California Verbal Learning Test-II Research Articles

Effects of walking exercise training on learning and memory and hippocampal neuroimaging outcomes in MS: A targeted, pilot randomized controlled trial

PurposeThe current pilot study involved a single-blind, randomized controlled trial (RCT) on the effects of treadmill walking exercise training compared with an active control condition on learning and memory (L/M) and hippocampal neuroimaging outcomes in 11 fully-ambulatory persons with multiple sclerosis (MS) who demonstrated impairments in new learning. MethodsThe study protocol is registered at clinicaltrials.gov: NCT03319771 (February 2018). Eleven fully-ambulatory persons with MS-related impairments in new learning were randomly assigned into either 12-weeks of supervised, treadmill walking exercise training or 12-weeks of low-intensity resistive exercise (active control condition). Participants underwent neuropsychological tests of L/M and hippocampal neuroimaging before and after the 12-week study period; outcomes were administered by treatment-blinded assessors. ResultsThere were moderate-to-large intervention effects on measures of verbal L/M (ηp2 = 0.11, d = 0.63, 95% CI: −0.61, 1.83), whereby those in the intervention condition demonstrated improvement in California Verbal Learning Test-II (CVLT-II) scores compared with the control condition. There were smaller effects on a composite L/M measure (ηp2 = 0.02, d = 0.28, 95% CI: −0.93, 1.46). There were large intervention effects on normalized hippocampal volume (ηp2 = 0.36, d = 1.13, 95% CI: 0.09, 2.82), whereby hippocampal volume was preserved in the intervention condition, compared with hippocampal atrophy in the control condition. By comparison, there were no intervention effects on hippocampal resting-state functional connectivity. ConclusionsCollectively, this study provides initial proof-of-concept data for further examining treadmill walking exercise training as a possible behavioral approach for managing L/M impairment and preserving hippocampal volume as common and debilitating manifestations of MS.

Female Sex as a Protective Factor in the Effects of Chronic Cannabis Use on Verbal Learning and Memory

AbstractObjective:The variability of findings in studies examining the effects of chronic cannabis use on neuropsychological functioning highlights the importance of examining contributing factors. Few studies examine the role of sex in the relationship between cannabis and neuropsychological functioning, despite known neurobiological structural differences between males and females. This study examined whether males and females experience differential cognitive effects of chronic cannabis use.Method:Chronic cannabis users (3+ days per week for >12 months, n = 110, 72% male) and non-users (n = 71, 39% male) completed a neuropsychological test battery. Two multivariate analyses of covariance (MANCOVAs) examined for sex differences in performance within users and non-users on neuropsychological tests, controlling for potential confounding variables. Bonferroni corrections were applied to adjust for multiple comparisons.Results:Male and female cannabis users did not differ in cannabis use variables. Female cannabis users performed better than males on multiple subtests of the California Verbal Learning Test-II (CVLT-II), a verbal learning and memory test. Male cannabis users performed better than female users on Trial 1 of the CVLT-II (p = .002), and Trail Making Test B (p = .001), which measure attention and cognitive flexibility, respectively. Non-user males and females performed comparably, with the exception of Trail Making Test B (p = .001).Conclusions:Results suggest that chronic cannabis use differentially impacts males and females, with females exhibiting better verbal learning and memory despite males demonstrating better attention and cognitive flexibility. Further research is needed to understand the potential protective mechanism of female sex on learning and memory effects of cannabis use.

A Retrospective Exploratory Analysis on Cardiovascular Risk and Cognitive Dysfunction in Multiple Sclerosis.

Background. Cardiovascular comorbidities have been associated with cognitive decline in the general population. Objectives. To evaluate the associations between cardiovascular risk and neuropsychological performances in MS. Methods. This is a retrospective study, including 69 MS patients. For all patients, we calculated the Framingham risk score, which provides the 10-year probability of developing macrovascular disease, using age, sex, diabetes, smoking, systolic blood pressure, and cholesterol levels as input variables. Cognitive function was examined with the Brief International Cognitive Assessment for MS (BICAMS), including the Symbol Digit Modalities Test (SDMT), the California Verbal Learning Test-II (CVLT-II), and the Brief Visuospatial Memory Test-Revised (BVMT-R). Results. Each point increase of the Framingham risk score corresponded to 0.21 lower CVLT-II score. Looking at Framingham risk score components, male sex and higher total cholesterol levels corresponded to lower CVLT scores (Coeff = −8.54; 95%CI = −15.51, −1.57; and Coeff = −0.11; 95%CI = −0.20, −0.02, respectively). No associations were found between cardiovascular risk and SDMT or BVMT-R. Conclusions. In our exploratory analyses, cardiovascular risk was associated with verbal learning dysfunction in MS. Lifestyle and pharmacological interventions on cardiovascular risk factors should be considered carefully in the management of MS, given the possible effects on cognitive function.

