Backward Spatial Span Research Articles

The relationship between nutrient intake and executive function in adults with post-traumatic stress disorder

BackgroundExecutive function (EF) deficits are common in adults with post-traumatic stress disorder (PTSD). Macro- and micronutrient intake are potential modifiable factors that may influence EF in PTSD. ObjectivesTo explore the relationship between the daily dietary intake of ω−3 and ω−6 polyunsaturated fatty acids (PUFAs), vitamin C, vitamin E, vitamin D, vitamin B12 and folate, and EF in adults with PTSD. MethodsThis was a cross-sectional observational study of adults with PTSD who completed neurocognitive assessments (n = 201). Digit span backwards, spatial span backwards, Stroop test and the Ruff Figural Fluency Task were used to assess EF. FoodFinder nutrient intake based on 24-h dietary recalls was used to calculate average daily nutrient intake. Multivariable linear regression models were used to regress EF on the nutrient variables. ResultsIntake of vitamin E, ω−3 PUFAs, and ω−6 PUFAs were all positively associated with planning and set-shifting, with vitamin E (adjusted β = 0.20, p = 0.004) and ω−6 (adjusted β = 0.17, p = 0.01) remaining significant after adjustment for age; sex; education and body mass index. Vitamin D intake was negatively associated with interference (adjusted β = −0.21, p = 0.01). Vitamin C, vitamin B12 and folate intake were not associated with EF. Limitations24-h dietary recall data is limited by recall bias. Circulating nutrient levels were not measured. ConclusionsDietary intake of vitamins E, ω−3 and ω−6 may be important modifiable factors affecting EF in adults with PTSD. Randomised controlled trials are needed to investigate whether micro- and macronutrient interventions can improve EF and other outcomes in PTSD.

Medium chain triglycerides with a C8:C10 ratio of 30:70 enhances cognitive performance and mitigates the cognitive decline associated with prolonged exercise in young and healthy adults

IntroductionProlonged exercise has been linked to a decline in cognitive function due to a variety of factors, such as a drop in oxygen in the prefrontal cortex and an increase in stress hormones and neurotransmitters. Medium chain triglycerides (MCTs) may possibly offset this decline as they provide energy for the brain via both direct and indirect pathways, alongside promoting chronic physiological adaptations within the brain. MethodsParticipants were divided into two groups; MCT (n = 9) and Placebo (n = 10). The MCT gels contained 6 g of MCT with a C8:C10 ratio of 30:70, whereas the placebo gels contained carbohydrates of similar calorific value to the MCT gels. Participants visited the laboratory on three occasions (familiarisation/fitness test, pre-supplementation, post-supplementation), during which they performed a battery of cognitive tasks assessing domains such as processing speed, working memory, selective attention, decision making and coordination, before and after a prolonged bout of exercise (60 mins at 90% gas exchange threshold (GET). A 2-week supplementation period between visits 2 and 3 involved the ingestion of 2 gels per day. ResultsExercise resulted in detriments in most cognitive tasks pre-supplementation for both groups, and post-supplementation for the Placebo group (main effect ps< 0.05). Post-supplementation, the effect of exercise was mediated in the MCT group for all cognitive tasks (main effect ps< 0.05), except for the Digit and Spatial Span Backwards test phases (main effect ps> 0.05). Furthermore, MCT supplementation enhanced before-exercise cognitive performance and in some measures, such as working memory, this was maintained after-exercise (interaction effect ps> 0.05). ConclusionsChronic MCT supplementation enhanced before-exercise cognitive performance and offset the cognitive decline caused by a prolonged bout of exercise. In some cases, improvements in before-exercise cognitive performance were maintained after-exercise.

Brain reserve theory: Are adults with intellectual disability more vulnerable to age than peers with typical development?

