Brief Visual Memory Test-Revised Research Articles

Novelty preference assessed by eye tracking: A sensitive measure of impaired recognition memory in epilepsy

ObjectiveEpilepsy patients often report memory deficits despite normal objective testing, suggesting that available measures are insensitive or that non-mnemonic factors are involved. The Visual Paired Comparison Task (VPCT) assesses novelty preference, the tendency to fixate on novel images rather than previously viewed items, requiring recognition memory for the “old” images. As novelty preference is a sensitive measure of hippocampal-dependent memory function, we predicted impaired VPCT performance in epilepsy patients compared to healthy controls. MethodsWe assessed 26 healthy adult controls and 31 epilepsy patients (16 focal-onset, 13 generalized-onset, 2 unknown-onset) with the VPCT using delays of 2 or 30 s between encoding and recognition. Fifteen healthy controls and 17 epilepsy patients (10 focal-onset, 5 generalized-onset, 2 unknown-onset) completed the task at 2-, 5-, and 30-minute delays. Subjects also performed standard memory measures, including the Medical College of Georgia (MCG) Paragraph Test, California Verbal Learning Test-Second Edition (CVLT-II), and Brief Visual Memory Test-Revised (BVMT-R). ResultsThe epilepsy group was high functioning, with greater estimated IQ (p = 0.041), greater years of education (p = 0.034), and higher BVMT-R scores (p = 0.024) compared to controls. Both the control group and epilepsy cohort, as well as focal- and generalized-onset subgroups, had intact novelty preference at the 2- and 30-second delays (p-values ≤ 0.001) and declined at 30 min (p-values > 0.05). Only the epilepsy patients had early declines at 2- and 5-minute delays (controls with intact novelty preference at p = 0.003 and p ≤ 0.001, respectively; epilepsy groups’ p-values > 0.05). ConclusionsMemory for the “old” items decayed more rapidly in overall, focal-onset, and generalized-onset epilepsy groups. The VPCT detected deficits while standard memory measures were largely intact, suggesting that the VPCT may be a more sensitive measure of temporal lobe memory function than standard neuropsychological batteries.

Reliability and validity of the electronic version of the Hopkins verbal learning test-revised in middle-aged and elderly Chinese people.

The aging population is increasing, making it essential to have a standardized, convenient, and valid electronic memory test that can be accessed online for older people and caregivers. The electronic version of the Hopkins Verbal Learning Test-Revised (HVLT-R) as a test with these advantages and its reliability and validity has not yet been tested. Thus, this study examined the reliability and validity of the electronic version of the HVLT-R in middle-aged and elderly Chinese people to provide a scientific basis for its future dissemination and use. We included 1,925 healthy participants aged over 40, among whom 38 were retested after 3-6 months. In addition, 65 participants completed both the pad and paper-and-pencil versions of the HVLT-R (PAP-HVLT-R). We also recruited 42 Alzheimer's disease (AD) patients, and 45 amnestic mild cognitive impairment (aMCI) patients. All participants completed the Pad-HVLT-R, the Hong Kong Brief Cognitive Test (HKBC), the Brief Visual Memory Test-Revised (BVMT-R), and the Logical Memory Test (LM). (1) Reliability: the Cronbach's α value was 0.94, the split-half reliability was 0.96. The test-retest correlation coefficients were moderate, ranging from 0.38 to 0.65 for direct variables and 0.16 to 0.52 for derived variables; (2) Concurrent validity: the Pad-HVLT-R showed a moderate correlation with the HKBC and BVMT-R, with correlation coefficients between total recall of 0.41 and 0.54, and between long-delayed recall of 0.42 and 0.59, respectively. It also showed a high correlation with the LM, with correlation coefficients of 0.72 for total recall and 0.62 for long-delayed recall; (3) Convergent validity: the Pad-HVLT-R was moderately correlated with the PAP version, with correlation coefficients ranging from 0.29 to 0.53 for direct variables and 0.15 to 0.43 for derived variables; (4) Discriminant capacity: the Pad-HVLT-R was effective in differentiating AD patients, as demonstrated by the ROC analysis with AUC values of 0.834 and 0.934 for total recall and long-delayed recall, respectively. (1) The electronic version of HVLT-R has good reliability and validity in middle-aged and elderly Chinese people; (2) The electronic version of HVLT-R can be used as an effective tool to distinguish AD patients from healthy people.