Age of onset of adolescent binge drinking is differentially associated with cortical thickness in post‐9/11 adult Veterans

Adolescence is a critical period for neural development andhas been associated with high rates of alcohol abuse. This research examined potential long-termbrain and behavioral effectsof early versus late-onset adolescent binge drinkingin an adult sample of post-9/11 Veterans. We compared cortical thickness measures in Veterans with a historyofbinge drinking that beganbefore the age of 15 (n=50; mean age=32.1years) to those with a history ofbinge drinkingwith onsetafter the age of 15 (n=300; mean age=32.1years). Data processing was conducted with FreeSurfer. A targeted neuropsychological battery (Digit Span test,Delis-Kaplan Executive Function SystemColor-Word Interference Test, California Verbal Learning Test-II) was used to examine the relationships between cortical thickness and attention, memory, and inhibition. A reference group of social drinkers with no history of early binge drinking (n=31) was usedto provide normative data. Early-onset adolescent binge drinkers(EBD)hadgreater corticalthickness in several regions thanlate-onset adolescent binge drinkers(LBD); both binge-drinking groups hadgreatercortical thicknessthanthe reference group. There was a stronger negative association between cortical thickness and age inEBDs thanLBDs in the (i) lateral orbitofrontal cortex, (ii) supramarginal gyrus, (iii) paracentral lobule, and (iv) anterior caudal cingulate. Poorer performance on the attention and inhibition tasks in the EBDswasalso associated with thicker cortices. This study demonstrates greater cortical thickness across frontoparietal regions in adults who began binge drinking in early versus late adolescence. A stronger negative association between cortical thickness and age in the EBDs suggests that early-onset adolescent binge drinking may be associated with accelerated cortical thinning. Thicker cortex in these regions, which are known to mediate inhibitory control, may increase impulsive behavior and contribute to the risk of alcohol addiction.

The Effect of Cumulative Lifetime Estrogen Exposure on Cognition in Depressed versus Non-Depressed Older Women

