Brief Visuospatial Memory Test-Revised Research Articles

A Phase IC Study Evaluating the Safety, Tolerability, Pharmacokinetics, and Cognitive Outcomes of BI 409306 in Patients with Mild-to-Moderate Schizophrenia.

IntroductionThis randomized, double-blind, parallel-group study investigated the safety, tolerability, pharmacokinetics (PK), and cognitive outcomes of BI 409306—a selective phosphodiesterase 9A (PDE9A) inhibitor—in patients with schizophrenia.MethodsPatients with mild-to-moderate schizophrenia were randomized (1:1:1:1) to receive BI 409306 at 25, 50, or 100 mg or placebo once daily over 14 days. The primary endpoints were safety and tolerability; the secondary endpoints were PK and cognitive outcomes.ResultsOf the 40 randomized patients, 38 (95%) completed the study. Patients were predominantly male (87.5%; mean age, 40.2 years). After a single dose, C max was reached within 30–45 min. The geometric mean (gMean) C max and AUC0-∞ ranged from 138 to 998 nmol/L and 217 to 2020 nmol∙h/L, respectively. Elimination was rapid (gMean t 1/2 range 1.10–1.85 h). After multiple doses, C max,ss was reached within 1 h; elimination was similar to that observed after a single dose. Total exposure at steady state and after a single dose were similar (accumulation ratio range: AUC, 0.758–1.13 and Cmax, 0.768–1.40). No deaths, adverse events (AEs) leading to discontinuation, or serious AEs were observed. Treatment-emergent AEs were mild, with no apparent dose-related trends. There was no worsening of schizophrenia symptoms (Positive and Negative Syndrome Scale) and no trends in suicidality (Columbia Suicide Severity Rating Scale). The Hopkins Verbal Learning Test–Revised (HVLT-R) and Brief Visuospatial Memory Test–Revised (BVMT-R) showed no effect on cognitive function.ConclusionAdministration of BI 409306 in patients with mild-to-moderate schizophrenia resulted in satisfactory safety and tolerability. BI 409306, PK was characterized by rapid absorption, monophasic to biphasic elimination, and minor accumulation with multiple dosing.Trial RegistrationClinicalTrials.gov identifier NCT01892384.FundingBoehringer Ingelheim Pharma GmbH & Co. KG.

Embedded Performance Validity Tests in the Hopkins Verbal Learning Test-Revised and the Brief Visuospatial Memory Test-Revised: A Replication Study.

Embedded performance validity tests (PVTs) within the Hopkins Verbal Learning Test-Revised (HVLT-R) and Brief Visuospatial Memory Test-Revised (BVMT-R) were recently identified. This study aimed to further validate/replicate these embedded PVTs. Eighty clinically referred veterans who underwent neuropsychological evaluation were included. Validity groups were established by passing/failing 2-3 well-validated PVTs, with 75% (n = 60) classified as valid and 25% (n = 20) noncredible. Fifty-two percent of valid participants were cognitively impaired. HVLT-R Recognition Discrimination (RD) of ≤5 yielded 67% sensitivity/80% specificity for identifying noncredible performance. Removal of seven valid participants with an amnestic profile who produced a false positive, improved specificity to 92%, which replicated the original findings. Replication efforts failed for BVMT-R Percent Retained; however, significant findings for RD were elucidated. Replication efforts were positive for the HVLT-R embedded PVT, corroborating its ability to identify invalid performance in this heterogeneous clinical veteran sample with and without cognitive impairment.

BICAMS in the Argentine population: Relationship with clinical and sociodemographic variables

ABSTRACTThe Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) was developed to provide valid assessment of cognitive impairment in multiple sclerosis (MS). The relationship between clinical and social variables and cognitive disorders has been extensively studied, but primarily in developed countries with a focus on other cognitive measures or batteries. The objectives of this study were to analyze the relationship between the BICAMS data and key clinical and sociodemographic variables in the Argentine MS population. A total of 50 MS patients were administered the Argentinean BICAMS Battery, comprised of the Symbol Digit Modalities Test (SDMT), the California Verbal Learning Test I (CVLT I), and the Brief Visuospatial Memory Test Revised (BVMTR). Disease progression, fatigue, depression, self-reported and informant report cognitive status, and employment status were assessed. Disease progression and employment status were most strongly associated with overall BICAMS performance (η2 effect size values ranging from .302 to .624, all comparisons statistically significant). Informant rating of patient cognition, age, depression, disease duration, fatigue, and work hours were significantly associated as well. Gender, years of education, and patient-reported cognitive status were nonpredictive. A similar pattern was seen at the individual test level, with more variables related to the SDMT and CVLT I than BVMTR. BICAMS is strongly associated with overall disease progression and employment status.

