Backward Span Research Articles

Abstract WMP20: Association Of Periventricular And Deep White Matter Hyperintensity With Cognitive Performance In A Middle-aged Population

Introduction: White matter hyperintensity (WMH) has been associated with manual dexterity performance in apparently healthy middle-aged population. However, the relative effect of WMH topographic distribution on cognition remains unknown. We hypothesized that periventricular WMH (PVWMH) is more strongly associated with manual dexterity and cognitive measures compared to deep WMH (DWMH) given its proximity to the white matter tracts involved in motor and executive functions. Methods: Apparently healthy middle-aged participants in the Genetic Study of Atherosclerosis Risk with brain MRI and cognitive measurements were selected. Cognitive measures included delayed word recall short (DWRS) and long (DWRL), digit symbol substitution (DSS), word fluency (WF), digit span forward test (DSFT), backward (DSBT) and total (DSTS), and grooved peg board test (GPBT) including the dominant and non-dominant hand (GPBTD, GPBTnD). PVWMH and DWMH volumes were measured using semi-automated segmentation paradigm. The relative associations of these measurements with PVWMH and DWMH volumes as multiple measurements within the same individual further nested within families were determined using multilevel linear models adjusting for intracranial volume, age, sex and cardiovascular risk factors. Results: 782 subjects were included (age 51.1±10.6, 58.4% female and 39% African American, PVWMH volume 437.4 [0-1646] mm 3 , DWMH volume 273.5 [76-665] mm 3 ). Within the same subject, PVWMH showed greater association than DWMH with worse performance on GPBT, GPBTD, GPBTnD, DWRS, and DWRL (P=0.006, 0.01, 0.01, 0.01 and 0.03, respectively) after adjusting for age and other cardiovascular risk factors. There was no difference in the association of PVWMH versus DWMH volumes with DSS, WF, DSFT, DSBT, DSTS (P=0.19, 0.52, 0.13, 0.6, and 0.6, respectively). Conclusions: PVWMH shows greater association than DWMH with cognitive measures of manipulative manual dexterity and recall suggesting that PVWMH and DWMH may have different cognitive phenotypes in middle-aged population with cerebral small vessel disease.

Pupil size as an indicator of cognitive activity in mild Alzheimer's disease.

It is well established that pupil activity indexes cognitive processing. For instance, research has consistently demonstrated that the pupil reacts to working memory span task performance. However, little is known about pupil reaction to cognitive processing in Alzheimer's Disease (AD). We thus investigated whether span tasks can modulate pupil size in patients with AD. We invited 24 patients with AD and 24 healthy older adults to perform backward and forward spans, as well as to count aloud in a control condition, while their pupil activity was recorded with eye tracking glasses. In patients with AD, analysis demonstrated larger pupil size during backward spans (M = 2.12, SD = .39) than during forward spans (M = 1.98, SD = .36) [t(23) = 3.22, p = .004], larger pupil size during forward spans than during counting (M = 1.67, SD = .33) [t(23) = 4.75, p < .001], as well as larger pupil size during backward spans than during counting [t(23) = 10.60, p < .001]. In control participants, analysis demonstrated larger pupil size during backward spans (M = 3.36, SD = .49) than during forward spans (M = 2.85, SD = .68) [t(23) = 5.82, p < .001], larger pupil size during forward spans than during counting (M = 2.09, SD = .62) [t(23) = 5.42, < .001], as well as larger pupil size during backward spans than during counting [t(23) = 9.70, p < .001]. Results also demonstrated a significant interaction effect between groups and conditions [F(2,92) = 16.63, p < .001]; in other words, patients with AD have shown fewer variations on the pupil size across the conditions compared to the control participants. The larger pupil size during backward spans, compared with forward spans or counting, can be attributed to the high cognitive load of backward spans. The modulation of pupil size, as observed across backward/forward spans and counting, can possibly be attributed to sympathetic/adrenergic and parasympathetic/cholinergic activities. Our study demonstrates the value of pupillometry as a potential biomarker of cognitive processing in AD.

