Changes In Verbal Memory Research Articles

Altered hippocampal centrality and dynamic anatomical covariance of intracortical microstructure in first episode psychosis.

Hippocampal circuitry has been posited to be fundamental to positive symptoms in psychosis, but its contributions to other factors important for outcome remains unclear. We hypothesized that longitudinal changes in the hippocampal circuit and concomitant changes of intracortical microstructure are altered in first episode psychosis (FEP) patients and that such changes are associated with negative symptoms and verbal memory. Longitudinal brain scans (2-4 visits over 3-15 months) were acquired for 27 FEP and 29 age- and sex-matched healthy controls. Quantitative T1 maps, sensitive to myelin content, were used to sample the microstructure of the hippocampal subfields and output circuitry (fimbria, alveus, fornix, mammillary bodies), and intracortical regions. Dynamic anatomical covariance in pair-wise regional trajectories were assessed for each subject, and graph theory was used to calculate a participation coefficient metric that quantifies the similarity/divergence between hippocampal and intracortical microstructure. The mean participation coefficient of the hippocampus was significantly reduced in FEP patients compared with controls, reflecting differences in output hippocampal regions. Importantly, lower participation coefficient of the hippocampal circuit was associated with worse negative symptoms, a relationship that was mediated by changes in verbal memory. This study provides evidence for reduced hippocampal centrality in FEP and concomitant changes in intracortical anatomy. Myelin-rich output regions of the hippocampus may be an important biological trigger in early psychosis, with cascading effects on broader cortical networks and resultant clinical profiles.

Top-Down vs. Bottom-Up: A Case Series in Verbal Working Memory Treatments for Chronic Traumatic Brain Injury Deficits

Purpose Individuals with traumatic brain injury may suffer chronic cognitive–linguistic deficits in areas such as verbal working memory, which impede attainment of long-term rehabilitation goals. The purpose of this study was to determine whether individual rehabilitation programs focusing on cognitive skill building of memory and attention in the verbal domain may provide comparable outcomes to traditional compensatory, mnemonics-based training approaches. Method Rhythmic language training is presented as a novel therapeutic tool for targeting discrete cognitive skills that may provide specific benefits for chronic traumatic brain injury symptoms that conventional therapy programs may not. Standardized testing with the California Verbal Learning Test–Second Edition ( Delis, Kramer, Kaplan, & Ober, 2000 ) was used for pre- and posttest comparisons in 2 cases presented as a series. Electroencephalography was employed concurrently with behavioral testing to examine changes in working memory for each case. Results Posttest measurements indicated positive changes in verbal working memory occurred, but to different degrees for each participant. Conclusion The preliminary positive effects observed in standardized testing for the experimental method of rhythmic language training warrant further investigation for potential clinical applications.

Reduction in Whole Brain Volume is Associated with Decline in Verbal Memory Following Prophylactic Cranial Irradiation for Limited-Stage Small-Cell Lung Cancer

Whole brain radiation therapy (WBRT) is associated with both radiographic reduction in brain volume and clinical decline in neurocognitive function, but the relationship between these findings is unknown. This study evaluated an association between whole brain volume loss and neurocognitive decline following prophylactic cranial irradiation (PCI) for limited-stage small-cell lung cancer (SCLC). This was a secondary analysis of a prospective clinical trial that accrued patients at a single institution from 2013 to 2016. Patients with limited-stage SCLC and complete response to standard thoracic chemo-radiation received PCI to a total of 25 Gy in 10 fractions, with mean hippocampal dose limited to less than 8 Gy. The primary objective was to determine whether changes in whole brain volume were associated with changes in verbal memory, assessed with the Hopkins Verbal Learning Test-Revised (HVLT-R). Whole brain volumes were measured on MR imaging obtained before and at 6, 12, 18, and 24 months after PCI. Volumes were evaluated as the absolute change (mL) and proportional change (%) compared to baseline. Verbal memory was assessed before and at 6 and 12 months after PCI. Univariate and multivariate linear regression evaluated associations between changes in whole brain volume and verbal memory. Twenty-two patients enrolled. The median whole brain volume before PCI was 1301 mL (range 1056 – 1578). Whole brain volumes progressively decreased following PCI, reaching the greatest extent of reduction at 18 months after PCI (median change -23 mL, range -142 – 20, p = 0.009). On univariate linear regression, decline in the Delayed Recall component of the HVLT-R was significantly associated with absolute and proportional reduction in whole brain volume at 6 months after PCI (β = 0.041/mL, p = 0.02; β = 0.57/%, p = 0.03). On multivariate linear regression, reduction in whole brain volume was associated with decline in the Delayed Recall and Percent Retained components of the HVLT-R, independent of global cognitive function prior to PCI or years of education (Table 1). This is the first study to quantitatively correlate reduction in whole brain volume and decline in neurocognitive function following WBRT. This suggests that loss of brain volume after WBRT may be clinically significant and subsequently impact cognition and quality of life. Formal comparative studies are needed to confirm these findings.Abstract 22; Table 1Multivariate linear regression correlating changes in verbal memory, evaluated by the HVLT-R, and changes in whole brain volume (WBV) after PCI. Covariates in each model included global cognitive function (Mini-Mental State Examination) prior to PCI and years of education.OutcomePredictorβpR2Change in HVLT-R Delayed RecallAbsolute change in WBV (mL)0.074/mL0.0160.35Proportional change in WBV (%)0.99/%0.0150.36Change in HVLT-R Percent RetainedAbsolute change in WBV (mL)0.95/mL0.00420.46Proportional change in WBV (%)12.9/%0.00300.48 Open table in a new tab

