HDL size over midlife were associated with a better subsequent immediate and/or delayed recall. Enhancing specific serum HDL metrics during midlife could be promising in cognitive restoration, particularly memory, the initial and predominant symptom of Alzheimer's disease.

The Effect of Metacognitive Intervention on the Listening Performance and Metacognitive Awareness of High- and Low-Working Memory Capacity EFL Learners.

EFL listening comprehension has been a stark challenge for language learners, but little is known about the combined effect of individual differences, such as working memory capacity, and metacognitive intervention. Thus, the present experimental study investigates the effect of metacognitive intervention on the listening performance and metacognitive awareness of high- and low-WMC EFL learners. For this purpose, Oxford Placement Tests were distributed among 120 male Iranian EFL learners, of which 94 were identified as intermediate. Then, backward visual digit span tests were administered to measure their working memory capacity. Based on the median of all scores, 80 learners were selected and randomly assigned to two experimental groups and two control groups each with 20 participants. Next, their performance on the International English Language Testing System and the Metacognitive Awareness Listening Questionnaire was measured before and after the 8-session metacognitive intervention. Results showed that high-WMC experimental learners had a higher gain with a large effect size in terms of listening performance compared with all the other groups. In addition, the experimental group learners reported the significantly higher use of the metacognitive strategies with a moderate effect size. Interestingly, low-WMC learners' listening performance and metacognitive awareness also improved as a result of the intervention. Our findings bear pedagogical significance in that individual differences in WMC should be considered more in both EFL language classes and the future line of research involving the metacognitive intervention.

Eight brain structures mediate the age-related alterations of the working memory: forward and backward digit span tasks.

Working memory (WM) as one of the executive functions is an essential neurocognitive ability for daily life. Findings have suggested that aging is often associated with working memory and neural decline, but the brain structures and resting-state brain networks that mediate age-related differences in WM remain unclear. A sample consisting of 252 healthy participants in the age range of 20 to 70years was used. Several cognitive tasks, including the n-back task and the forward and backward digit span tests were used. Also, resting-state functional imaging, as well as structural imaging using a 3T MRI scanner, were performed, resulting in 85 gray matter volumes and five resting-state networks, namely the anterior and posterior default mode, the right and left executive control, and the salience networks. Also, mediation analyses were used to investigate the role of gray matter volumes and resting-state networks in the relationship between age and WM. Behaviorally, aging was associated with decreased performance in the digit span task. Also, aging was associated with a decreased gray matter volume in 80 brain regions, and with a decreased activity in the anterior default mode network, executive control, and salience networks. Importantly, the path analysis showed that the GMV of the medial orbitofrontal, precentral, parieto-occipital, amygdala, middle occipital, posterior cingulate, and thalamus areas mediated the age-related differences in the forward digit span task, and the GMV of superior temporal gyrus mediated the age-related differences in the backward digit span task. This study identified the brain structures mediating the relationship between age and working memory, and we hope that our research provides an opportunity for early detection of individuals at risk of age-related memory decline.

Is virtual reality-based cognitive training in parallel with functional near-infrared spectroscopy-derived neurofeedback beneficial to improve cognitive function in older adults with mild cognitive impairment?

Purpose Cognitive training in parallel with functional near-infrared spectroscopy (fNIRS)-derived neurofeedback has been identified to be beneficial in enhancing cognitive function in patients with mild cognitive impairment (MCI). However, effects of virtual reality (VR)-based cognitive training ensuring ecological validity in parallel with fNIRS-derived neurofeedback on neural efficiency has received little attention. This study investigated effects of VR-based cognitive training in parallel with fNIRS-derived neurofeedback on cognitive function and neural efficiency in patients with MCI. Method Ninety participants were randomly assigned into the active group (AG) receiving VR-based cognitive training in parallel with fNIRS-derived neurofeedback, the sham group (SG), or wait-list group (CG). The AG and SG group performed each intervention for fifteen minutes a session, for eight sessions. The Trail Making Test Part B and Backward Digit Span Test were used for outcomes. In addition, activity in the dorsolateral prefrontal cortex (DLPFC) during cognitive testing using fNIRS was measured. Results After the eight sessions, the AG achieved greater improvements in all outcomes than the other groups. In addition, the AG showed a lower DLPFC activity during cognitive testing than the other groups. Conclusions VR-based cognitive training in parallel with fNIRS-derived neurofeedback is superior to enhancing cognitive function and neural efficiency.