Life expectancy is on rise and the intriguing question is: When does cognitive decline occur among adults with intellectual disability, compared to adults with typical development? This cross-sectional study examined cognitive performance of crystallised/fluid intelligence, working and long-term memory of adults with intellectual disability of etiologies other than Down syndrome (IQ 50-68) and adults with typical development (IQ 85-114) in four age cohorts (30-39; 40-49; 50-59; 60-69). The WAIS IIIHEB and the Rey-AVLT were administered to both groups. Four patterns of cognitive performance were found: (a) Vocabulary (crystallised intelligence), Spatial Span Forward and Retention yielded similar scores across all four age cohorts in participants with typical development and with intellectual disability. (b) Similarities, Raven and Digit Span Backward exhibit lower scores only in 50-59 or 60-69 compared to the 30-39 age cohort in both groups, (c) Digit Span Forward, Spatial Span Backward and Total Leaning (LTM) yielded lower scores in the 50-59 or 60-69 age cohorts in the typical group, but similar scores in participants with intellectual disability along the age cohorts, (d) Block Design (fluid intelligence) yielded a lower score in the 50-59 cohort versus lower scores only at ages 60-69 in participants with typical development. Our findings suggest a possible parallel trajectory in age-related cognitive performance for individuals with and without intellectual disability in six measures, and a possible more preserved trajectory in fluid intelligence and some memory measures in adults with intellectual disability compared to their peers. Caution should be exercised regarding Digit and Spatial Span Backwards, which yielded a floor effect in participants with intellectual disability. The Cognitive Reserve Theory, the Safeguard Hypothesis and late maturation might serve as explanations for these findings.

A-273 MRI White Matter Hyperintensities and Neuropsychological Performance in a Young Adult Clinical Sample

Abstract Objective: Investigate the association of white-matter hyperintensities (WMH) on routine clinical MRI and neuropsychological test performance in a young adult clinical sample referred for neuropsychological assessment. Method: From a sample of 607 patients that underwent comprehensive neuropsychological evaluation, two groups were selected based on MRI results: 1) normal (n = 50 (30 females), Mage = 46.20, Medu = 15.16) and 2) WMH without other MRI abnormality (n = 35 (20 females), Mage = 47.83, Medu = 14.24). Exclusion criteria included dementia, other brain neuropathology (e.g. stroke, neurodegeneration, traumatic brain injury, multiple sclerosis, etc.), below normal scores on performance validity tests, and age &amp;gt; 59 years. Results: Independent samples t-tests revealed statistically significant group differences for: Block Design (d=.55), Digit Span Backward (d=.49), Spatial Span Backward (d=.49), DKEFS Trails Number (d=.78), DKEFS Trails Letter (d=.59), and Matrix Reasoning (d=.52); although, means for both groups were within the average range for all neuropsychological tests. Using logistic regression analyses, odds ratios were calculated for a person with WMH having an impaired index score using two z-score cut-offs: -1.67 and -1.00. WMH were associated with an index z-score &amp;lt; -1.00 on Matrix Reasoning (OR = 8.44, 95% CI: 1.69-42.22). A trend was near statistical significance (p= .06) at the -1.00 z-score cut-off on attention/processing speed tests (OR = 3.19, 95% CI: .93-16.39). Results for -1.67 cut-off were not significant. Conclusions: These findings indicate that even in younger adults, WMH are associated with increased probability of mild inefficiency/decline in problem-solving/reasoning, and may be associated with mild decline in attention/processing speed.

Effect of Modified Bifrontotemporal Electroconvulsive Therapy on Executive Function in Patients With Psychiatric Illness: A Longitudinal Observational Study.

The study was conducted to compare the pre-electroconvulsive therapy (ECT) and post-ECT status of the executive functions of patients and report any deficits found at long-term follow-up. The secondary objective of the study was to compare the performance at executive function tests after ECT with patient characteristics and ECT parameters. In a prospective longitudinal observational study, 50 patients in the age group of 18 to 65 years who were receiving modified bifrontotemporal ECT for the first time and admitted in psychiatry ward of a tertiary care hospital from July 2015 to June 2016 were assessed for executive functions using a neuropsychological battery consisting of digit span forward, digit span backward, spatial span forward, spatial span backward, phonemic verbal fluency test, semantic verbal fluency test, Stroop test, and Wisconsin Card Sorting Test, a day before ECT and then followed up at 3 and 6 months. Patients' score improved on all the tests of executive function at 3-month follow-up and was significant for some tests. Improvement was sustained for all the tests 6 months after ECT. Number of years of formal education of patients before illness significantly influenced patients' performance on most of the executive function tests after ECT. Younger age of the patient positively influenced patients' performance on digit span forward and backwards and semantic verbal fluency. There are no executive function deficits 3 to 6 months after brief pulse modified ECT with bilateral electrode placement. A higher premorbid education level is associated with better performance on executive functions after ECT.