<h3>Introduction</h3> There are sex differences in the prevalence and age-matched incidence of Alzheimer's Disease (AD), with women constituting up to two-thirds of individuals living with AD in the United States. Symptoms of depression and anxiety are also higher in women and can increase dementia risk. Additionally, the decline in estrogen level impacts cognitive function, often leading to difficulties with memory, attention, and concentration. Estrogen withdrawal during menopause also precipitates an increase in depressive symptoms and cognitive decline. Cumulative lifetime estrogen exposure (CLEE), estimated by variables known to influence estrogen levels across the life span, has been correlated with cognitive function later in life. In particular, higher levels of CLEE are associated with improvement in memory performance in older women. Our report is the first to examine how CLEE relates to depression and cognitive function in older women with depression compared to non-depressed controls. <h3>Methods</h3> A total of 135 participants aged 60 years and older were included in the analysis. Sixty-four clinically depressed women (mean age 69.1 (SD 6.4) years) were compared to 71 non-depressed age-matched controls (mean age 66.1 (SD 8.3) years) using a lifetime estrogen exposure questionnaire. Depressed participants were included with the 24-item Hamilton Rating Scale for Depression (HAMD) score of > 14 at baseline. CLEE was defined by combining the reproductive span (age of menopause minus age of menarche) and any post-menopausal hormone replacement therapy use. Participants were divided into higher versus lower CLEE groups based on a median of 480 months of estrogen exposure. Participants completed a comprehensive neuropsychological test battery that evaluated learning (California Verbal Learning Test-II [Trial 1 through 5 Total] or Hopkins Verbal Learning Test [Total Recall], Rey–Osterrieth Complex Figure Test [3-minute recall]); delayed recall (California Verbal Learning Test-II [long delayed free recall] or Hopkins Verbal Learning Test [Delayed Recall], Rey–Osterrieth Complex Figure Test [30-minute delayed recall]); and executive functioning (Trail Making Test B, Controlled Oral Word Association test [FAS]).We transformed raw scores to <i>z</i>-scores for each test score for each participant. <i>Z-</i>scores were reversed when necessary so that high <i>z</i>-scores represented good performance for all measures. These <i>z</i>-scores were averaged within each neuropsychological domain to produce composite scores.General linear models were used to examine whether cognitive domain scores were associated with CLEE in depressed and non-depressed women, controlling for age, educational level and ethnicity. <h3>Results</h3> Depressed and non-depressed women had significantly different levels of CLEE: 448.6 (SD 66.0) vs. 487.3 (SD 108.6), t(133) = 2.52, p = .01. CLEE was not associated with cognitive performance in the combined sample of depressed and non-depressed participants, controlling for depression status. However, amongst non-depressed participants, higher CLEE group was significantly associated with better performance on delayed recall (F(1,60) = 5.45, p=0.02; effect size = .64). <h3>Conclusions</h3> Consistent with previous findings, higher CLEE was associated with better performance on delayed recall, though we found this effect only among non-depressed participants. This suggests an enduring protective role of estrogen on memory in non-depressed older postmenopausal women. CLEE was not associated with cognitive function in older women with depression. Further research should examine the role of the CLEE in older women in depression, treatment response and in cognitive decline. <h3>Funding</h3> K24 AT009198 R01 AT008383 (NCCIH) R01 AT008383-04S (NCCIH)

Memory in multiple sclerosis: A reappraisal using the item specific deficit approach.

As many as 65% of people with multiple sclerosis (MS) have clinically significant memory impairment, but the nature of this deficit is controversial. Some investigations suggest that an inability to retrieve newly learned information from memory is prominent, whereas others imply that compromised acquisition accounts for impairment. Prior research has not simultaneously evaluated acquisition and retrieval processes in MS, and fewer have attempted to account for initial acquisition when studying retrieval. The Item Specific Deficit Approach (ISDA) offers a method of quantifying acquisition, retrieval, and retention processes, with the latter two mechanisms being adjusted for initial acquisition. To simultaneously quantify acquisition and retrieval abilities, the ISDA was applied to list learning performance in two independent samples of people with MS and corresponding healthy comparison groups. Study 1 included 85 people with MS and 47 healthy individuals. Study 2 involved a separate sample of 79 people with MS and 22 healthy people. They were administered neuropsychological batteries, and participants with MS were classified as globally impaired or unimpaired. The California Verbal Learning Test-II was administered to assess new-learning in both studies, and responses were scored using the ISDA. Both studies revealed that cognitively impaired people with MS manifest weaknesses involving acquisition and retrieval. Nearly identical effect sizes emerged across samples, with cognitive impairment achieving a medium effect upon acquisition and a large effect upon retrieval. These findings accord well with previous research showing diminished acquisition and retrieval among people with MS. The results may also reconcile contradictory findings in the extant literature by showing that memory impairment in MS is not exclusively attributable to either acquisition or retrieval. Rather, both processes may manifest across people with MS. The replication across samples with nearly identical effect sizes implies that these effects are reliable and possess external validity. These data hold implications for memory rehabilitation interventions involving people with MS, and suggest that acquisition and retrieval processes should be addressed in treatment. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Transcranial Photobiomodulation to Improve Cognition in Gulf War Illness.