Dynamics of Changes in the Level of Cognitive Functioning Among Patients After SARS-CoV-2 Infection ‒ A Proposal for Remote Neuropsychological Assessment in a Longitudinal Study

Study purpose: The aim of this longitudinal study was to assess the cognitive functioning of people who had COVID-19, to determine the dynamics of changes observed in this area over a period of 3‒4 months, to compare the patients' results with those of a control group, and to verify the usefulness of a new method of remote neuropsychological assessment. Method: A longitudinal study was conducted using the Brief Test of Adult Cognition by Telephone (BTACT) neuropsychological assessment tool, which was translated into Polish for the purpose of the study. The study included subjects following SARS-CoV-2 infection (COVID(+) group) and control subjects (COVID(‒) group). Cognitive functions in both groups were assessed twice, 3‒4 months apart. The study was conducted from July 2020 to January 2022. Results: Data comparisons were performed using mixed ANOVA with repeated measures. Compared to the COVID(‒) group, the COVID(+) group scored significantly lower on the first and second measurements of the Backward Digit Span Test and on the first measurement of the Number Series Test. Additionally, an improvement was observed in COVID(+) group scores in the second measurement compared to the first measurement in: Rey Auditory-Verbal Learning Test (RAVLT) in both the immediate and delayed recall condition; the Backward Digit Span Test, the Number Series Test and 30 Seconds and Counting Task (30-SACT). Conclusions: The obtained results show an impairment in working memory functions and inductive reasoning in COVID(+) subjects compared to COVID(‒) subjects. In addition, the study indicates the usefulness of BTACT in tracking the changes in cognitive functioning over time in individuals following SARS-CoV-2 infection. Tests to assess working memory (Rey Auditory-Verbal Learning Test (RAVLT), Backward Digit Span Test) and a test of inductive reasoning (Number Series Test) appear to be particularly useful in monitoring the mentioned changes.

Central Auditory Processing Abilities in Children with Non-Syndromic Cleft Lip/and Palate-a Behavioural Study.

The present study aimed to assess the central auditory processing abilities and working memory in children with non-syndromic cleft lip and palate (NSCLP) and to compare with the developed normative and craniofacially normal peers. Sixteen NSCLP children aged 7 to 12 years and fifteen craniofacially normal peers were recruited in this study. Speech perception in noise Kannada (SPIN-K), gap detection threshold (GDT), dichotic consonant-vowel (DCV), and masking level difference (MLD) tests were administered to assess various central auditory processing abilities. Working memory abilities were assessed by using forward-digit span and backward-digit span tests. The results showed significant differences in SPIN-K, dichotic CV, GDT, forward digit, and backward digit span scores between children with NSCLP and craniofacially normal peers. Thus, it can be concluded from the present study that children with NSCLP have a risk of developing auditory processing deficits. To conclude, assessment of central auditory processing abilities in children with NSCLP is recommended.

The effect of structured brain gym and brisk walking training on the executive functions of university students: a single-blinded randomised controlled trial

ABSTRACT The purpose of the study was to investigate the effect of structured brain gym and brisk walking training on the executive functions (inhibitory control, working memory and cognitive flexibility) of university students. The study was designed as a single-blinded prospective randomised controlled trial with the participation of university students. 42 sedentary university students(18–25 years) joined in the study. The participants were randomly divided into three groups (two intervention groups and one control group): The Structured Brain Gym Group (SBGG), the Brisk Walking Group (BWG) and the Control Group (CG). The interventions consisted of 50-min exercise twice a week for an 8-week period. BWG attended into brisk walking programme as moderate-intensity aerobic exercise; meanwhile, SBGG performed structured brain gym activities. CG did not participate in any regular physical activities during the 8 weeks. Executive function tests (Stroop colour test, forward and backward digit span test, frontal assessment battery and verbal fluency test) were applied to the participants as a pre-test and post-test. Kruskal–Wallis, Wilcoxon test and Mann–Whitney U tests were used in the statistical analyses. According to the statistical analysis, both BWG and SBGG indicated significant improvement in inhibitory control (p < 0.05) and general frontal functions (p < 0.05) following the intervention. However, compared to BWG, the improvement in inhibitory control was better in SBGG. No change was found in working memory and cognitive flexibility in any of the groups. We can recommend that cognitively demanding and fun aerobic exercise tasks can be used to improve young adult’s inhibitory control.