Impact of stimulant medication on behaviour and executive functions in children with attention-deficit/hyperactivity disorder.

BACKGROUNDChildren with attention-deficit/hyperactivity disorder (ADHD) often exhibit behaviour challenges and deficits in executive functions (EF). Psychostimulant medications [e.g., methylphenidate (MPH)] are commonly prescribed for children with ADHD and are considered effective in 70% of the cases. Furthermore, only a handful of studies have investigated the long-term impact of MPH medication on EF and behaviour.AIMTo evaluate behaviour and EF challenges in children with ADHD who were involved in an MPH treatment trial across three-time points.METHODSThirty-seven children with ADHD completed a stimulant medication trial to study the short- and long-term impact of medication. Children with ADHD completed three neuropsychological assessments [Continuous Performance Test (CPT)-II, Digit Span Backwards and Spatial Span Backwards]. Parents of children with ADHD completed behaviour rating scales [Behaviour Rating Inventory of Executive Functioning (BRIEF) and Behaviour Assessment System for Children-Second Edition (BASC-2)]. Participants were evaluated at: (1) Baseline (no medication); and (2) Best-dose (BD; following four-week MPH treatment). Additionally, 18 participants returned for a long-term naturalistic follow up (FU; up to two years following BD).RESULTSRepeated measure analyses of variance found significant effects of time on two subscales of BRIEF and four subscales of BASC-2. Neuropsychological assessments showed some improvement, but not on all tasks following the medication trial. These improvements did not sustain at FU, with increases in EF and behaviour challenges, and a decline in performance on the CPT-II task being observed.CONCLUSIONParents of children with ADHD reported improvements in EF and behaviours during the MPH trial but were not sustained at FU. Combining screening tools and neuropsychological assessments may be useful for monitoring medication responses.

Evaluating the Impact of Cochlear Implantation on Cognitive Function in Older Adults.

We hypothesize that treating hearing loss through cochlear implantation in older adults will improve cognitive function. Prospective, interventional study. Thirty-seven participants aged 65 years and older who met criteria for cochlear implantation were enrolled. Subjects underwent preoperative cognitive testing with a novel arrangement of standard neuropsychological tests, including tests of general cognition and mood (Mini-Mental Status Exam [MMSE]), tests of verbally based stimuli and responses (Digit Span, Stroop, Hopkins Verbal Learning Test-Revised [HVLT-R], Hayling Sentence Completion), and comparable visually based tests (Spatial Span, d2 Test of Attention, Brief Visuospatial Memory Test [BVMT], Trails A and B). Testing was repeated 12 months postoperatively. One year postoperatively, subjects showed a statistically significant improvement in hearing and on the following tests of cognitive function: concentration performance of the d2 Test of Attention, Hayling Sentence Completion Test, HVLT-R (total and delayed recall), Spatial Span (backward), and Stroop Color Word Test. A subgroup analysis was performed comparing 13 participants with preoperative cognitive impairment (MMSE ≤ 24) to 24 participants with normal cognition (MMSE ≥ 25). In this subgroup analysis, a greater magnitude of improvement was seen in those with impaired cognition, with statistically significant improvement in Digit Span (scaled score), Stroop Word (T-score), Stroop Color-Word (residual and T-score), HVLT-R, and Hayling (overall). All verbally based test scores improved, and 75% of the visually based test scores improved. This study demonstrates the cognitive benefits of cochlear implantation in older adults 1 year after surgery. For older adults with cognitive impairment prior to cochlear implantation, the cognitive benefits were even greater than in subjects with normal cognition. 3, nonrandomized controlled cohort Laryngoscope, 132:S1-S15, 2022.