The pattern glare and visual memory are disrupted in patients with major depressive disorder

BackgroundVisual memory impairment is one of the most commonly complained symptoms in patients with major depressive disorder (MDD). Pattern glare is also a distorted visual phenomenon that puzzles patients with MDD. Nevertheless, how these two phenomena interact in MDD remains unknown. This study investigated the association between pattern glare and visual memory in MDD patients.MethodsSixty-two patients with MDD and forty-nine age-, sex- and education level-matched healthy controls (HCs) were included in this study. The Pattern Recognition Memory (PRM) test and the Brief Visual Memory Test-Revised (BVMT-R) were applied to measure visual memory. The pattern glare test including three patterns with different spatial frequencies (SFs) was used to explore pattern glare levels.ResultsPatients with MDD scored lower on the PRM-PCi, BVMT-R1, BVMT-R2, BVMT-R3, and BVMT-Rt and higher on the PRM-MCLd than HCs (all p < 0.05). Pattern glare scores for MDD patients were higher with mid-SF (p < 0.001), high-SF (p = 0.006) and mid-high SF differences (p = 0.01) than for HCs. A positive correlation between mid-SF and PRM-MCLd scores in all participants was observed (p = 0.01, r = 0.246). A negative correlation between mid-high difference scores and BVMT-R2 scores (p = 0.032, r = -0.317) was observed in HCs, but no significant correlation was observed in MDD patients.ConclusionsThe present study showed that visual memory and pattern glare are disrupted in MDD. Visual memory may be associated with pattern glare and needs to be studied in future work.

A-92 Assessing Perceived Workload on the Brief Visual Memory Test in Traumatic Brain Injury Survivors

Abstract Objective We examined perceived workload as it is related to Brief Visual Memory Test-Revised (BVMT-R) short-delay and long-delay performance in traumatic brain injury (TBI) and healthy comparison (HC) participants. Method The sample consisted of 39 TBI participants and 54 HC participants. Demographically corrected BVMT-R scores were used to evaluate short-delay and long-delay performances. The perceived workload was measured using the NASA-TLX. Results ANOVA revealed that the HC group outperformed the TBI group on the BVMT-R short-delay and long-delay score, p &amp;lt; 05, η p 2 = 0.05. ANCOVAs controlling for age were used to evaluate NASA-TLX group differences. In regards to the NASA-TLX, TBI participants reported higher levels of physical demand, effort, frustration and overall subjective workload on the BVMT-R short-delay compared to HC participants, p &amp;lt; 05, η p 2 = 0.01–0.09. Furthermore, on the long-delay of the BVMT-R, the NASA-TLX revealed that the TBI group reported higher levels of temporal demand, effort, frustration and overall subjective workload compared to the HC group, p &amp;lt; 0.05, η p 2 = 0.05–0.14. Conclusions Results revealed that TBI participants demonstrated worse BVMT-R performances than HC participants. However, TBI survivors reported higher perceived workload demands compared to the HC group in both short-delay and long-delay of the BVMT-R. Our findings suggest that TBI impacts non-verbal memory performance in both BVMT-R short-delay and long-delay. Also, brain injury may be impacting TBI survivors’ awareness of their non-verbal memory performance. Further work is required to determine what drives the impaired perception of non-verbal memory performance among TBI survivors.