Does acute aerobic exercise enhance selective attention, working memory, and problem-solving abilities in Alzheimer's patients? A sex-based comparative study.

The present study aimed to evaluate the effect of acute aerobic exercise on certain cognitive functions known to be affected by Alzheimer's disease (AD), with a particular emphasis on sex differences. A total of 53 patients, with a mean age of 70.54 ± 0.88 years and moderate AD, voluntarily participated in the study. Participants were randomly assigned to two groups: the experimental group (EG), which participated in a 20-min moderate-intensity cycling session (60% of the individual maximum target heart rate recorded at the end of the 6-min walk test); and the control group (CG), which participated in a 20-min reading activity. Cognitive abilities were assessed before and after the physical exercise or reading session using the Stroop test for selective attention, the forward and backward digit span test for working memory, and the Tower of Hanoi task for problem-solving abilities. At baseline, both groups had comparable cognitive performance (p > 0.05 in all tests). Regardless of sex, aerobic acute exercise improved attention in the Stroop test (p < 0.001), enhanced memory performance in both forward (p < 0.001) and backward (p < 0.001) conditions, and reduced the time required to solve the problem in the Tower of Hanoi task (p < 0.001). No significant differences were observed in the number of movements. In contrast, the CG did not significantly improve after the reading session for any of the cognitive tasks (p > 0.05). Consequently, the EG recorded greater performance improvements than the CG in most cognitive tasks tested (p < 0.0001) after the intervention session. These findings demonstrate that, irrespective to sex, a single aerobic exercise session on an ergocycle can improve cognitive function in patients with moderate AD. The results suggest that acute aerobic exercise enhances cognitive function similarly in both female and male patients, indicating promising directions for inclusive therapeutic strategies.

Impact of inflammation on cognitive function in patients with highly inflammatory rheumatoid arthritis

ObjectiveTo evaluate cognitive function in patients with rheumatoid arthritis (RA) and inflammatory activity.Patients and methodsWe performed a cross-sectional study of a cohort of patients with RA initiating their first biological...

The study of the relationship between moderate to severe sleep obstructive apnea and cognitive impairment, anxiety, and depression.

The present study endeavored to investigate the interconnection between obstructive sleep apnea (OSA) and cognitive function, alongside the manifestations of depression and anxiety. Simultaneously, an analysis was conducted to discern the factors exerting influence upon cognitive function. A cohort of 102 patients, who had undergone polysomnography (PSG) at Binhu Hospital, Anhui Medical University, between January 2022 and June 2023, was encompassed in the study. Employing the PSG findings, these individuals were classified into two distinct categories: the grouping consisted of those with either negligible or mild OSA, and the other comprised individuals with moderate to severe OSA. Utilizing the Montreal Cognitive Assessment (MoCA-Beijing), Stroop Color and Word Test (SCWT), Digit Span Test (DST), Self-rating Depression Scale (SDS), and Self-rating Anxiety Scale (SAS), scores were recorded and analysed for each of the respective assessments. Additionally, discrepancies and associations between these groups were also scrutinized. The group exhibiting moderate to severe OSA demonstrated significantly elevated measurements in parameters such as neck circumference, BMI, completion times for SCWT-A, B, C, Sleep Inefficiency Index (SIE), SAS, and SDS, in comparison to the No or Mild OSA group. Furthermore, the moderate-severe OSA group manifested notably diminished MoCA scores in areas of visual-spatial and executive function, memory, language, abstraction, delayed recall, orientation, total MoCA score, lowest oxygen saturation (LSaO2), average oxygen saturation, Digit Span Test-backward(DST-b), and Digit Span Test-forward(DST-f), as contrasted with the no-mild OSA group. These inter-group disparities exhibited statistical significance (p < 0.05). The MoCA total score portrayed inverse correlations with age, Apnea-Hypopnea Index (AHI), BMI, SIE, SAS, SDS, CT90%, AHT90%, and Hypoxic Apnea Duration (HAD) (ranging from -0.380 to -0.481, p < 0.05). Conversely, it displayed positive correlations with DST-f, DST-b, LSaO2, and average oxygen saturation (ranging from 0.414 to 0.744, p < 0.05). Neck circumference, AHI, and SAS were autonomously linked to MoCA scores (OR = 1.401, 1.028, 1.070, p < 0.05), while AHI exhibited an independent correlation with SDS and SAS scores (OR = 1.001, p = 0.003). Patients grappling with moderate to severe OSA frequently reveal cognitive impairment and concomitant emotional predicaments encompassing depression and anxiety. These manifestations share an intimate association with AHI, LSaO2, and average oxygen saturation. Notably, anxiety, when coupled with OSA, emerges as an autonomous influential element impinging upon cognitive impairment.