The effects of medium chain triglyceride (MCT) supplementation using a C8:C10 ratio of 30:70 on cognitive performance in healthy young adults

PurposeThe brain can utilise medium chain triglycerides (MCTs) as an alternative fuel to glucose, and research has shown that MCT ingestion improves cognitive function in diseased and/or elderly individuals. The aim of this study is to determine if these improvements can also be observed in young, healthy adults. Furthermore, we aim to establish the ideal dosage and timeframe necessary for an effect. MethodsParticipants were divided equally into three groups of 10 (Placebo (0 g), 12 g and 18 g MCT/day) and were supplemented for 4 weeks. The supplement had a C8:C10 ratio of 30:70. Participants visited the laboratory once a week for 5 weeks (baseline, test weeks 1–4) to undergo a battery of cognitive tests; Trail Making, Digit Span, Spatial Span, Covert Shift of Attention, and Rapid Visual Information Processing. ResultsAfter 2–3 weeks of supplementation, MCT ingestion enhanced performance in cognitive tasks, including: Trail Making A/B and Digit Span Forwards/Backwards (ps<0.001) when compared to a placebo group taking a carbohydrate gel. In Spatial Span Backwards, there was a significant main effect of group (p = 0.002). Where significance was seen, there were main effects of time after 2–3 weeks (ps<0.05). There was minimal difference between the two MCT intervention groups in most measures (ps>0.05). There were also null results in tasks measuring attention and reaction time (ps>0.05). ConclusionsMCT ingestion improved cognitive performance after 2–3 weeks, with minimal difference between taking 12 g and 18 g MCT/day groups, suggesting a possible dose-response threshold at 12 g MCT/day when supplementing over a short period.

Cognitive and language performance predicts effects of spelling intervention and tDCS in Primary Progressive Aphasia

Predictors of treatment effects allow individual tailoring of treatment characteristics, thereby saving resources and optimizing outcomes. Electrical stimulation coupled with language intervention has shown promising results in improving language performance in individuals with Primary Progressive Aphasia (PPA). The current study aimed to identify language and cognitive variables associated with response to therapy consisting of language intervention combined with transcranial direct current stimulation (tDCS). Forty individuals with PPA received written naming/spelling intervention combined with anodal tDCS or Sham, using a between-subjects, randomized design, with intervention delivered over a period of 3 weeks. Participants were assessed using a battery of neuropsychological tests before and after each phase. We measured letter accuracy during spelling of trained and untrained words, before, immediately after, 2 weeks, and 2 months after therapy. We used step-wise regression methods to identify variables amongst the neuropsychological measures and experimental factors that were significantly associated with therapy outcomes at each time-point. For trained words, improvement was related to pre-therapy scores, in RAVLT (5 trials sum), pseudoword spelling, object naming, digit span backward, spatial span backward and years post symptom onset. Regarding generalization to untrained words, improvement in spelling was associated with pseudoword spelling, RAVLT proactive interference, RAVLT immediate recall. Generalization effects were larger under tDCS compared to Sham at the 2-month post training measurement. We conclude that, for trained words, patients who improve the most are those who retain for longer language skills such as sublexical spelling processes (phoneme-to-grapheme correspondences) and word retrieval, and other cognitive functions such as executive functions and working memory, and those who have a better learning capacity. Generalization to untrained words occurs through improvement in knowledge of phoneme-to-grapheme correspondences. Furthermore, tDCS enhances the generalizability and duration of therapy effects.

Reduced hippocampal subfield volumes and memory function in school-aged children born preterm with very low birthweight (VLBW).

BackgroundThe hippocampus, an essential structure for learning and memory, has a reduced volume in preterm born (gestational age < 37 weeks) individuals with very low birth weight (VLBW: birth weight < 1500 g), which may affect memory function. However, the hippocampus is a complex structure with distinct subfields related to specific memory functions. These subfields are differentially affected by a variety of neuropathological conditions, but it remains unclear how these subfields may be affected by medical complications following preterm birth which may cause aberrant brain development, and the consequences of this on learning and memory function in children with VLBW.MethodsChildren born preterm with VLBW (n = 34) and term-born controls from the Norwegian Mother and Child Cohort Study (MoBa) (n = 104) underwent structural MRI and a neuropsychological assessment of memory function at primary school age. FreeSurfer 6.0 was used to analyze the volumes of hippocampal subfields which were compared between groups, as was memory performance. Correlations between abnormal hippocampal subfields and memory performance were explored in the VLBW group.ResultsAll absolute hippocampal subfield volumes were lower in the children with VLBW compared to MoBa term-born controls, and the volumes of the left and right dentate gyrus and the right subiculum remained significantly lower after correcting for total intracranial volume. The VLBW group had inferior working memory performance and the score on the subtest Spatial Span backwards was positively correlated to the volume of the right dentate gyrus.ConclusionsHippocampal subfield volumes seem to be differently affected by early brain development related to preterm birth. The dentate gyrus appears particularly susceptible to adverse effects of preterm birth. Reduced working memory function among children with VLBW was associated with smaller volume of right dentate gyrus. This finding demonstrates alterations in hippocampal structure-function relationships associated with early brain development related to preterm birth.