Neuropsychological and MRI diagnostics in secondary progressive multiple sclerosis

HintergrundDie Multiple Sklerose ist im longitudinalen Verlauf oft ein Krankheitskontinuum mit initial schubförmig-remittierender Phase (RRMS) und späterer sekundärer Progredienz (SPMS). Die meisten bisher zugelassenen Therapien sind bei SPMS nicht ausreichend wirksam. Die frühe Erkennung der SPMS-Konversion ist daher entscheidend für die Therapiewahl. Wichtige Entscheidungshilfen können dabei die Testung kognitiver Teilleistungen und die Magnetresonanztomographie (MRT) sein.Ziel der ArbeitDarstellung der Bedeutung kognitiver Testungen und von MRT-Untersuchungen für Prädiktion und Erfassung der SPMS-Konversion. Ausarbeitung von Strategien der Verlaufsbeobachtung und Therapiesteuerung in der Praxis, insbesondere in der ambulanten Versorgung.Material und MethodenÜbersichtsarbeit auf Basis einer unsystematischen Literaturrecherche.ErgebnisseStandardisierte kognitive Testung kann für die frühe SPMS-Diagnose hilfreich sein und die Verlaufsbewertung erleichtern. Eine jährliche Anwendung sensitiver Screeningtests wie Symbol Digit Modalities Test (SDMT) und Brief Visual Memory Test-Revised (BVMT‑R) oder der Brief International Cognitive Assessment for MS (BICAMS)-Testbatterie ist empfehlenswert. Persistierende inflammatorische Aktivität im MRT in den ersten drei Jahren der Erkrankung sowie das Vorhandensein kortikaler Läsionen sind prädiktiv für eine SPMS-Konversion. Ein standardisiertes MRT-Monitoring auf Merkmale einer progressiven MS kann den klinisch und neurokognitiv begründeten SPMS-Verdacht stützen.DiskussionDie interdisziplinäre Versorgung von MS-Patienten durch klinisch versierte Neurologen, unterstützt durch neuropsychologische Testung und MRT, hat einen hohen Stellenwert für die SPMS-Prädiktion und Diagnose. Letztere erlaubt eine frühe Umstellung auf geeignete Therapien, da bei SPMS andere Interventionen als für die RRMS notwendig sind. Nach erfolgter medikamentöser Umstellung erlaubt die klinische, neuropsychologische und bildgebende Vigilanz ein stringentes Monitoring auf neuroinflammatorische und -degenerative Aktivität sowie Therapiekomplikationen.

Brief Visuospatial Memory Test-Revised: normative data and clinical utility of learning indices in Parkinson’s disease

ABSTRACT Introduction: The Brief Visual Memory Test-Revised (BVMT-R) is a frequently used visuospatial declarative memory test, but normative data in the Czech population are lacking. Moreover, the BVMT-R includes promising learning indexes that can be used to detect learning deficits in Parkinson’s disease (PD). However, its clinical usefulness has not yet been thoroughly examined. Early detection of memory impairment in PD is essential for effective treatment. Therefore, this study aimed to provide BVMT-R Czech normative data for clinical use and to find the detection potential of the principal BVMT-R scores, including new learning indices, to capture the cognitive deficit in PD. Method: The BVMT-R were administered to a normative sample of 920 participants aged 17 to 95 years and to a clinical sample of 60 PD patients; 25 with mild cognitive impairment (PD-MCI) and 35 with normal cognition (PD-NC). In order to provide normative values, multiple regression analyses were employed, and to compare the clinical and control sample, Bayesian Hierarchical Linear Models were used. Results: The best model for regression-based norms showed to be with age + age2 + education + sex as predictors. From all learning indexes, L6 (sum of trials 1–3), followed by, L4 (sum of trials 1–3 multiplied by the difference between the highest and the lowest score) best differentiated between controls or PD-NC and PD-MCI. Conclusions: We provide regression-based normative values for BVMT-R that could be used in clinical settings and meta-analytic efforts. Furthermore, we revealed visuospatial learning and memory deficit in PD-MCI. We have also identified the most discriminative learning index adapted to BVMT-R.