Relationship between function and resting state functional magnetic resonance imaging amplitude of low-frequency fluctuations in childhood and adolescence-first-onset obsessive-compulsive disorder

Objective To investigate the characteristics and relationship of cognitive function and resting state functional magnetic resonance imaging(fMRI) amplitude of low-frequency fluctuations (ALFF)in childhood and adolescence-first-onset obsessive-compulsive disorder(OCD). Methods Twenty-four childhood and adolescence-first-onset OCD patients (patient group) and thirty-three age/gender/education-matched healthy controls (healthy control group) were enrolled in this study.The participants′ cognitive function was tested with trail making test (TMT), symbol coding, Hopkins verbal learning test-revised (HVLT-R), brief visuospatial memory test-revised (BVMT-R), verbal fluency test (VF), digital span test, maze test and Stroop test.Then a resting-state fMRI scan was conducted for each participant.Amplitude of low-frequency fluctuation approach was used to explore the diffe-rences of resting-state brain function between patients and controls, and analyze the significant brain regions by adopting t test.The cognitive functions of patients and healthy control group in the significant brain regions were compared by using Pearson correlation analysis. Results The patient group had lower scores than healthy control group in symbol coding, BVMT-R and digital span test, and the differences were statistically significant [(45.24±10.32)scores vs.(56.85±9.57) scores, (21.94±6.99)scores vs.(30.58±3.92) scores, (64.06±20.00) scores vs.(78.03±18.08) scores; t=3.96, 4.90, 2.50; all P<0.05]. Corrected by Alphasim, patient group showed significantly increased ALFF in the left and right temporal lobe, left and right posterior lobe of cerebellum, right middle temporal gyrus, but ALFF decreased in the area of left and right lenticula, left putamen compared with the healthy control group (all P<0.05 ). The patients group showed that TMT scores were positively correlated with the value of ALFF in the right temporal lobe (r=0.67), and color scores were positively correlated with the value of ALFF in the right middle temporal gyrus (r=0.53), but colour scores were negatively correlated with the value of ALFF in the right temporal lobe (r=-0.54); the healthy control group showed that BVMT-R and digital span test scores were positively correlated with the value of ALFF in the left temporal lobe (r=0.47, 0.41), but digital span test scores were negatively correlated with the value of ALFF in the right temporal lobe (r=-0.49), and colour scores were negatively correlated with the value of ALFF in the left temporal lobe (r=-0.35), while word and color-word scores were negatively correlated with the value of ALFF in the right middle temporal gyrus (r=-0.39, -0.36); the correlation coefficient above had statistical significance (all P<0.05). Conclusions The childhood and adolescence-first-onset OCD patients had cognitive impairment, including speed of processing, visual learning and memory, working memory; and the patients showed abnormal spontaneous neural activity at some brain regions.The cognitive dysfunction may be associated with abnormal spontaneous neuronal activity in childhood and adolescence-first-onset OCD. Key words: Obsessive-compulsive disorder; Child; Adolescent; Cognitive function; Functional magnetic resonance imaging; Amplitude of low-frequency fluctuation

Could Cognitive Assessments Enhance Ability to Detect Transition to Psychosis?

Could Cognitive Assessments Enhance Ability to Detect Transition to Psychosis?

Incidental Learning: A Brief, Valid Measure of Memory Based on the WAIS-IV Vocabulary and Similarities Subtests.