Prefrontal and temporal cortical thickness in adolescents with traumatic brain injury

To investigate the impact of traumatic injury on the developing prefrontal-temporal adolescent cortex, and correlated brain structural measures with neurocognitive functioning. Nineteen adolescents (12 males, 7 females, age range: 11-17y, mean 15y 8mo, standard deviation 1y 7mo, median 15y 11mo) with traumatic brain injury (TBI) were included. Cortical thickness of frontal and temporal lobes was assessed using magnetic resonance imaging. We correlated cortical thickness of prefrontal-temporal regions with age, time since injury, and neurocognitive functioning, and compared these results with a matched control cohort without TBI. We found thinner prefrontal (p=0.039) and temporal cortices (p=0.002) in adolescents with TBI compared to typically developing children. Furthermore, significant age effect was observed on the prefrontal (r=-0.75, p=0.003) and temporal (r=-0.66, p=0.013) cortical thickness in typically developing adolescents, but not in adolescents with TBI. Executive function (measured using the Behaviour Rating Inventory of Executive Function questionnaire, with lower scores meaning higher functioning) was correlated with prefrontal cortical thickness in typically developing adolescents (r=0.72, p=0.009). Opposite trends were found for correlations between cortical thickness and executive function in the TBI and control cohort. Structural maturation in typically developing adolescents correlates with functional development: the older the adolescent, the thinner the prefrontal cortex, the better executive function. In adolescents with TBI we observed an opposite trend, that appeared significantly different from the control group: the thinner the prefrontal and temporal cortex, the worse executive functioning. Cortical thickness is negatively correlated with age in typically developing adolescents. Prefrontal cortex thickness correlates negatively with executive function in typically developing adolescents. Correlations between cortical thickness and executive functioning rise for adolescents without traumatic brain injury (TBI). Correlations between cortical thickness and executive functioning fall for adolescents with TBI. Adolescents with TBI have a long-term impairment of adaptive functioning in daily living.

Role of the left hemisphere in visuospatial working memory.

Visuospatial processing deficits are typically associated with damage to the right hemisphere. However, deficits on spatial working memory have been reported among some individuals with focal left hemisphere damage (LHD). It has been suggested that the left hemisphere may play a role in such non-verbal working memory tasks due to the use of subvocal, verbally-mediated strategies. The current study investigated the role of the left hemisphere in spatial working memory by testing spatial span performance, both forward and backward, in a large group of individuals with a history of left hemisphere stroke. Our first aim was to establish whether individuals with LHD are indeed impaired on spatial span tasks using standardized span tasks with published normative data. Our second aim was to identify the role that language plays in supporting spatial working memory by comparing LHD individuals with and without aphasia, and by relating spatial span performance to performance on a series of language measures. Our third aim was to identify left hemisphere brain regions that contribute to spatial working memory using voxel-based lesion symptom mapping (VLSM), a whole-brain statistical approach that identifies regions critical to a particular behavior on a voxel-by-voxel basis. We found that 28% of individuals with LHD performed in the clinically-impaired range on forward spatial span and 16% performed in the clinically-impaired range on backward spatial span. There were no significant differences in performance between individuals with and without aphasia, and there were no correlations between spatial span performance and language functions such as repetition and comprehension. The VLSM analysis showed that backward spatial span was associated with a left fronto-parietal network consisting of somatosensory cortex, the supramarginal gyrus, lateral prefrontal cortex, and the frontal eye fields. Regions identified in the VLSM analysis of forward spatial span did not reach the conservative statistical threshold for significance. Overall, these results suggest that spatial working memory, as measured by spatial span, can be significantly disrupted in a subset of individuals with LHD whose lesions infringe on a network of regions in the left hemisphere that have been implicated in domain-general working memory and attentional control mechanisms.