Introduction: Approximately 25–30% of veterans deployed to Kuwait, 1990-91, report persistent multi-symptom Gulf War Illness (GWI) likely from neurotoxicant exposures. Photobiomodulation (PBM) in red/near-infrared (NIR) wavelengths is a safe, non-invasive modality shown to help repair hypoxic/stressed cells. Red/NIR wavelengths are absorbed by cytochrome C oxidase in mitochondria, releasing nitric oxide (increasing local vasodilation), and increasing adenosine tri-phosphate production. We investigated whether PBM applied transcranially could improve cognition, and health symptoms in GWI.Materials and Methods: Forty-eight (40 M) participants completed this blinded, randomized, sham-controlled trial using Sham or Real, red/NIR light-emitting diodes (LED) applied transcranially. Fifteen, half-hour transcranial LED (tLED) treatments were twice a week (7.5 weeks, in-office). Goggles worn by participant and assistant maintained blinding for visible red. Pre-/Post- testing was at Entry, 1 week and 1 month post- 15th treatment. Primary outcome measures were neuropsychological (NP) tests; secondary outcomes, Psychosocial Questionnaires, including PTSD.Results: Primary Analyses (all participants), showed improvement for Real vs. Sham, for Digit Span Forwards (p < 0.01); and a trend for Trails 4, Number/Letter Sequencing (p < 0.10). For secondary outcomes, Real group reported more improvement on the SF-36V Plus, Physical Component Score (p < 0.08). Secondary Analyses included only subjects scoring below norm (50%ile) at Entry, on specific NP test/s. Real and Sham improved at 1 week after 15th treatment; however, at 1 month, only those receiving Real improved further: Digit Span Total, Forwards and Backwards; Trails 4, Number/Letter Sequencing; California Verbal Learning Test-II, long delay free recall; Continuous Performance Test-II, False Alarm Rate; and Color-Word Interference, Stroop, Trial 3, Inhibition; Sham group worsened, toward Entry values. Only those with more post-traumatic stress disorder (PTSD) symptomatology at Entry, receiving Real, continued to have additional PTSD reduction at 1 month; Sham regressed.Conclusion: This study was underpowered (n = 48), with large heterogeneity at Entry. This likely contributed to significance or trend to significance, for only two of the NP tests (Digit Span Forwards; Trails 4, Number/Letter Sequencing) and only one general health measure, the SF-36V Plus, Physical Component Score. More subjects receiving Real, self-reported increased concentration, relaxation and sleep. Controlled studies with newer, transcranial LED home treatment devices are warranted; this is expected to increase enrollment.Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT01782378.

Brief international cognitive assessment for multiple sclerosis (BICAMS) cut-off scores for detecting cognitive impairment in multiple sclerosis

Background: Cognitive impairment (CI) affects 35–65% of multiple sclerosis (MS) patients. The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) has been proposed as a highly feasible and cost-effective tool for cognitive impairment (CI) screening in MS. The tool yields scores that should, ideally, readily convey patients’ cognitive status to the clinicians. Methods: To this aim, this study sought for cut-off scores of the three BICAMS test in a sample of 960 MS patients. We used three definitions for CI: 1.5, 1,65 and 2 standard deviations below the mean. Receiver operating characteristic (ROC) statistics helped us determine the capacity of BICAMS to diagnose CI. Optimal cut-offs were determined by the delta distance. Positive and negative predictive values, along with overall accuracy were also calculated. Results: Symbol Digit Modalities Test (SDMT) and California Verbal Learning Test-II (CVLT-II) showed a diagnostic accuracy ranging from 74.6 to 77.4%, across the three CI definitions. The accuracy of Brief Visuospatial Memory Test-Revised (BVMT-R) was over 88%. SDMT had a balanced sensitivity, while CVLT-II and BVMT-R had higher specificities than sensitivities at detecting CI. More specifically, BVMT-R showed 100% specificity for all CI definitions. Raw cut-off scores for BICAMS tests are also provided within the manuscript, along with the diagnostic calculations. Conclusions: In this study, we confirmed that BICAMS is a good screening tool for CI and that simple cut-offs can be used in the everyday neurological practice.

Pythagorean Self Awareness Intervention in Caregivers of Patients with Motor Disabilities.

Caregiving for disabled people is a strenuous task often provided by family members, with adverse repercussions on the caregivers’ health. The aim of this study was to evaluate, for the first time, the effects of a novel cognitive-based stress management technique, the Pythagorean Self-Awareness Intervention (PSAI) on the stress levels and other cognitive and psychological characteristics of non-paid caregivers of patients with motor disability. In this quasi-experimental study, 59 caregivers of first-degree relatives with motor disabilities due to chronic neurological diseases, inpatients at a Rehabilitation Center, in Athens, Greece, were assigned to an intervention (PSAI, n=28) and a control group (received unstructured consultation, n=31). Psychological, cognitive, and sleep-related measurements (Zarit Burden Interview tool, Pittsburgh Sleep Quality Index, Self-Efficacy Scale, Depression, Anxiety and Stress Scale, Symbol Digit Modalities Test, California Verbal Learning Test-II, Brief Visuospatial Memory Test-Revised) were held at baseline and after 8 weeks (at completion of PSAI) in both groups. PSAI was found to decrease caregivers’ stress, depressive symptoms and anxiety and improve their sleep quality, visual memory, self-efficacy, and cognitive speed processing. Future randomized controlled studies are needed to investigate the effects of this novel intervention in larger samples of caregivers.