Research on Cognitive Function in Anxious Depression Patients in China

Background: This study aimed to evaluate cognitive function in patients with anxious depression.Methods: This was a part of the “Objective Diagnostic Indicators and Individualized Drug Intervention of Major Depressive Disorder (MDD)” study. All participants, including patients with MDD and healthy controls (HCs), completed the 17-item Hamilton Depression Scale (HAMD17) and the Hamilton Anxiety Scale (HAMA). Anxious depression was defined as a HAMD17 anxiety/somatization factor score ≥7. Cognitive function was assessed at baseline and at the end of week 8. HC cognitive function was assessed at baseline.Results: A total of 1048 people were included in the analysis, including 328 patients in the anxious depression group (G1=328), 221 patients in the MDD without anxious depression group (G2=221), and 499 in the HC group (G3=499). There were significant differences in the HAMA at baseline (t=13.050, p<0.001), HAMD17 at baseline (t=16.722, p<0.001), and HAMA at weekend 8 (z=-3.477, p=0.001) between G1 and G2. Cognitive functioning on the Hopkins Verbal Learning Test-Revised (HVLT-R) (t=2.948, p=0.003) and the Brief Visual Memory Test-Revised (BVMT-R) (t=2.843, p=0.005) was better in G1 than in G2 at baseline. Cognitive functioning on the HVLT-R (OR=1.081, p=0.006) was better in G1 than in G2 at weekend 8. The Stroop-color-word test (SCWT) (OR=0.976, p=0.004) and the Continuous Performance Test (CPT) (OR=0.698, p=0.007) showed significant differences at baseline; however, after the acute treatment phase, there were no significant differences in executive function (assessed by SCWT) (p=0.148) or attention/vigilance (assessed by CPT) (p=0.416) between G1 and G3.Conclusions: Patients with anxious depression have more severe depressive symptoms but better cognitive function, especially for verbal learning, compared with nonanxious depression patients. After the acute treatment phase, executive function and attention/vigilance in anxious depression patients may be remitted.

The effect of short-term use of benzodiazepines on cognitive function of major depressive disorder patients being treated with antidepressants

BackgroundThis study aimed to evaluate the effect of short-term use of benzodiazepines (BZDs) on cognitive function of major depressive disorder (MDD) patients being treated with antidepressants (ADs). MethodsThis was a part of a multi-center, multi-stage and prospective study of “Objective Diagnostic Indicators and Individualized Drug Intervention of Major Depressive Disorder (OIMDD)”. Three hundred and fifty-three patients treated with the selective serotonin reuptake inhibitors (SSRIs) alone (Group 1) and 49 patients treated with SSRIs combined with short-term use of BZDs (Group 2) during the acute treatment period were included in the analysis. Cognitive function and depressive and anxiety symptoms were assessed at baseline, weekend 8 and 48. A cognitive test battery included 5 domains: information processing speed assessed by the Animal Verbal Fluency Scale (AVFS), Digit Symbol Coding Test (DSCT) and Color Trial Test (CTT), verbal learning assessed by the Hopkins Verbal Learning Test-Revised (HVLT-R), visual learning assessed by the Brief Visual Memory Test-Revised (BVMT-R), executive function assessed by the Stroop Color Word Test (SCWT), and attention or vigilance assessed by the Continuous Performance Test (CPT). ResultsSignificant differences were found in education level (χ2 = 5.442, p = 0.020), the severity of depressive (t = −1.982, p = 0.048) and anxiety symptoms (t = −2.629, p = 0.009) between Group 1 and 2 at baseline. There were no significant differences between G1 and G2 in cognitive functions at baseline. After Multiple correction, DSCT was better in patients treated with BZDs combined with ADs than in patients with ADs alone at weekend 8 without controlling education level, depressive and anxiety symptoms at baseline (F = −2.747, p = 0.042). After controlling these factors at baseline, the DSCT was still slightly high in patients treated with ADs combined with BZDs than in patients with ADs alone at weekend 8 (OR = 1.052, 95%CI:1.000–1.105). The repeated measurement analysis of variance showed that the DSCT could be improved by the treatment of BZDs combined with ADs at 1-year follow-up compared to baseline (F = 7.569, p = 0.006). ConclusionsThe findings suggest that short-term use of BZDs does not impair cognitive function of MDD patients; conversely, it could improve the information processing speed after acute treatment and at 1 year follow up.