Effect of Trataka (Yogic Visual Concentration) on the Performance in the Corsi-Block Tapping Task: A Repeated Measures Study.

Background and Objective: Attention and memory are essential aspects of cognitive health. Yogasanas, pranayama, and meditation have shown to improve cognitive functions. There has been no assessment of Trataka (yogic visual concentration) on working or on spatial memory. The present study was planned to assess the immediate effects of Trataka and of eye exercise sessions on the Corsi-block tapping task (CBTT).Methods: A total of 41 healthy volunteers of both genders with age 23.21 ± 2.81 years were recruited. All participants underwent baseline assessment, followed by 2 weeks of training in Trataka (including eye exercise). Each training session lasted for 20 min/day for 6 days a week. After completion of the training period, a 1-week washout period was given. Each participant then was assessed in two sessions in Trataka and in eye exercise on two separate days, maintaining the same time of the day. Repeated measure analysis of variance with Holm’s adjustment was performed to check the difference between the sessions.Results: Significant within-subjects effects were observed for forward Corsi span andforward total score (p < 0.001), and also for backward Corsi span (p < 0.05) and backward total score (p < 0.05). Post hoc analyses revealed Trataka session to be better than eye exercises and baseline. The eye exercise session did not show any significant changes in the CBTT.Conclusion: The result suggests that Trataka session improves working memory, spatial memory, and spatial attention.

Changes in Auditory Working Memory Capacities During Adolescence.

The aim of the article was to compare the auditory working memory capacities during adolescence period. A total of 45 participants between the age of 10 and 22years were included in the study. The participants were grouped in 3 based on their age range from 10 to 14 (group 1), 14-18 (group 2), and 18-22years (group 3) for the study. Participants with normal hearing thresholds and no history of middle ear pathology were enrolled for the study. Auditory working memory tests were carried out in these individuals which included midpoint and maximum scores of ascending span, descending span, digit forward span, and digit backward span. Statistical analysis was carried out using the SPSS version 25.0, descriptive and inferential statistics were carried out. Data was normally distributed on the Shapiro-Wilk's test of normality due to which a one-way ANOVA was done to establish the nature of significance across the groups and Tukey's post hoc test was done for establishing the presence of significance between the groups (group 1-group 2, group 2-groups 3, and group 1-group 3). To identify the relationship between the age of individuals and working memory scores, a Pearson correlation was done. Results reveal the presence of significant difference across the groups and between the groups too (p < 0.05) with noticeable significant effect seen in group 3 (18-22years) than in group 2 (14-18years) and group 1 (10-14years) respectively. There is a positive effect of age and changes in working memory abilities. This implies the presence of maturation during adolescence period at the level of prefrontal cortex and other cortical areas. Supporting literatures state there is presence of reduced activation on functional imaging studies during early adulthood period which could attribute to the significantly high scores in age range 18-22years.

Visuospatial and Tactile Working Memory in Individuals with Congenital Deafness.

Studies examining visuospatial working memory (WM) in individuals with congenital deafness have yielded inconsistent results, and tactile WM has rarely been examined. The current study examined WM span tasks in the two modalities among 20 individuals with congenital deafness and 20 participants with typical hearing. The congenital deafness group had longer forward and backward spans than typical hearing participants in a computerized Corsi block-tapping test (Visuospatial Span), whereas no such difference was found in the Tactual Span (tactile WM). In the congenital deafness group, age of sign language acquisition was not correlated with either condition of the visuospatial task, and Tactual and Visuospatial Spans scores were correlated in the backward but not the forward condition. The typical hearing group showed no correlation between the tasks. The findings suggest that early deafness leads to visuospatial but not tactile superiority in WM, specifically with respect to the storage component. More broadly, it appears that deafness-related compensation mechanisms in WM do not affect the other modalities in a uniform manner.

Is Working Memory Compromised in Individuals with Sensorineural Hearing Loss with Auditory Neural Origin?