Hippocampal atrophy and cognitive function in transient ischemic attack and minor stroke patients over three years.

Transient ischemic attack (TIA) and minor ischemic stroke (IS) is associated with a increased risk of late life dementia. In this study we aim to study the extent to which the rates of hippocampal atrophy in TIA/IS differ from healthy controls, and how they are correlated to neuropsychological measurements. TIA or minor stroke patients were tested with a neuropsychological battery including tests of executive function, and verbal and non-verbal memory at three time points out to 3 years. Annualized rates of hippocampal atrophy in TIA/IS patients were compared to controls. A linear-mixed regression model was used to assess the difference in rates of hippocampal atrophy after adjusting for time and demographic characteristics. TIA/IS patients demonstrated a higher hippocampal atrophy rate than healthy controls over a 3-year interval: the annual percentage change of the left hippocampal volume was 2.5% (78mm3 per year (SD 60)) for TIA/IS patients compared to 0.9% (29mm3 per year (SD 32)) for controls (p<0.01); and the annual percentage change of the right hippocampal volume was 2.5% (80mm3 per year (SD 46)) for TIA/IS patients compared to 0.5% (17mm3 per year (SD 33)) for controls (P<0.01). Patients with higher annual hippocampal atrophy were more likely to report higher TMT B times, but lower ROC total score, lower California Verbal Learning Test-II total recall, and lower ROC Figure recall scores longitudinally. TIA/IS patients experience a higher rate of hippocampal atrophy independent of TIA/IS recurrence that are associated with changes in episodic memory and executive function over 3 years.

Consequences of mesial temporal sparing temporal lobe surgery in medically refractory epilepsy

ObjectiveWe compared long-term seizure outcome, neuropsychological outcome, and occupational outcome of anterior temporal lobectomy (ATL) with and without sparing of mesial structures to determine whether mesial sparing temporal lobectomy prevents memory decline and thus disability, with acceptable seizure outcome. MethodsWe studied patients (n = 21) and controls (n = 21) with no evidence of mesial temporal sclerosis (MTS) on MRI who had surgery to treat drug-resistant epilepsy. Demographic and pre- and postsurgical clinical characteristics were compared. Patients had neuropsychological assessment before and after surgery. Neuropsychological analyses were limited to patients with left-sided surgery and available data (n = 14 in each group) as they were at risk of verbal memory impairment. The California Verbal Learning Test II (CVLT-II) (sum of trials 1–5, delayed free recall) and the Logical Memory subtest of the Wechsler Memory Scale III or IV (WMS-III or WMS-IV) (learning and delayed recall of prose passages) were used to assess verbal episodic learning and memory. Seizure and occupational outcomes were assessed. ResultsThe chance of attaining seizure freedom was similar in the two groups, so sparing mesial temporal structures did not lessen the chance of stopping seizures. Sparing mesial temporal structures mitigated the extent of postoperative verbal memory impairment, though some of these individuals suffered decline as a consequence of surgery. Occupational outcome was similar in both groups. SignificanceMesial temporal sparing resections provide a similar seizure outcome as ATL, while producing a better memory outcome. Anterior temporal lobectomy including mesial structure resection did not increase the risk of postoperative disability.

STN-DBS Increases Proactive but Not Retroactive Interference During Verbal Learning in PD.