P2‐270: Apathy and depression in subjective cognitive impairment (SCI) and mild cognitive impairment (MCI)

Background: Apathy, a behavioral syndrome characterized by amotivation and diminished goal-oriented behavior, and depression are commonly reported in MCI and dementia. Both apathy and depression have been associated with functional decline in these populations. Additionally, apathy is an important predictor of conversion from MCI to dementia. This study sought to investigate the relationships among apathy, depression and functional ability in geriatric patients with subjective and objective memory difficulties before progression to dementia. Methods: Participants were patients (n 1⁄4 40; mean age 1⁄4 74 + 7.9) with subjective memory complaints who were referred for neuropsychological assessment. All patients were proficient in English. The neuropsychological test battery included objective cognitive measures, as well as a self-report measure of mood, the Geriatric Depression Scale (GDS) and two familyreport measures of behavior: the Functional Activities Questionnaire (FAQ) and the Frontal Systems Behavior Scale (FrSBe). The FrSBe measures the frequency of behaviors associated with three frontal-behavioral domains: apathy (FrSBe-A), executive dysfunction (FrSBe-ED) and disinhibition (FrSBe-D). Participants were classified with Subjective Cognitive Impairment (SCI) if they performed within 1.5 standard deviations of the normative mean on objective cognitive measures. Participants were classified with Mild Cognitive Impairment-Amnestic (MCI-A) if they performed greater than 1.5 standard deviations below the normative mean on the delayed recall portion of the Hopkins Verbal Learning Test-Revised (HVLT-R), Logical Memory subtest of the Wechsler Memory Scale-III (WMS-III) or the Brief Visual Memory Test-Revised (BVMT-R).Results: The GDS correlated significantly with the FrSBe Total Score (r 1⁄4 .455) and each dimension of the FrSBe; FrSBe-A (r 1⁄4 .369), FrSBe-ED (r 1⁄4 .416) and FrSBe-D (r 1⁄4 .411). The GDS also correlated significantly with the FAQ (r 1⁄4 .376). The FAQ correlated significantly with the FrSBe-A (r 1⁄4 .472), but not with the FrSBe-ED or the FrSBe-D. Conclusions: In this sample of geriatric patients with subjective memory complaints and some with Amnestic MCI, significant relationships were found among self-report of depression and family members’ ratings of frontal systems behavior and functional capabilities. Specifically, apathy and depression were associated with functional ability. P2-271 TRAJECTORY CHANGE OF GLOBAL COGNITIVE FUNCTION PRIOR TO DEMENTIA DIAGNOSIS

The effects of l-amphetamine sulfate on cognition in MS patients: results of a randomized controlled trial