The study aimed to investigate the working memory and speech recognition in noise from individuals with Sensori Neural Hearing Loss (SNHL) with and without auditory neuropathy spectrum disorder (ANSD). The purpose of assessing working memory recommends for a potential intervention program to perceive speech. Twenty participants in the age range of 16-44years, diagnosed as having mild to moderate SNHL were recruited for the study. The participants were divided into two groups based on the presence and absence of ANSD (10 in each group). The visual working memory was assessed in all the participants using the Operation Span Test, Reading Span Test and Visual Backward Test. Speech perception ability was assessed using the SNR 50 test. There was no significant difference between the scores of Operation Span, Reading Span, and Visual Backward Span for individuals with SNHL with and without ANSD. There was a significant difference between the scores of SNR 50 for individuals with SNHL with and without ANSD. The visual working memory in individuals with and without ANSD is similar. Speech perception in noise is significantly affected in ANSD than SNHL without ANSD. Thus, it is recommended to use speech reading, which utilizes visual working memory to interpret the message, as previous studies have reported that individuals with ANSD show limited benefit in auditory mode of rehabilitation alone.

Verbal Working Memory in Second Language Reading Comprehension: A Correlational Study

This study investigated the correlation and predictive capacity of verbal working memory (VWM) to the reading comprehension of children in their first language (L1) and second language (L2). The term verbal working memory refers to a cognitive system with a limited capacity that can hold and manipulate verbal and auditory information temporarily. A sub-aim was to investigate the contribution of L2 linguistic knowledge in L2 reading comprehension. Sixty-three Grade 3 South African children completed a reading comprehension test and VWM assessment (forward span, backward span, and sentence repetition tasks). L2 participants completed a receptive language assessment to delineate whether their linguistic knowledge (L2 vocabulary and grammar knowledge) would be more predictive of L2 reading comprehension in comparison with VWM. Regression and correlation analyses revealed that VWM is not predictive of L1 or L2 reading comprehension. L2 linguistic knowledge, however, significantly correlates with L2 comprehension and VWM capacity, although it is not a significant predictor of L2 reading comprehension. Our findings suggest that reading in an L2 is a multidimensional skill in which no single isolated variable can account for good versus poor reading comprehension.

Semantic memory and reading comprehension: the relationship through adulthood and aging.

Literature shows a relationship between working memory and reading comprehension during lifespan and aging. In addition, a difference between genres of text was shown: the expository text affects the already limited cognitive resources of the older adults, whereas narrative text comprehension seems to be preserved. Undoubtedly, also semantic knowledge plays a key role in reading comprehension; though, and to our knowledge, there are no studies clearly showing the relation between semantic knowledge and reading comprehension in aging. In the current study, we administered to younger adults and older adults a semantic working memory task, two word-span tasks and two reading comprehension tests (narrative and expository genre) to investigate the role of semantic knowledge during comprehension. In line with previous findings, we found that younger adults used flexibly either taxonomic or thematic knowledge, whereas the older adults mainly used thematic knowledge (better preserved from age-related decline). Originally, we found that in younger adults, thematic knowledge accounted for narrative text comprehension, whereas backward span performance accounted for expository text comprehension. On the contrary, in older adults no specific predictors were found for narrative text comprehension, whereas both thematic knowledge and education level were significant predictors of expository text comprehension. Results were discussed in the light of the possible protective role of some factors such as education level and mostly, as an instance of cognitive reserve exemplified by use of thematic knowledge as a residual ability.

A Short, Valid, and Flexible Web-Based Screener for Mild Cognitive Impairment

Clinical assessments for identifying mild cognitive impairment (MCI) can be costly and time-consuming. Few screeners for MCI exist that can be implemented quickly and outside of the clinic using flexible, cost-effective methods, such as web-based, mobile device-friendly assessments. Using data from middle-aged, racially and ethnically diverse Offspring Study participants (N=34 with MCI, N=54 without MCI; mean age: 53.9±3.4), we analyzed the sensitivity and specificity of several web- and telephone-based measures to identify MCI, after accounting for age and education. Web assessments included the Verbal Paired Associates (PA) and Visual PA tests. Phone assessments included the Number Series, Letter and Category Fluency, Number Span Forward & Backward, the AD8, and self-reported memory complaints. The discriminant ability of the web-based Visual PA test for MCI (ROC Area = .69) was comparable to phone-based measures, including the Category Fluency (ROC Area = .69), Number Span Forward (ROC Area = .61) and Backward (ROC Area = .67), and Letter Fluency (ROC Area = .68). Visual PA strongly predicted MCI, with a 98% reduction in the odds of MCI for every additional correct answer (OR=0.02), but our results are imprecise (95%CI: .000 to .76). A web-based Visual PA measure appears comparable to phone assessments in detection of MCI, although substantial uncertainty in its diagnostic precision remains. However, it is short, easily administered on a large-scale, and our evidence suggests that it can provide a sensitive and specific test to refer racially and ethnically diverse individuals for more thorough clinical assessment.