Proactive interference (PI) refers to the interference of previously learned materials with new learning and reflects the failure of inhibitory processes in memory. Retroactive interference (RI) refers to the unfavorable effect of new learning on the later recall of previously learned information. Although subthalamic nucleus deep brain stimulation (STN-DBS) does not affect global cognition in Parkinson's disease (PD), it has negative effects on specific aspects of cognition, including verbal fluency and executive inhibitory control of action.To this end, we set to test the acute effect of STN-DBS on PI and RI during verbal learning. Twenty PD patients with STN-DBS were tested on the California Verbal Learning Test-II using an ON/OFF stimulation design. The results showed that stimulation increased PI ON stimulation (P = 0.012) but had no effect on RI (P = 0.816). Our results extend the role of STN to the inhibitory control that is required during memory encoding or recall for prevention of PI. © 2020 International Parkinson and Movement Disorder Society.

Can accelerated transcranial direct current stimulation improve memory functions? An experimental, placebo-controlled study

The aim of this study was to investigate whether transcranial Direct Current Stimulation (tDCS) could improve verbal memory functions in healthy old and younger participants. We hypothesized that active tDCS led to significantly improved memory function, compared to placebo tDCS. Forty healthy participants (20 old and 20 younger participants) were included in the study. We applied a novel stimulation protocol, where six sessions of anodal tDCS were administrated during two consecutive days. Each tDCS session lasted 30 min. The current intensity was 2mA and the stimulation area was the left temporal lobe at T3 in the 10–20 EEG system. Immediate recall, delayed recall and recognition memory were assessed with California Verbal Learning Test II (CVLT-II) and executive functions were assessed with the Trail Making Test (TMT) before the first tDCS session and after the last tDCS session. Half of the participants received placebo tDCS, whereas the other half received active tDCS. We did not reveal any significant differences between active and placebo tDCS in memory functions. However, there was a significant difference between active and placebo tDCS in executive function measured by the Trail Making Test (TMT). This experimental study failed to reveal significant differences between active and placebo accelerated tDCS for verbal memory functions. However, accelerated tDCS was found to be well-tolerated in this study.

The weak association between neurofilament levels at multiple sclerosis onset and cognitive performance after 9 years

BackgroundNeurofilament light chain level in serum (sNfL) and cerebrospinal fluid (CSF-NfL) is a promising biomarker of disease activity in multiple sclerosis (MS). However, predictive value of neurofilaments for development of cognitive decline over long-term follow-up has not been extensively studied. ObjectiveTo investigate the relationship between early neurofilament levels and cognitive performance after 9-years. MethodsWe included 58 MS patients from the SET study. sNfL levels were measured at screening, at 1 and 2 years. CSF-NfL were measured in 36 patients at screening. Cognitive performance was assessed by the Brief International Cognitive Assessment for Multiple Sclerosis and the Paced Auditory Serial Addition Test-3 s at baseline, at 1, 2 and 9 years. Association between neurofilament levels and cognition was analyzed using Spearman´s correlation, logistic regression and mixed models. ResultsWe did not observe associations among early sNfL levels and cross-sectional or longitudinal cognitive measures, except of a trend for association between higher sNfL levels at screening and lower California Verbal Learning Test-II (CVLT-II) scores at year 1 (rho=-0.31, unadjusted p = 0.028). Higher sNfL level was not associated with increased risk of cognitive decline, except of a trend for greater risk of CVLT-II decrease in patients with higher sNfL levels at 1 year (OR=15.8; 95% CI=1.7–147.0; unadjusted p = 0.015). Similar trends were observed for CSF-NfL. ConclusionWe found only weak association between sNfL levels at disease onset and evolution of cognitive performance over long-term follow-up.

A-03 Executive and Memory Components of Prospective Memory in Aging and Dementia

Abstract Objective Prospective memory (PM) involves remembering to perform an intended action in the future. PM is critical for older adults’ daily functioning. This ability is not a unitary construct, so in this study, we determined the roles of executive and memory functioning in different subtypes of PM, including simple PM (ability to execute a single action in the future) and complex PM (ability to execute different actions depending on the context). Method Participants included 58 healthy older adults, 64 persons with mild cognitive impairment (MCI), and 17 participants with Alzheimer’s disease. Simple PM was defined as remembering to ask the examiner for a pill after each neuropsychological test performed. Complex PM was defined as asking for the correct number of pills based on whether the test just completed involved memory (1 pill) or not (2 pills). An Executive composite score included Trail Making Test-B and FAS. The Memory composite score included delayed recall from the California Verbal Learning Test-II and the Brief Visuospatial Memory Test-Revised. Results Whole group analyses showed that simple PM was significantly correlated with memory functions, and complex PM was significantly correlated with both memory and executive functions. Specific to the MCI group, regression analyses showed that executive and memory skills predicted both simple PM and complex PM. Conclusions These findings suggest that complex PM requires more executive demands than simple PM. For those with MCI, better executive and memory functions predicted PM generally. These findings indicate that both types of PM may be important for assessing the risk state for dementia.