We assessed the validity of a brief incidental learning measure based on the Similarities and Vocabulary subtests of the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV). Most neuropsychological assessments for memory require intentional learning, but incidental learning occurs without explicit instruction. Incidental memory tests such as the WAIS-III Symbol Digit Coding subtest have existed for many years, but few memory studies have used a semantically processed incidental learning model. We conducted a retrospective analysis of 37 veterans with traumatic brain injury, referred for outpatient neuropsychological testing at a Veterans Affairs hospital. As part of their evaluation, the participants completed the incidental learning tasks. We compared their incidental learning performance to their performance on traditional memory measures. Incidental learning scores correlated strongly with scores on the California Verbal Learning Test-Second Edition (CVLT-II) and Brief Visuospatial Memory Test-Revised (BVMT-R). After we conducted a partial correlation that controlled for the effects of age, incidental learning correlated significantly with the CVLT-II Immediate Free Recall, CVLT-II Short-Delay Recall, CVLT-II Long-Delay Recall, and CVLT-II Yes/No Recognition Hits, and with the BVMT-R Delayed Recall and BVMT-R Recognition Discrimination Index. Our incidental learning procedures derived from subtests of the WAIS-IV Edition are an efficient and valid way of measuring memory. These tasks add minimally to testing time and capitalize on the semantic encoding that is inherent in completing the Similarities and Vocabulary subtests.

Embedded performance validity tests within the Hopkins Verbal Learning Test – Revised and the Brief Visuospatial Memory Test – Revised

Objective: Various research studies and neuropsychology practice organizations have reiterated the importance of developing embedded performance validity tests (PVTs) to detect potentially invalid neurocognitive test data. This study investigated whether measures within the Hopkins Verbal Learning Test – Revised (HVLT-R) and the Brief Visuospatial Memory Test – Revised (BVMT-R) could accurately classify individuals who fail two or more PVTs during routine clinical assessment.Method: The present sample of 109 United States military veterans (Mean age = 52.4, SD = 13.3), all consisted of clinically referred patients and received a battery of neuropsychological tests. Based on performance validity findings, veterans were assigned to valid (n = 86) or invalid (n = 23) groups. Of the 109 patients in the overall sample, 77 were administered the HLVT-R and 75 were administered the BVMT-R, which were examined for classification accuracy.Results: The HVLT-R Recognition Discrimination Index and the BVMT-R Retention Percentage showed good to adequate discrimination with an area under the curve of .78 and .70, respectively. The HVLT-R Recognition Discrimination Index showed sensitivity of .53 with specificity of .93. The BVMT-R Retention Percentage demonstrated sensitivity of .31 with specificity of .92.Conclusions: When used in conjunction with other PVTs, these new embedded PVTs may be effective in the detection of invalid test data, although they are not intended for use in patients with dementia.

Does medial temporal lobe thickness mediate the association between risk factor burden and memory performance in middle-aged or older adults with metabolic syndrome?

Metabolic syndrome (MetS) is a cluster of cardiovascular and metabolic abnormalities that together may increase the risk of developing cognitive decline and dementia; however, the neural substrate is incompletely understood. We investigated cortical thickness in the medial temporal lobe (MTL), hippocampal volume, as well as relationships among metabolic risk factor burden, structure and memory performance. Path-analytic models were tested to explore the relations between MetS risk factor, structure and memory performance. Participants were 65 non-demented, middle-aged and older adults, 34 with and 31 without metabolic syndrome. We analyzed archival T1-weighted magnetic resonance imaging (MRI) acquired at 3T and Total Recall and Delayed Recall scores from the Brief Visuospatial Memory Test Revised (BVMT-R). Middle-aged adults with MetS showed less MTL thickness, particularly in entorhinal cortex; while older adults showed a trend for left hippocampal volume loss. Lower MTL thickness, particularly in entorhinal cortex, was associated with greater metabolic risk factor burden in middle-aged adults. In older adults, hippocampal volume was associated with Total Recall and Delayed Recall, while in middle-age entorhinal cortical thickness mediated the association between metabolic disease burden and episodic memory function. The differential findings in middle-aged and older adults with MetS contribute to an understanding of the relationships between metabolic syndrome, structural changes in the brain and increased risk for cognitive decline.

Schizophrenia, smoking status, and performance on the matrics Cognitive Consensus Battery.