Analysis of functional hop test with dual task on injured and uninjured athletes

Purpose: Maladaptive neuroplasticity may develop after injury. However, most of the test applications in the return to the sport process mainly focus on the motor end of the sensorimotor system. In this study, we aimed to examine the performance outputs of the functional hop tests with the dual task methodology.&#x0D; Methods: Triple hop for distance (THD), crossover hop for distance (CHD) and 6-meter hop for timed (6MHT) tests were done. For the cognitive task the backward digit span test of the Wechsler intelligence scale was preferred. Nineteen athletes with a history of unilateral lower extremity injuries were assigned to the previously injured group (PIG), and 20 athletes with no previous injury were assigned to the control group (CG).&#x0D; Results: There were no significant differences between the results of the cognitive task levels and Mini Mental State Examination scores of the athletes in our study (p&gt;0.05). PIG athletes showed significantly lower jump performances compared to CG athletes; in the injured extremity side, differences were found between the groups' THD, CHD, and 6MHT values during a single task (p

Attention and executive function impairments in obstructive sleep apnea are associated with decreased sleep spindles.

Sleep spindles play a key role in sleep-mediated cognitive processes. Cognitive functions are well-known to be affected in obstructive sleep apnea (OSA). Here, we analyzed attention and executive functions in patients with OSA and investigated the relationship between sleep spindles and cognitive abilities. Sixty patients with OSA (18-65years, 19 females and 41 males) and a control group (n = 41) including age-and sex-matched healthy individuals were consecutively and prospectively enrolled. All participants had a full-night polysomnography, and sleep spindles were analyzed using a semi-automated program. For the evaluation of short-term memory, attention and executive functions, Stroop test, forward and backward digit span tests were applied to all participants upon awakening following polysomnography. Scores of forward and backward digit span and Stroop tests were worse in OSA patients in compared to those in controls. Mean density of sleep spindles was decreased in OSA patients than those in controls (p = 0.044). A positive correlation was found between fast sleep spindle frequency and forward digit span (r = 2.222; p = 0.038) and backward digit span test scores (r = 2,157; p = 0.042) in OSA patients. In patients with moderate to severe OSA, sleep spindle density was positively correlated with forward (r = 2.323, p = 0.029) and backward (r = 2.500, p = 0.016) DSTs, and the duration of sleep spindles had positive correlation with backward DST (r = 2.452, p = 0.010). Our findings demonstrated that the disturbances in sleep spindle characteristics in OSA are associated with the cognitive impairments in attention, short-term memory, and executive functions, especially in patients with moderate to severe OSA.

Associations between Quantitative Sleep Analysis and Cognitive Functions in Healthy Adults