Sentence Imitation With Masked Morphemes in Czech: Memory, Morpheme Frequency, and Morphological Richness.

Purpose This study examined two markers of language impairment (LI) in a single experiment, testing sentence imitation and grammatical morphology production using an imitation task with masked morphemes. One goal was to test predictions of the morphological richness account of LI in Czech. We also tested the independent contributions of language and memory skills to sentence imitation performance. Method Seventeen children with LI (5;1-7;6 [years;months]) and 17 vocabulary-matched typically developing (TD) children (3;8-4;11) were administered a sentence imitation task where each sentence had one noun or verb ending replaced by a coughing sound. In addition, a receptive vocabulary and the digit span (backward and forward) tasks were administered. Results Children with LI were significantly less accurate than TD children in sentence imitation task. Both vocabulary and digit span had unique effects on sentence imitation scores. Children with LI were less successful in imitating the target words, especially verbs. However, if they succeeded, their completions of the masked morphemes were no less accurate than in TD children. The accuracy of completions was affected by the morpheme frequency and homophony, but these effects were similar in TD and affected children. Conclusions Sentence imitation is a measure of language skills and verbal memory. Results on morpheme completions are consistent with processing models of LI, but some predictions of the morphological richness model were not confirmed. The results suggest that children with LI might have a deficit in organizing morphosyntactic relations in sentences, rather than in morphological processing proper.

Effectiveness of a Serious Game for Cognitive Training in Chronic Stroke Survivors with Mild-to-Moderate Cognitive Impairment: A Pilot Randomized Controlled Trial

Previous cognitive training games for stroke survivors required the close supervision of therapists. We aim to demonstrate the preliminary therapeutic effectiveness of Neuro-World, serious mobile games for cognitive training, in chronic stroke survivors with mild-to-moderate cognitive impairment without therapist supervision. For that, we conducted a randomized, controlled clinical trial at a single long-term care rehabilitation center with 50 stroke survivors in the chronic stage with mild-to-moderate cognitive impairment. Participants were randomized to standard medical care (n = 25) or standard medical care plus administration of Neuro-World (n = 25) over 12 weeks. A two-way mixed model ANOVA and Tukey’s post hoc tests identified significant differences in outcomes between the experimental and the control groups at post-intervention but not at baseline. Within the experimental group, there were statistically significant improvements in all the outcomes except for the language category of the Mini-Mental State Examination and Digit Forward Span. The improvements were clinically significant for the total Mini-Mental State Examination, Digit Forward Span, and Digit Backward Span. Within the control group, there were no improvements in any of the outcomes. The practice of Neuro-World led to significant improvements in cognitive function and marginal mitigation of depressive symptoms in chronic stroke survivors with mild-to-moderate cognitive impairment.

Visuospatial short-term and working memory disturbance in the primary progressive aphasias: Neuroanatomical and clinical implications