Cognitive deficits and high rates of nicotine dependence are consistently documented in the schizophrenia literature. However, there is currently no consensus about how regular smoking influences cognition in schizophrenia or which cognitive domains are most affected by chronic smoking. Previous studies have also failed to disambiguate the effects of chronic nicotine from those of acute exposure. The current study uses a novel approach to testing nicotine addicted patients at a time-point between acute enhancement and withdrawal and implements the MATRICS Cognitive Consensus Battery (MCCB) to compare the overall cognitive performance of regular smokers (n=40) and nonsmokers (n=36) with schizophrenia. Controlling for age, gender, and education, smokers with schizophrenia were significantly more impaired on a visual learning task, the Brief Visuospatial Memory Test-Revised (BVMT-R), than their nonsmoking peers. Among smokers, smoking behavior (i.e., exhaled carbon monoxide levels of smokers) predicted BVMT-R T score; greater smoking was associated with more impaired visual learning. Negative symptom severity was not predictive of greater visual learning deficits in smokers or nonsmokers. Future longitudinal research will be required to determine if there is a dose-response relationship between chronic nicotine and visual learning impairment in patients at various stages of psychotic illness.

The positive effects of high-frequency right dorsolateral prefrontal cortex repetitive transcranial magnetic stimulation on memory, correlated with increases in brain metabolites detected by proton magnetic resonance spectroscopy in recently detoxified alcohol-dependent patients.

ObjectiveTo explore the effect of right dorsolateral prefrontal cortex (DLPFC) repetitive transcranial magnetic stimulation (rTMS) on memory, and its correlation with levels of hippocampal brain metabolites detected by proton magnetic resonance spectroscopy (1H-MRS) in recently detoxified alcohol-dependent patients.Materials and methodsIn this randomized, double-blind sham-controlled trial, alcohol-dependent patients were enrolled and randomized into two groups: the experimental group (rTMS, 10 Hz, on right DLPFC, 20 sessions) and the control group (sham stimulation). Memory function was assessed using Hopkins Verbal Learning Test-Revised (HVLT-R) and Brief Visuospatial Memory Test-Revised (BVMT-R) before and after treatment. 1H-MRS was used to detect the levels of N-acetyl aspartic acid (NAA), choline (Cho), and creatine (Cr) in bilateral hippocampi before and after treatment.ResultsThirty-eight patients (18 in the experimental group and 20 in the control group) were included in the analyses. The experimental group showed significantly greater changes in HVLT-R, BVMT-R, NAA/Cr, and Cho/Cr after rTMS from baseline than the control group. The percentage change in BVMT-R and HVLT-R correlated with the percentage change in NAA/Cr and Cho/Cr in the right brain.ConclusionHigh-frequency right DLPFC rTMS was associated with improvement in memory dysfunction, which is correlated with levels of hippocampal brain metabolites detected by 1H-MRS in recently detoxified alcohol-dependent patients.

Validation of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) in Greek population with multiple sclerosis

BackgroundCognitive impairment is experienced by about 50% of patients with Multiple Sclerosis (MS) worldwide and affects their employment, disease management and quality of life in general. The Brief International Cognitive assessment for MS (BICAMS) is a brief, practical and potentially universal battery for cognitive impairment in MS patients. It consists of three tests: the Symbol Digit Modalities Test (SDMT), the California Verbal Learning Test-2 (CVLT-2) and the Brief Visuospatial Memory Test-Revised (BVMT-R). ObjectiveThe objective of this study was to validate the BICAMS in Greek MS patients and controls. MethodsForty four MS patients and seventy nine healthy control (HC) participants were recruited and tested. They were group matched for age, education, gender and also premorbid cognitive reserve. All of them completed the three tests of the BICAMS battery. Instead of CVLT-2, the Greek validated form (Greek Verbal Learning Test, GVLT), was used. In addition, cognitive reserve was assessed using the Cognitive Reserve Index questionnaire (CRIq) standardized for the Greek population. ResultsSignificant difference was found in the performance of the two groups in all tests (p<0.0001, p<0.02, p<0.009 for SDMT, GVLT and BVMT-R respectively). Test-retest reliability was good for all the tests. Based on the criterion of 1 or more tests below the 5th percentile of healthy controls performance, 47% of patients were found impaired. ConclusionsThe study provides validation of BICAMS in Greek population and therefore facilitates the use of this battery in clinical practice and in future studies of MS patients in Greece.