A-08 Predictors of Everyday Problem Solving in Subtypes of Mild Cognitive Impairment

Abstract Objective The Everyday Problems Test (EPT) evaluates problem solving ability needed to complete activities of daily living (ADLs), such as medication and financial management. This study assessed the contributions of executive functioning and subtypes of memory on everyday problem solving in healthy aging, amnestic mild cognitive impairment (MCI), and non-amnestic MCI. Method Participants included healthy older adults (n = 56) and individuals with MCI (amnestic MCI n = 25; non-amnestic MCI n = 36). Composite scores were derived for Executive Functioning (Trail Making Test-B and FAS), Immediate Memory (short delayed recall scores from the California Verbal Learning Test-II and the Brief Visuospatial Memory Test-Revised) and Delayed Memory (long delayed recall scores from both memory tests). The EPT was the measure of everyday problem solving. Results We found that for the control group and the entire MCI group (both amnestic and non-amnestic MCI), executive functioning, immediate memory, and delayed memory predicted problem solving. When examining the separate MCI subtypes, executive functioning and delayed memory predicted problem solving in non-amnestic-MCI, but not amnestic MCI. Conclusions Findings suggest that healthy older adults engage a range of cognitive skills (executive and memory skills) when they engage in everyday problem-solving. Executive and memory skills are also utilized for those with non-amnestic MCI when performing ADLs. Interestingly, in those exhibiting memory impairment and with increased risk for the Alzheimer’s type of dementia, memory and executive functions do not predict ADL problem solving. These findings indicate that people with amnestic-MCI may benefit from being given compensatory strategies to support their memory difficulties when they must perform everyday problem-solving.

A-213 Comparing WAIS-IV Reliable Digit Span and Age Corrected Scaled Score’s Performance Validity Cutoffs when Patients’ Effort is Determined by One or More Performance Validity Tests (PVTs)

Abstract Objective The purpose of the present study was to compare Wechsler Adult Intelligence Scale-IV (WAIS-IV) Reliable Digit Span (RDS) and Digit Span Age-Corrected Scaled Score (DS-ACSS) sensitivity and specificity, when the effort criterion was determined by between one and five performance validity test (PVT) cut scores. Method Data were collected from 82 adults (18–49) referred for clinical questions of multiple sclerosis, mild traumatic brain injury, and attention deficit hyperactivity disorder. Patients were administered full neuropsychological batteries,with different combinations of PVTs (including Advanced Clinical Solutions Word Choice, Animals raw score, Trails A T-score, Wisconsin Card Sorting Test [WCST; Suhr &amp; Boyer] equation, and California Verbal Learning Test-II Forced Choice). Chi-square and receiver operating characteristic (ROC) analyses were utilized. Results Using established RDS (≤7) and DS-ACSS (≤6) cut scores, specificity was highest (90&amp;37; and 86%, respectively), with equivalent sensitivity (90%), when effort was determined by WCST (Suhr &amp; Boyer) equation failure alone. Related area under the curve for RDS was .90 (CI = .76–1.0) and for DS-ACSS was .88 (CI = .74–1.0). Conclusions In this clinical sample, the highest sensitivity and specificity were observed when the RDS cut score was utilized, and effort was based on the WCST criterion. However, the DS-ACSS cut score resulted in strong sensitivity/specificity combinations across more effort classification groups.