IntroductionPrimary progressive aphasia (PPA) comprises three main variants: logopenic (lv-PPA), non-fluent (nfv-PPA) and semantic variant (sv-PPA). Differentiating the language profiles of the PPA variants remains challenging, especially for lv-PPA and nfv-PPA. As such, diagnostic tools that do not rely on speech and language may offer some utility. Here, we investigated the short-term and working memory profiles of the PPA variants and typical Alzheimer's disease (AD), with a particular interest in the visuospatial system. We hypothesised visuospatial short-term and working memory would be more compromised in lv-PPA and AD than in the other PPA variants, and that this would relate to degeneration of posterior temporoparietal brain regions. MethodThirty-three lv-PPA, 26 nfv-PPA, 31 sv-PPA and 58 AD patients, and 45 matched healthy controls were recruited. All participants completed the WMS-III Spatial and Digit Span tasks and underwent a structural brain MRI for voxel-based morphometry analyses. ResultsRelative to Controls, Spatial Span Forward (SSF) performance was impaired in lv-PPA and AD but not in nfv-PPA or sv-PPA. In contrast, Digit Span Forward (DSF) performance was impaired in lv-PPA and nfv-PPA (to a similar level), and AD, but was relatively intact in sv-PPA. As expected, most backward span scores across both modalities were lower than forward span scores. Neuroimaging analyses revealed that SSF and SSB performance in all patients combined correlated with grey matter intensity decrease in several clusters located in temporo-parieto-occipital brain regions. Post-hoc group comparisons of these regions showed that grey matter loss was more extensive in the lv-PPA and AD groups than in the nfv-PPA and sv-PPA groups. ConclusionsThe findings suggest that the visuospatial short-term and working memory profiles of the PPA variants are separable and likely reflect their distinct patterns of temporo-parieto-occipital brain atrophy.

The effects of transcranial direct current stimulation on within- and cross-paradigm transfer following multi-session backward recall training

Transcranial direct current stimulation (tDCS) has been shown to enhance the efficacy and generalisation of working memory (WM) training, but there has been little systematic investigation into how coupling task-specific WM training with stimulation impacts more specifically on transfer to untrained tasks. This randomised controlled trial investigated the boundary conditions to transfer by testing firstly whether the benefits of training on backward digit recall (BDR) extend to untrained backward recall tasks and n-back tasks with different materials, and secondly which, if any, form of transfer is enhanced by tDCS. Forty-eight participants were allocated to one of three conditions: BDR training with anodal (10 min, 1 mA) or sham tDCS, or visual search training with sham tDCS, applied over the left dorsolateral prefrontal cortex. Transfer was assessed on within- (backward recall with digits, letters, and spatial locations) and cross-paradigm (n-back with digits and letters) transfer tests following three sessions of training and stimulation. On-task training gains were found, with transfer to other backward span but not n-back tasks. There was little evidence that tDCS enhanced on-task training or transfer. These findings indicate that training enhances paradigm-specific processes within WM, but that tDCS does not enhance these gains.

Affective and cognitive theory of mind in Alzheimer’s disease: The role of executive functions

ABSTRACTIntroduction: Although there are plenty of studies on affective or cognitive theory of mind (ToM) in Alzheimer’s Disease (AD), few have investigated both these dimensions and even fewer have examined the ability to identify an emotion from context in relation to the executive function deficit. Thus, the purpose of this study was to examine the deficit of affective and cognitive ToM in AD patients in the light of their executive function deficit. We were especially interested in the ability to attribute emotions to a character from a context and the ability to recognize facial expressions and to understand social clumsiness.Method: Twenty-eight mild AD patients and 33 healthy participants completed two sessions, one involving neuropsychological tests evaluating the executive functions, and the other comprising three tasks (Facial Expression Attribution, Facial Expression Recognition, Faux Pas test) assessing affective and cognitive ToM.Results: Compared to the healthy participants, the AD patients were impaired in the recognition of shame, anger and the neutral expression. They had difficulties in inferring surprise and disgust from visual context in situations where no facial expression was available, and were also impaired in all aspects of the Faux Pas test. Globally, and independently of the Group factor, performance in the three ToM tasks was correlated with performance in the backward span test, and the significant proportion of variance in performance in the Facial Expression Recognition and Faux Pas test was explained by the performance in backward span test. However, separate analyses did not show any significant correlations for the AD patients.Conclusions: Our results suggest an impairment of affective and cognitive ToM in AD patients. This impairment is selective as it concerns only some emotions. Considering these results with caution, it is possible that, patients’ working memory difficulties explain, at least in part, their difficulties in ToM tasks.