Defects in processing speed and memory are common in multiple sclerosis (MS) patients. In other populations, amphetamines have been shown to enhance cognition, but their use is limited by adverse behavioral effects. The L-isomer may have equivalent cognition enhancement with less adverse effects due to decreased potency in subcortical areas. The aim of this study was to assess the safety and efficacy of L-amphetamine sulfate in the treatment of cognitive dysfunction in MS. This was a 2:1 randomized, placebo-controlled, double-blind trial, involving 33 MS clinics across the USA. One hundred and fifty-one clinically definite MS patients with documented cognitive dysfunction who were relapse free for >or=90 days, with an Expanded Disability Status Scale (EDSS) <or=6.5, and with no other medical/psychiatric condition that may cause psychological dysfunction were randomized to 30 mg of oral L-amphetamine sulfate or placebo for 29 days, including a dose escalation period. A history of cardiac disease, uncontrolled hypertension or electrocardiograph abnormalities resulted in exclusion. The primary outcomes were the Subject Global Assessment of Change and Symbol Digit Modalities Test (SDMT). Secondary outcomes were the results from the California Verbal Learning Test, second edition (CVLT2), Brief Visual Memory Test-Revised (BVMTR), and Paced Auditory Serial Addition Test (PASAT). One hundred and thirty-six subjects completed the study. No differences were found at baseline in demographics or in the results of the neuropsychological tests. After treatment, the active group performed significantly better for total learning (P = 0.041) and delayed recall (P < 0.01) on the BVMTR, and for delayed recall (P = 0.012) on the CVLT2. Five patients (four from the treatment group, one placebo) withdrew due to intolerable adverse events. L-amphetamine sulfate was associated with improved learning and memory and was well tolerated in this study. However, because the positive findings were observed on secondary outcome measures, the study requires replication before L: -amphetamine sulfate can be recommended for the treatment of cognitive impairment in MS.

The effect of Aricept® in persons with persistent memory disorder following traumatic brain injury: a pilot study

Primary objective : To investigate the effectiveness of donepezil hydrochloride (Aricept®) in treating persistent memory deficits in people with traumatic brain injury. Research design : Single subject ABAC design was used so that each participant could serve as their own control. Methods and procedures : Seven TBI survivors with persistent memory dysfunction, at least 1.5 years post-injury, underwent two 6-month trials of Aricept®. The following tests were used to assess memory and cognition: Brief Visual Memory Test-Revised (BVMT-R), Hopkins Verbal Learning Test, Digit Span and Letter Number Sequence sub-test of the Wechsler Adult Intelligence Scale-III, Controlled Oral Word Association Test and Memory Functioning Questionnaire. Experimental intervention : During the first treatment phase, participants received 5 mg/day of Aricept® for 1 month, increasing to 10 mg/day of Aricept® for an additional 5 months. During the second treatment phase, participants received 5 mg/day of Aricept® for the entire 6 months. Main outcomes and results : A repeated measures analysis of variance indicated significant improvement on immediate and delayed memory portions of the BVMT-R when taking 10 mg/day of Aricept®. Conclusions : Findings contribute to the growing body of research into the use of Aricept® in treating memory deficits in TBI survivors and support the need for further research.

Neuropsychological and magnetic resonance imaging (MRI) diagnostics in secondary progressive multiple sclerosis

Background: Multiple sclerosis is often a longitudinal disease continuum with an initial relapsing-remitting phase (RRMS) and later secondary progression (SPMS). Most currently approved therapies are not sufficiently effective in SPMS. Early detection of SPMS conversion is therefore critical for therapy selection. Important decision-making tools may include testing of partial cognitive performance and magnetic resonance imaging (MRI). Aim of the work: To demonstrate the importance of cognitive testing and MRI for the prediction and detection of SPMS conversion. Elaboration of strategies for follow-up and therapy management in practice, especially in outpatient care. Material and methods: Review based on an unsystematic literature search. Results: Standardized cognitive testing can be helpful for early SPMS diagnosis and facilitate progression assessment. Annual use of sensitive screening tests such as Symbol Digit Modalities Test (SDMT) and Brief Visual Memory Test-Revised (BVMT-R) or the Brief International Cognitive Assessment for MS (BICAMS) test battery is recommended. Persistent inflammatory activity on MRI in the first three years of disease and the presence of cortical lesions are predictive of SPMS conversion. Standardized MRI monitoring for features of progressive MS can support clinically and neurocognitively based suspicion of SPMS. Discussion: Interdisciplinary care of MS patients by clinically skilled neurologists, supported by neuropsychological testing and MRI, has a high value for SPMS prediction and diagnosis. The latter allows early conversion to appropriate therapies, as SPMS requires different interventions than RRMS. After drug switching, clinical, neuropsychological, and imaging vigilance allows stringent monitoring for neuroinflammatory and degenerative activity as well as treatment complications.