A comparative study of the effects of yoga and clinical Pilates training on walking, cognition, respiratory functions, and quality of life in persons with multiple sclerosis: A quasi-experimental study

ObjectiveThe purpose was to investigate the effects of yoga and clinical Pilates training on walking, respiratory muscle strength, cognition, and quality of life and compare the effects of two popular exercise methods in persons with multiple sclerosis (pwMS). MethodsTwenty-eight pwMS (Pilates group = 16, yoga group = 12) received the program once a week for eight weeks in addition to home exercises. At baseline and the end of the training, participants underwent assessments. The outcome measures were walking speed, mobility, balance confidence, respiratory muscle strength, cognition, and quality of life. ResultsFollowing the program, there was no significant difference in mobility (p = 0.482), perceived walking quality (p = 0.325), respiratory muscle strength (maximum inspiratory pressure: p = 0.263, maximum expiratory pressure: p = 0.866), and cognition (Symbol Digit Modalities Test: p = 0.324, California Verbal Learning Test-II: p = 0.514, Brief Visuospatial Memory Test-Revised: p = 0.279) between the two groups. Improvements were higher in balance confidence (p = 0.006), walking speed (p = 0.004), and quality of life (p = 0.019) in the clinical Pilates group compared to the yoga group. ConclusionThis study showed positive effects in walking and respiratory aspects in pwMS who received yoga and clinical Pilates training. Pilates training was superior in improving walking speed, quality of life, and balance confidence compared to yoga training.

Neural mechanisms of AVPR1A RS3-RS1 haplotypes that impact verbal learning and memory

Converging evidence from both human and animal studies has highlighted the pervasive role of the neuropeptide arginine vasopressin (AVP), which is mediated by arginine vasopressin receptor 1A (AVPR1A), in both social and nonsocial learning and memory. However, the effect of genetic variants in AVPR1A on verbal learning and memory is unknown. The hippocampus is a heterogeneous structure that consists of several anatomically and functionally distinct subfields, and it is the principal target structure for the memory-enhancing effect of AVP. We tested the hypothesis that genetic variants in the RS3 and RS1 repeat polymorphisms may influence verbal learning and memory performance evaluated by the California Verbal Learning Test-II (CVLT-II) by modulating the gray matter volume (GMV) and resting-state functional connectivity (rsFC) of whole hippocampus and its subfields in a large cohort of young healthy subjects (n = 1001). Using a short/long classification scheme for the repeat length of RS3 and RS1, we found that the individuals carrying more short alleles of RS3-RS1 haplotypes had poorer learning and memory performance compared to that of those carrying more long alleles. We also revealed that individuals carrying more short alleles exhibited a significantly smaller GMV in the left cornu ammonis (CA)2/3 and weaker rsFC of the left CA2/3-bilateral thalamic (primarily in medial prefrontal subfields) compared to those carrying more long alleles. Furthermore, multiple mediation analysis confirmed that these two hippocampal imaging measures jointly and fully mediated the relationship between the genetic variants in AVPR1A RS3-RS1 haplotypes and the individual differences in verbal learning and memory performance. Our results suggest that genetic variants in AVPR1A RS3-RS1 haplotypes may affect verbal learning and memory performance in part by modulating the left hippocampal CA2/3 structure and its rsFC with the thalamus.

Prefrontal GABA Levels Correlate with Memory in Older Adults at High Risk for Alzheimer's Disease.

γ-Aminobutyric acid (GABA), a primary inhibitory neurotransmitter in the brain, plays a significant role in aging and in neurodegenerative disorders, including Alzheimer’s disease (AD). We investigated the relationship between GABA levels in the dorsomedial/dorsoanterolateral prefrontal cortex (DM/DA-PFC) and memory in high-AD risk participants. Thirty-eight participants (14 Cognitively Normal [CN], 11 with Subjective Cognitive Decline (SCD), and 13 Mild Cognitive Impairment [MCI]) underwent magnetic resonance spectroscopy at 3 Tesla. SCD and MCI participants were grouped together to form a single high-AD risk group (N = 24) for the purposes of statistical analyses. Partial correlations of GABA+/Cr level with verbal memory, assessed on California Verbal Learning Test-II, and nonverbal memory, assessed on Brief Visuospatial Memory Test and Rey-Osterrieth test, were examined separately within the high-AD risk and CN groups. GABA+/Cr levels were positively correlated with long-delayed verbal memory (r = 0.69, P = 0.009) and immediate nonverbal memory (r = 0.97, P = 0.03) in high-AD risk, but not in CN participants. These results remained significant after controlling for depression. These preliminary findings, which require replication due to the limited sample sizes, are the first report of an association between GABA+/Cr levels within the DM/DA-PFC and memory performance in high-AD risk individuals.