Effects of body mass index and education on verbal and nonverbal memory

ABSTRACTWe previously reported that higher education protects against executive dysfunction related to higher body mass index (BMI) in younger, but not older, adults. We now extend the previous analyses to verbal and nonverbal memory. Fifty-nine healthy, dementia-free community-dwelling adults ranging in age from 18 to 81 years completed the Hopkins Verbal Learning Test – Revised (HVLT-R) and the Brief Visuospatial Memory Test – Revised (BVMT-R). Self-reported years of education served as a proxy for cognitive reserve. We found that more highly educated individuals maintained their BVMT-R immediate recall performance across the range of BMI, but in less educated individuals, higher BMI was associated with worse performance. Our findings suggest that education may play a protective role against BMI-related nonverbal learning deficits, similar to previous reports for verbal memory and executive functioning. Results highlight the importance of considering educational background when determining the risk for BMI-related cognitive impairment in clinical settings.

Assessing the criterion validity of four highly abbreviated measures from the Minimal Assessment of Cognitive Function in Multiple Sclerosis (MACFIMS)

Objective: Cognitive dysfunction is prevalent in multiple sclerosis. As self-reported cognitive functioning is unreliable, brief objective screening measures are needed. Utilizing widely used full-length neuropsychological tests, this study aimed to establish the criterion validity of highly abbreviated versions of the Brief Visuospatial Memory Test – Revised (BVMT-R), Symbol Digit Modalities Test (SDMT), Delis–Kaplan Executive Function System (D-KEFS) Sorting Test, and Controlled Oral Word Association Test (COWAT) in order to begin developing an MS-specific screening battery. Method: Participants from Holy Name Medical Center and the Kessler Foundation were administered one or more of these four measures. Using test-specific criterion to identify impairment at both −1.5 and −2.0 SD, receiver-operating-characteristic (ROC) analyses of BVMT-R Trial 1, Trial 2, and Trial 1 + 2 raw data (N = 286) were run to calculate the classification accuracy of the abbreviated version, as well as the sensitivity and specificity. The same methods were used for SDMT 30-s and 60-s (N = 321), D-KEFS Sorting Free Card Sort 1 (N = 120), and COWAT letters F and A (N = 298). Results: Using these definitions of impairment, each analysis yielded high classification accuracy (89.3 to 94.3%). Conclusions: BVMT-R Trial 1, SDMT 30-s, D-KEFS Free Card Sort 1, and COWAT F possess good criterion validity in detecting impairment on their respective overall measure, capturing much of the same information as the full version. Along with the first two trials of the California Verbal Learning Test – Second Edition (CVLT-II), these five highly abbreviated measures may be used to develop a brief screening battery.

Regression-Based Norms for the Brief Visuospatial Memory Test-Revised in Italian population and application in MS patients

Objective: The Brief Visuospatial Memory Test-Revised (BVMT-R) is one of the most widely used tests for the assessment of learning and memory in the visual/spatial domain. The aim of this study was to use multiple regression to derive normative data for the use of BVMT-R in an Italian population. Method: We employed a regression-based norms procedure to maximally utilize a relatively small sample while controlling for a variety of demographic factors in addition to age. Additionally, we used these norms to compare the performance of Italian healthy controls with patients diagnosed with multiple sclerosis (MS), thereby providing evidence of the method’s validity. Results: A total of 200 healthy volunteers and 70 MS patients participated in this study and completed the BVMT-R according to the published procedures. Regression-based norms were generated for the Italian sample and are presented herein. Conclusions: Using these norms, the performance of the MS patients was found to be significantly worse than that of the controls.

A new assessment tool for patients with multiple sclerosis from Spanish-speaking countries: validation of the Brief International Cognitive Assessment for MS (BICAMS) in Argentina

Background: The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) is an international assessment tool for monitoring cognitive function in multiple sclerosis (MS) patients. BICAMS comprises the Symbol Digit Modalities Test (SDMT), the California Verbal Learning Test – Second Edition (CVLT II) and the Brief Visuospatial Memory Test – Revised (BVMT-R). Our objective was to validate and assess the reliability of BICAMS as applied in Argentina and to obtain normative data in Spanish for this population. Method: The sample composed of 50 MS patients and 100 healthy controls (HC). In order to test its reliability, BICAMS was re-administered in a subset of 25 patients. Results: The sample’s average age was 43.42 ± 10.17 years old, and average years of schooling were 14.86 ± 2.78. About 74% of the participants were women. The groups did not differ in age, years of schooling, or gender. The MS group performed significantly worse than the HC group across the three neuropsychological tests, yielding the following Cohen’s d values: SDMT: .85; CVLT I: .87; and BVMT-R: .40. The mean raw scores for Argentina normative data were as follows: SDMT: 56.71 ± 10.85; CVLT I: 60.88 ± 10.46; and BVMT-R: 23.44 ± 5.84. Finally, test–retest reliability coefficients for each test were as follows: SDMT: r = .95; CVLT I: r = .87; and BVMT-R: r = .82. Conclusion: This BICAMS version is reliable and useful as a monitoring tool for identifying MS patients with cognitive impairment.