ABSTRACT Background: We investigated the role of sleep structure and sleep spindles on cognitive functions in healthy adults. Materials and Methods: Our study included 41 participants aged 18–65 years who had no other medical/sleep disorders. All participants underwent full-night polysomnography (PSG). The Standardized Mini-Mental Examination (SMME), Clock Drawing Test (CDT), forward and backward Digit Span Test (DST), Stroop test, and Beck Depression Inventory (BDI) were performed on all participants. Results: The study comprised 12 (29.2%) women and 29 (70.8%) men whose mean age was 47.0 ± 12.2 years. The mean forward DST score was significantly better in men than in women (P = 0.025). As age increased, the number of incorrect answers in the Stroop test (P = 0.016) increased. Of PSG data, a shorter duration of superficial sleep was associated with better scores in forward (t = −2.219; P = 0.040) and backward DST (t = −2.463; P = 0.024). Sleep spindle analysis showed that men had a significantly lower density compared with women (P = 0.046). A trend for a negative correlation was observed between increased sleep spindle density and lower Stroop test scores (t = −0.442; P = 0.051). The SMME, CDT, and BDI showed no significant associations with sleep structure. Decreased duration of sleep spindles significantly correlated with higher scores in forward (t = −0.480; P = 0.032) and backward DST (t = −0.489; P = 0.025). Conclusion: Our study showed that men had better functioning in attention, although they had a lesser amount of sleep spindles than women. This finding may be explained by socioenvironmental differences between the sexes. Sleep spindle characteristics, such as density and duration, are possibly associated with cognitive functions.

Minimal effect of long-term clonazepam on cognitive function in patients with isolated rapid eye movement sleep behavior disorder.

Despite its widespread use in patients with isolated rapid eye movement sleep behavior disorder (iRBD), the cognitive effect of clonazepam is uncertain. This study aimed to investigate the effect of cumulative clonazepam on cognitive function in patients with iRBD. Demographic characteristics, baseline cognitive test, and most recent cognitive test information were collected retrospectively. Based on cumulative clonazepam doses, patients were classified into 4 subgroups: group 1, < 365 mg (1 mg × 1 year); group 2, 365 mg to < 1,095 mg (1 mg × 3 years); group 3, 1,095 mg to < 2,190 mg (1 mg × 6 years); and group 4, 2,190 mg or more. Cognitive test scores were calculated as z scores adjusted for age, education, and sex. This study included 101 patients with iRBD (63 males). Groups 1, 2, 3, and 4 had 14, 20, 32, and 35 patients, respectively. In within-group comparisons, follow-up Digit Span Backward test and the Trail Making Test A scores decreased in group 3, and follow-up Trail Making Test A and the Trail Making Test B scores decreased significantly in group 4. In the multiple regression analysis to determine influential factors on cognitive decline, cumulative clonazepam dose did not show a significant correlation with any cognitive domain. Follow-up cognitive function showed significant correlation only with baseline cognitive function. Memory and executive functions tended to decline in patients with iRBD. However, there was no significant effect of cumulative clonazepam. There was no evidence that long-term use of clonazepam was related to cognitive decline in patients with iRBD. Lee M, Kim TK, Hong JK, Yoon I-Y. Minimal effect of long-term clonazepam on cognitive function in patients with isolated rapid eye movement sleep behavior disorder. J Clin Sleep Med. 2024;20(7):1173-1182.

Investigating the Correlation between English Spoken Fluency and Working Memory Capacity in both Dialogic and Monologic Presentations

Studies on second language (L2) speech fluency recommend studying fluency in a dialogic context. In response to the researchers' calls, this study introduced monologic and dialogic tasks to investigate the various aspects of speed, breakdown, and repair fluency in the oral performancemost L2 fluency studies have looked at oral fluency in a monologic task. Dialogue is the more authentic and natural way of communication, which is apparent in everyday language use. Currently, there is a scarcity of research examining dialogue fluency in non-native bilingual speakers who share the same L2. The existing body of research on language learning and processing has underscored significant connections between individual differences (IDs) in working memory capacity (WMC) and models of L2 speech production in both first language (L1). Nevertheless, it remains unclear whether variations in WMC are linked to dysfluency in L2 monologue and dialogue. Therefore, this study also aimed to fill this gap in the literature by investigating the correlation between utterance fluency in both monologue and dialogue and WMC. A total of 64 undergraduate Saudi students were given various tasks as part of the study. An argumentative task was presented as a monologue focused on a prevalent topic in the participants’ country. In contrast, during a dialogic discussion task, 32 pairs engaged in exchanging opinions on a popular subject in their country. Additionally, participants underwent two challenging working memory (WM) tests: the Operation Span Test and the Backward Digit Span Test. The findings aligned with prior research, indicating that L2 participants demonstrated greater fluency in dialogue compared to monologue, as evident in speed and breakdown measures of utterance fluency. Interestingly, WMC did not emerge as a robust predictor for variations in L2 oral performances between monologue and dialogue.