How do stimulant treatments for ADHD work? Evidence for mediation by improved cognition.

Stimulant medications such as methylphenidate (MPH) are the frontline treatment for Attention-Deficit/Hyperactivity Disorder (ADHD). Despite their well-documented efficacy, the mechanisms by which stimulants improve clinical outcomes are not clear. The current study evaluated whether MPH effects on classroom behavior were mediated by improved cognitive functioning. Children with ADHD (n=82; 9-12years old) participated in a week-long summer research camp, consisting of cognitive testing, classroom periods, and recreational activities. After a baseline day, participants completed a 3-day randomized, double-blind, placebo-controlled trial of MPH (at doses approximating 0.3 and 0.6mg/kg of immediate-release MPH dosed TID). Cognitive domains included inhibitory control (Stop Signal Task and prepulse inhibition of startle), attention (Continuous Performance Task and reaction time variability), and working memory (forward and backward spatial span). Clinical outcomes included math seatwork productivity and teacher-rated classroom behavior. A within-subjects path-analytic approach was used to test mediation. MPH-placebo and dose-response contrasts were used to evaluate drug effects. Methylphenidate improved seatwork productivity and teacher ratings (ds=1.4 and 1.1) and all domains of cognition (ds=0.3-1.1). Inhibitory control (Stop Signal Task, SST) and working memory backward uniquely mediated the effect of MPH (vs. placebo) on productivity. Only working memory backward mediated the impact of MPH on teacher-rated behavior. The dose-response (0.6 vs. 0.3mg/kg) effects were more modest for clinical outcomes (ds=0.4 and 0.2) and cognition (ds=0-0.3); there was no evidence of cognitive mediation of the clinical dose-response effects. These findings are novel in demonstrating that specific cognitive processes mediate clinical improvement with stimulant treatment for ADHD. They converge with work on ADHD theory, neurobiology, and treatment development in suggesting that inhibitory control and working memory may be mechanisms of stimulant treatment response in ADHD. More work is necessary to evaluate the degree to which these findings generalize to chronic treatment, a broader array of clinical outcomes, and nonstimulant treatments.

Influence of working memory on stimulus generalization in anomia treatment: A pilot study

Abstract Neuropsychological testing of distinct cognitive domains holds promise as a prognostic indicator of aphasia therapy success; however, it is unclear the degree to which cognitive assessments may also predict generalization abilities. The present study aimed to assess the relationship between working memory skills and stimulus generalization from a visual picture-naming treatment to an auditory definition-naming task. Seven individuals with aphasia completed verbal and nonverbal assessments of working memory prior to participating in a cued picture-naming treatment for anomia. After treatment ended, stimulus generalization percentages were calculated for definition naming for the same items that were trained using picture naming. Scores on two nonverbal working memory measures, the backward spatial span and the 1-back, and one verbal working memory assessment, the picture span, were positively correlated with generalization percentage. These results provide preliminary evidence of the relationship between working memory and stimulus generalization. When comparing performance across working memory measures, the spatial span and the picture span were highly correlated in this sample. We propose that despite the verbal and nonverbal distinction, these tasks may have tapped into working memory similarly by relying on a shared central processing mechanism.

Categorization Working Memory Span Task: Validation study of two Brazilian alternate versions.

The Categorization Working Memory Span Task (CWMS task) is a complex working memory (WM) span test that has been used previously to assess age and individual differences in WM as well as the relationship between WM and complex aspects of cognition such as listening comprehension. Two alternate versions of the task have been developed to be used as outcome variables in WM training protocol, which mirrors the task involved in the CWMS task. (1) To translate and adapt the CWMS task for Brazilian Portuguese; (2) to test the equivalence of its 2 alternate versions; (3) to examine temporal stability; (4) to examine the influence of age and schooling on CWMS task; (5) to establish its relationship with other tests of WM. Eighty-one older adults completed version A, and 86 completed version B of the CWMS task. After 6months, a subsample (n=85) completed the same version of the task. Versions A and B of the task generated comparable scores. Both versions had adequate temporal stability, which was higher for the CWMS total recall, which is the classical variable in this task to represent WM performance, when compared to the other variables generated by the test. The CWMS task variables were moderately correlated with schooling and other cognitive tests (Mini Mental State Examination, Letter-Number Sequencing, Spatial Span Backward, Digit Span Forward). The 2 versions of the CWMS task were equivalent and stable temporally. The task was influenced by schooling and global cognition.