SELECTIVE NARROWING OF PERIPHERAL SOCIAL NETWORKS PREDICTS POOR LONG-TERM COGNITION IN OLD AGE

Socioemotional selectivity theory posits that emotionally meaningful goals such as spending precious time with close family and friends are prioritized in late life as a function of limited future time horizons. Research documents that older individuals include a smaller proportion of peripheral social partners than younger individuals in their social networks, and that this selectivity is associated with better daily emotional experience (English & Carstensen, 2014). Such limitation of social partners, however, might adversely affect cognitive function in the long run, since exposure to novel and cognitively stimulating environments has been tied to better cognitive functioning (Park et al., 2014). The current study examined the long-term association between proportions of peripheral social partners in older adults’ social networks and cognitive performance. Sixty-one older participants (Mage = 71.53) reported the size of their inner, middle, and outer social circles using the Social Convoy Questionnaire (Kahn & Antonucci, 1980) and completed Digit Span Backward, Digit Span Forward, and Digit Symbol tasks at baseline and five years later. Results of multiple regression analysis show that participants who had a smaller proportion of social partners in their outer social circle at baseline performed poorer on the Backward Span task assessed five years later than those with a larger outer circle proportion. Results hold controlling baseline cognition, physical health, age, SES, education, and trait openness. We discuss the findings in terms of potential tradeoffs between the age-related social selection and working memory in the long run.

Cognitive test norms and comparison between healthy ageing, mild cognitive impairment, and dementia: A population‐based study of older Aboriginal Australians

ObjectiveThe prevalence of dementia and cognitive impairment is higher in Aboriginal Australians compared to the national population, increasing the need to understand cognitive impairment in this at‐risk population. This article reports normative data for a range of commonly used cognitive tests, in a population‐based small normative sample of older Aboriginal Australians living in urban/regional New South Wales.MethodParticipants included a representative random sample of community‐dwelling older adults (60-years and older) with no cognitive impairment (n = 31), mild cognitive impairment (MCI; n = 38), or dementia diagnosis (n = 35), all from the Koori Growing Old Well Study. Cognitive tests included the Addenbrooke's Cognitive Examination Revised (ACE‐R), Digit Span (Forward and Backward), Logical Memory, and the Oral Trail Making Test (A and B).ResultsDescriptive statistics and percentile scores for each test were reported for the normative sample. Comparison of performance between the diagnostic groups showed significant differences between the groups on most cognitive tests. The control group consistently performed better than the dementia group; and better than the MCI group on all tests, except for simple attention and sequencing tasks (Digit Span Forward and Oral Trail Making A). The MCI group also scored better than the dementia group on all tests, except for the Logical Memory Recognition task.ConclusionResults support the utility of these cognitive tests that are commonly used in clinical and research settings, and demonstrate that these tests can discriminate between diagnostic groups in Aboriginal Australians. The normative data provided will enhance cognitive assessment of individuals within this population.

Cognitive assessment instruments used in elderly Brazilians in the last five years.

Detecting and monitoring cognitive deficits in elderly populations are necessary, as they can impact individuals´ functionality. This integrative review aims to analyze the scientific production on the use of cognitive assessment instruments in Brazilian elderly individuals through articles published in the last five years, indexed in the Web of Science, Pubmed, Scopus and Bireme databases. Inclusion criteria were original articles published in English and Portuguese from 2012 to 2016, the age criterion to define elderly individuals and scores higher than 6 in the adapted CASP. The exclusion criterion was conference abstracts submitted for publication. The final sample consisted of 100 articles. Sixty-one cognitive assessment instruments were used in the studies, especially the Mini-Mental State Examination. This review features the use of cognitive instruments in the Brazilian literature, their different versions and domains evaluated. The literature includes a large number of instruments. The most used tests were the MMSE (version proposed by Brucki et al.), the Verbal Fluency Test ("animal" category) and the Digit Span Memory Test (forward span and backward span). The findings presented in this review are relevant not only for observational and experimental research but also for clinical practice.