Association of Hippocampal Magnetic Resonance Imaging With Learning and Memory Deficits in HIV-1-Seropositive Patients.

To investigate the relationship between cognitive impairment and hippocampal morphological and functional changes in HIV-seropositive patients. Thirty HIV+ patients who complain of memory decrease and 15 healthy volunteers were recruited. Performances of learning and memory were assessed using Hopkins Verbal Learning Test-Revised (HVLT-R) and Brief Visuospatial Memory Test-Revised (BVMT-R). Bilateral hippocampal volume, apparent diffusion coefficient (ADC) value, fractional anisotropy value, and magnetic resonance spectroscopy variables of bilateral hippocampus and parahippocampal gyrus were detected by 3.0 T magnetic resonance scanner. We found significant differences in all cognitive outcomes but one between HIV+ and HIV- patients. There was a difference in the ADC value of left parahippocampal gyrus between mild-impairment group and severe-impairment group (P = 0.018). We found differences in the choline (Cho), Cho/creatinine (Cr), and N-acetylaspartate/Cr of left hippocampus (P = 0.002, P = 0.008, P = 0.002) and the Cho/Cr of right parahippocampal gyrus (P = 0.023) between HIV+ and HIV- patients and in the myoinositol of left hippocampus (P = 0.003) and the glutamate and glutamine of right hippocampus (P < 0.001) between mild-impairment group and severe-impairment group. We found significant positive correlations between N-acetylaspartate/Cr of left hippocampus and outcomes of HVLT-R and BVMT-R. There were significant negative correlations between ADC values of hippocampus and parahippocampal gyrus and outcomes of HVLT-R and BVMT-R and between Cho and Cho/Cr of hippocampus and parahippocampal gyrus and outcomes of HVLT-R and BVMT-R. The performance of verbal learning and visual memory was significantly decreased in HIV-1-seropositive patients. The cognitive impairment of HIV infection was associated with conductive function and metabolic changes of hippocampus and parahippocampal gyrus in this study.

NTCT-06HIPPOCAMPAL PROTON MR SPECTROSCOPY IN THE ASSESSMENT OF RADIATION INJURY AND THE CORRELATION TO NEUROCOGNITIVE FUNCTION IMPAIRMENT

BACKGROUND: The hippocampus is considered as the main radiosensitive brain structure responsible for postradiotherapy cognitive decline. We prospectively assessed correlation between memory change and hippocampal N-acetylaspartate (h-tNAA) concentration, a neuronal density and viability marker, measured by 1H-MR spectroscopy (MRS). METHODS: Patients with brain metastases underwent pre-radiotherapy (WBRT, 10x3.0Gy) MRS focused on the h-tNAA concentration and memory testing by Auditory Verbal Learning Test (AVLT) and Brief Visuospatial Memory Test-Revised (BVMT-R) was performed. The both procedures were repeated four months after WBRT and the h-tNAA and memory changes were correlated. RESULTS: Of the 20 patients, ten passed whole protocol. The h-tNAA concentration significantly decreased from pre-WBRT 8.9, 8.86 and 8.88 [mM] in the right, left and both hippocampi to 7.16, 7.65 and 7.4, respectively. In the memory tests a significant decrease was observed in AVLT_total-recall, BVMT-R_total-recall and BVMT-R_delayed-recall. The trend toward correlation was between the decreases in the left h-tNAA and BVMT-R_delayed-recall (p = 0.096) and between the right h-tNAA and AVLT_total-recall (p = 0.0885). CONCLUSIONS: A significant post-WBRT decrease in h-tNAA was proven by MRS as a feasible method for the in vivo investigation of radiation injury. Continuing recruitment focusing on other cognitive tests and metabolites is needed. Supported by grants IGA NT/14600, NT/14120 of the Czech Ministry of Health.

Long-term effect of early-life stress from earthquake exposure on working memory in adulthood.