Attention, vigilance, and visuospatial function in hospitalized elderly medical patients: relationship to delirium syndromal status and motor subtype profile.

A battery of nine bedside cognitive tests was performed on elderly medical inpatients with DSM-IV delirium, subsyndromal delirium (SSD), and no delirium (ND). Patients with delirium were compared according to clinical (motor) subtypes. A total of 198 patients (mean age 79.14 ± 8.26) were assessed with full syndromal delirium (FSD: n = 110), SSD (n = 45), and ND (n = 43). Delirium status was not associated with differences in terms of gender distribution, age, or overall medication use. Dementia burden increased with greater delirium status. Overall, the ability to meaningfully engage with the tests varied from 59% for the Vigilance B test to 85% for Spatial Span Forward test and was lowest in patients with FSD, where engagement ranged from 32% for the Vigilance B test to 77% for the Spatial Span Forwards test. The ND group was distinguished from SSD group for the Months of the year backwards, Vigilance B, global VSP, Clock Drawing test, and Interlocking Pentagons test. The SSD group was distinguished from the FSD group by Vigilance A, Spatial Span Forward, and Spatial Span Backwards. Regarding differences among motor subtypes in terms of percentage engagement and performance, the No subtype group had higher ratings across all tests. Delirious patients with no subtype had significantly lower scores on the DRS-R98 than for the other three subtype categories. Simple bedside tests of attention, vigilance, and visuospatial ability are useful in distinguishing neurocognitive disorders, including SSD from other presentations.

Balanced bifrontal transcranial direct current stimulation enhances working memory in adults with high-functioning autism: a sham-controlled crossover study

BackgroundWorking memory (WM) often is impaired in autism spectrum disorder (ASD). Such impairment may underlie core deficits in cognition and social functioning. Transcranial direct current stimulation (tDCS) has been shown to enhance WM in both healthy adults and clinical populations, but its efficacy in ASD is unknown. We predicted that bifrontal tDCS would improve WM performances of adults with high-functioning autism during active stimulation compared to sham stimulation and that such enhancement would generalize to an untrained task.MethodsTwelve adults with high-functioning ASD engaged in a battery of WM tasks that included backward spatial span, backward digit span, spatial n-back and letter n-back. While engaged, 40 min of 1.5 mA bifrontal stimulation was applied over the left and the right dorsolateral prefrontal cortices (DLPFC). Using a single-blind crossover design, each participant received left anodal/right cathodal stimulation, right anodal/left cathodal stimulation, or sham stimulation, in randomized counterbalanced order on three separate days. Following tDCS, participants again engaged in letter and spatial n-back tasks before taking the Brief Test of Attention (BTA). We used repeated-measures ANOVA to compare overall performance on the WM battery as measured by a composite of z-scores for all five measures. Post hoc ANOVAs, t tests, Friedman’s tests, and Wilcoxon signed-rank tests were used to measure the online and offline effects of tDCS and to assess performances on individual measures.ResultsCompared to sham stimulation, both left DLPFC anodal stimulation (t11 = 5.4, p = 0.0002) and right DLPFC anodal stimulation (t11 = 3.57, p = 0.004) improved overall WM performance. Left anodal stimulation (t11 = 3.9, p = 0.003) and right anodal stimulation (t11 = 2.7, p = 0.019) enhanced performances during stimulation. Enhancement transferred to an untrained task 50 min after right anodal stimulation (z11 = 2.263, p = 0.024). The tasks that showed the largest effects of active stimulation were spatial span backward (z11 = 2.39, p = 0.017) and BTA (z11 = 2.263, p = 0.024).ConclusionsIn adults with high-functioning ASD, active bifrontal tDCS given during WM tasks appears to improve performance. TDCS benefits also transferred to an untrained task completed shortly after stimulation. These results suggest that tDCS can improve WM task performance and could reduce some core deficits of autism.Trial registrationNCT01602263

Phonological awareness and spatial visual memory among sample of dyslexic children