Relationship between Working Memory and Identification of a Few Native Phonetic Contrasts

Objectives: Large individual variability is documented for identification performance of native phones, especially in challenging situations. It is not known whether the ability to utilize cues available for phone identification is facilitated by cognitive abilities, thereby explaining a proportion of the individual variability. This study investigated the relationship between working memory capacity and identification of a few Malayalam phones in the absence of contextual cues among native listeners. Methods: Forty native listeners of Malayalam, aged between 18 and 25, participated in this study. Participants identified 8 Malayalam phones embedded in nonsense words. Working memory capacity was measured using tasks such as reading span, operation span, digit forward span, and digit backward span. Identification score for each phone, total phone identification score (average identification score from 8 phones), and reaction time during identification were obtained. Results: Phone identification score of participants ranged from 57.8% to 99%. Pearson product moment correlation analysis showed a significant positive correlation between all measures of working memory capacity and total phone identification score, indicating that working memory capacity play a role in the identification of phones. Reaction time showed a significant negative correlation with digit backward span and operation span. The measures of working memory capacity accounted for 24.7% of the variability in phone identification score. Conclusion: Identification of phones in the absence of contextual cues increases the cognitive load. Therefore, higher working memory capacity might aid in native phone identification in difficult situations. This study reveals the top down influence of cognition on native speech perception.

Effect of the Wii Sports Resort on the improvement in attention, processing speed and working memory in moderate stroke

BackgroundStroke is the most common neurological disease in the world. After the stroke, some people suffer a cognitive disability. Commercial videogames have been used after stroke for physical rehabilitation; however, their use in cognitive rehabilitation has hardly been studied. The objectives of this study were to analyze attention, processing speed, and working memory in patients with moderate stroke after an intervention with Wii Sports Resort and compared these results with a control group.MethodsA pre-post design study was conducted with 30 moderate stroke patients aged 65 ± 15. The study lasted eight weeks. 15 participated in the intervention group and 15 belong to the control group. They were assessed in attention and processing speed (TMT-A and B) and working memory (Digit Span of WAIS-III). Parametric and effect size tests were used to analyze the improvement of those outcomes and compared both groups.ResultsAt the baseline, there was no difference between TMT-A and B. A difference was found in the scalar score of TMT-B, as well as in Digit Backward Span and Total Digit Task. In TMT-A and B, the intervention group had better scores than the control group. The intervention group in the Digit Forward Span and the Total Digit obtained a moderate effect size and the control group also obtained a moderate effect size in Total Digit. In the Digit scalar scores, the control group achieved better results than the intervention group.ConclusionsThe results on attention, processing speed and working memory improved in both groups. However, according to the effect sizes, the intervention group achieved better results than the control group. In addition, the attention and processing speed improved more than the working memory after the intervention. Although more studies are needed in this area, the results are encouraging for cognitive rehabilitation after stroke.

Clustering and Switching Patterns in Semantic Fluency and Their Relationship to Working Memory in Mild Cognitive Impairment.

Background and PurposeSemantic verbal fluency test is a neuropsychological assessment that can sensitively detect neuropathological changes. Considering its multifactorial features tapping various cognitive domains such as semantic memory, executive function, and working memory, it is necessary to examine verbal fluency performance in association with underlying cognitive functions. The objective of the current study was to investigate semantic fluency patterns of people with mild cognitive impairment (MCI) based on clustering and switching and their relationship with working memory.MethodsTwenty-six individuals with MCI and 23 normal elderly adults participated in this study. A semantic verbal fluency test (animal version) was administered and the performance was analyzed using the following measures: number of correct words, cluster size, and number of switches. Scores of digit forward (DF) and backward span tasks were employed as working memory measures.ResultsAnalyses of variance revealed significant group differences in the numbers of correct words and switches. Multivariate logistic regression and receiver-operating characteristic analyses showed that the number of switches more sensitively distinguished MCI existence than the number of correct words. Stepwise linear regression analysis showed that DF task and age significantly predicted the number of correct words while only the DF task significantly predicted the number of switches.ConclusionsDecrement in semantic verbal fluency in MCI seems to be associated with impaired switching abilities. Working memory capacity might serve as the underlying cognitive factor related to decreased verbal fluency in MCI.