ObjectiveThe present study aimed to investigate the long-term effect of 1976 Tangshan earthquake exposure in early life on performance of working memory in adulthood.MethodsA total of 907 study subjects born and raised in Tangshan were enrolled in this study. They were divided into three groups according to the dates of birth: infant exposure (3–12 months, n=274), prenatal exposure (n=269), and no exposure (born at least 1 year after the earthquake, n=364). The prenatal group was further divided into first, second, and third trimester subgroups based on the timing of exposure during pregnancy. Hopkins Verbal Learning Test-Revised and Brief Visuospatial Memory Test-Revised (BVMT-R) were used to measure the performance of working memory. Unconditional logistic regression analysis was used to analyze the influential factors for impaired working memory.ResultsThe Hopkins Verbal Learning Test-Revised scores did not show significant difference across the three groups. Compared with no exposure group, the BVMT-R scores were slightly lower in the prenatal exposure group and markedly decreased in the infant exposure group. When the BVMT-R scores were analyzed in three subgroups, the results showed that the subjects whose mothers were exposed to earthquake in the second and third trimesters of pregnancy had significantly lower BVMT-R scores compared with those in the first trimester. Education level and early-life earthquake exposure were identified as independent risk factors for reduced performance of visuospatial memory indicated by lower BVMT-R scores.ConclusionInfant exposure to earthquake-related stress impairs visuospatial memory in adulthood. Fetuses in the middle and late stages of development are more vulnerable to stress-induced damage that consequently results in impaired visuospatial memory. Education and early-life trauma can also influence the performance of working memory in adulthood.

Demographically corrected normative data for the Hopkins Verbal Learning Test-Revised and Brief Visuospatial Memory Test-Revised in an elderly sample

ABSTRACTDemographic variables, such as age, education, and gender, routinely affect performance on neuropsychological tests. Whereas normative data are available to correct for these variables on many tests, data are lacking on the Hopkins Verbal Learning Test-Revised (HVLT-R) and Brief Visuospatial Memory Test-Revised (BVMT-R), especially in the elderly. The current study examined the influence of age, education, and gender on HVLT-R and BVMT-R scores in 290 cognitively intact older adults. Age negatively correlated with nearly every score on the HVLT-R and BVMT-R, and education positively correlated with most scores on these same 2 memory tests. There were fewer gender differences on these tests. Using stepwise multiple regression, HVLT-R and BVMT-R scores were predicted from age, education, and/or gender. When observed scores are compared to these demographically adjusted predicted scores, clinicians can make assumptions about how an individual compared to his/her age-, education-, and gender-matched peers. The current conorming of these 2 memory tests also allows for direct comparison between verbal and visual memory in older patients.

Hippocampal proton MR spectroscopy as a novel approach in the assessment of radiation injury and the correlation to neurocognitive function impairment: initial experiences.

BackgroundThe hippocampus is considered as the main radiosensitive brain structure responsible for postradiotherapy cognitive decline. We prospectively assessed correlation of memory change to hippocampal N-acetylaspartate (h-tNAA) concentration, a neuronal density and viability marker, by 1H-MR spectroscopy focused on the hippocampus.MethodsPatients with brain metastases underwent whole brain radiotherapy (WBRT) to a dose of 30 Gy in ten fractions daily. Pre-radiotherapy 1H-MR spectroscopy focused on the h-tNAA concentration and memory testing was performed. Memory was evaluated by Auditory Verbal Learning Test (AVLT) and Brief Visuospatial Memory Test-Revised (BVMT-R). Total recall, recognition and delayed recall were reported. The both investigation procedures were repeated 4 months after WBRT and the h-tNAA and memory changes were correlated.ResultsOf the 20 patients, ten passed whole protocol. The h-tNAA concentration significantly decreased from pre-WBRT 8.9, 8.86 and 8.88 [mM] in the right, left and both hippocampi to 7.16, 7.65 and 7.4 after WBRT, respectively. In the memory tests a significant decrease was observed in AVLT total-recall, BVMT-R total-recall and BVMT-R delayed-recall. Weak to moderate correlations were observed between left h-tNAA and AVLT recognition and all BVMT-R subtests and between the right h-tNAA and AVLT total-recall.ConclusionsA significant decrease in h-tNAA after WBRT was proven by 1H-MR spectroscopy as a feasible method for the in vivo investigation of radiation injury. Continuing patient recruitment focusing on other cognitive tests and metabolites is needed.