This study aims to identify the relationship between phonological awareness and spatial visual memory, as well as, to detect the differences between Kuwaiti males and females and non-Kuwaitis with regard to reading learning difficulties in certain variables. The study adopts a comparative descriptive approach and uses sample of 350 primary students (3-5 grades) with reading learning difficulties (200 males and 150 females) Kuwaitis and non-Kuwaitis. Their ages ranged between 8- 10 years. Phonological awareness test and spatial visual memory test are applied. The findings of the study show that there is a statistically significant positive correlation between the components of phonological awareness tests (syllable &amp; phoneme deletion test and non-word reading accuracy test) and between spatial visual memory tests (Forward Spatial Span Test and Backward Spatial Span Test) from males and females sample. There are no significant differences between males and females in phonological awareness skills (phoneme deletion test, and non-word reading accuracy test). Females show better performance than males in spatial visual memory tasks (Forward Spatial Span Test and Backward Spatial Span Test). Non-Kuwaitis show better performance than Kuwaitis in phonological awareness skills (syllable &amp; phoneme deletion, and non-word reading accuracy test) and in spatial visual memory tasks (Forward Spatial Span Test and Backward Spatial Span Test). The results of the regression suggested that the integration of sounds is the only test that can predict reading disabilities. As (syllable &amp; phoneme deletion, and t non-word reading accuracy test) are the most predictable of spatial visual memory.

Phonological awareness and spatial visual memory among sample of dyslexic children

This study aims to identify the relationship between phonological awareness and spatial visual memory, as well as, to detect the differences between Kuwaiti males and females and non-Kuwaitis with regard to reading learning difficulties in certain variables. The study adopts a comparative descriptive approach and uses sample of 350 primary students (3-5 grades) with reading learning difficulties (200 males and 150 females) Kuwaitis and non-Kuwaitis. Their ages ranged between 8- 10 years. Phonological awareness test and spatial visual memory test are applied. The findings of the study show that there is a statistically significant positive correlation between the components of phonological awareness tests (syllable &amp; phoneme deletion test and non-word reading accuracy test) and between spatial visual memory tests (Forward Spatial Span Test and Backward Spatial Span Test) from males and females sample. There are no significant differences between males and females in phonological awareness skills (phoneme deletion test, and non-word reading accuracy test). Females show better performance than males in spatial visual memory tasks (Forward Spatial Span Test and Backward Spatial Span Test). Non-Kuwaitis show better performance than Kuwaitis in phonological awareness skills (syllable &amp; phoneme deletion, and non-word reading accuracy test) and in spatial visual memory tasks (Forward Spatial Span Test and Backward Spatial Span Test). The results of the regression suggested that the integration of sounds is the only test that can predict reading disabilities. As (syllable &amp; phoneme deletion, and t non-word reading accuracy test) are the most predictable of spatial visual memory.

Attention, vigilance and visuospatial function in hospitalized elderly medical patients–relationship to delirium syndromal status and motor subtype profile

ObjectiveThe early and efficacious detection of neurocognitive disorders poses a key diagnostic challenge. We examined how nine bedside cognitive tests perform across the spectrum of delirium and motor subtypes.MethodsThe performance on a battery of nine bedside cognitive tests were compared in elderly medical inpatients with DSM-IV delirium, subsyndromal delirium, and no neurocognitive disorder and in different motor subtypes of patients with delirium.ResultsOne hundred and ninety-eight patients (mean age 79.14 ± 8.26) were assessed with no delirium (n = 43), subsyndromal delirium (n = 45), and full syndromal delirium (n = 110). The ability to meaningfully engage with the tests varied from 59% for vigilance B test to 85% for Spatial Span forward test and was found to be least in the full syndromal delirium group. The no delirium group was distinguished from the delirium groups for all the tests and from the full syndromal delirium group for the vigilance B test and global visuospatial function test. The subsyndromal delirium group differed from the full syndromal delirium group in respect of global visuospatial function test, spatial span backwards and vigilance A tests. Patients with full syndromal delirium were best identified using the interlocking pentagons test and clock drawing test. The ability to engage with testing was higher for those in the no subtype group.ConclusionsSimple bedside tests of attention, vigilance, and visuospatial ability are useful to help to distinguish neurocognitive disorders namely subsyndromal delirium from other presentations.Disclosure of interestThe author has not supplied his/her declaration of competing interest.