A prospective evaluation of whole brain volume loss and neurocognitive decline following hippocampal-sparing prophylactic cranial irradiation for limited-stage small-cell lung cancer.

This study evaluated an association between whole brain volume loss and neurocognitive decline following prophylactic cranial irradiation (PCI) for limited-stage small-cell lung cancer (SCLC). This was a secondary analysis of a prospective clinical trial that accrued patients at a single institution from 2013 to 2016. Patients with limited-stage SCLC treated with standard chemo-radiation received PCI 25Gy/10 fractions, with mean hippocampal dose limited to < 8Gy. Whole brain volumes were measured using MR imaging obtained before and at 6, 12, 18, and 24months after PCI. Verbal memory was measured by the Hopkins Verbal Learning Test-Revised (HVLT-R) before and at 6 and 12months after PCI. Univariate and multivariate linear regression evaluated associations between changes in whole brain volume and verbal memory. Twenty-two patients enrolled. The median whole brain volume before PCI was 1301mL. Subsequent reduction in whole brain volume was greatest at 18months after PCI (median change - 23mL, range - 142 to 20, p = 0.03). At 6months after PCI, reduction in volume was independently associated with decline in verbal memory, measured by two components of the HVLT-R (Delayed Recall: 0.06/mLvolume change, p = 0.046; Percent Retained: 0.66/mL volume change, p = 0.030), when controlling for education and global cognitive function at baseline. This is the first study to correlate reduction in whole brain volume and decline in neurocognitive function following whole brain radiation therapy (WBRT). This suggests that loss of brain volume after WBRT may be clinically significant and subsequently impact cognition and quality of life.

Predicting time to dementia using a quantitative template of disease progression

IntroductionCharacterization of longitudinal trajectories of biomarkers implicated in sporadic Alzheimer's disease (AD) in decades before clinical diagnosis is important for disease prevention and monitoring. MethodsWe used a multivariate Bayesian model to temporally align 1369 Alzheimer's disease Neuroimaging Initiative participants based on the similarity of their longitudinal biomarker measures and estimated a quantitative template of the temporal evolution of cerebrospinal fluid Aβ1−42, p-tau181p, and t-tau and hippocampal volume, brain glucose metabolism, and cognitive measurements. We computed biomarker trajectories as a function of time to AD dementia and predicted AD dementia onset age in a disjoint sample. ResultsQuantitative template showed early changes in verbal memory, cerebrospinal fluid Aβ1–42 and p-tau181p, and hippocampal volume. Mean error in predicted AD dementia onset age was <1.5 years. DiscussionOur method provides a quantitative approach for characterizing the natural history of AD starting at preclinical stages despite the lack of individual-level longitudinal data spanning the entire disease timeline.

A novel cognitive-behavioral stress management method for multiple sclerosis. A brief report of an observational study

ABSTRACTObjectives: Psychological stress is an important risk factor for multiple sclerosis (MS) onset, relapse, neurological symptoms and psychosocial adjustment to the disease. Mounting evidence suggests that stress management could halt the disease progression and improve patients’ wellbeing. The aim of this study was to investigate the effectiveness of a novel cognitive-behavioral stress management technique (called Pythagorean Self-Awareness Intervention – PSAI) routinely used in our clinics in patients with MS.Methods: In this observational study, 148 MS patients receiving PSAI for 8-weeks were compared patients who followed only usual care. Measurements included cognitive function, psychological distress and physical fatigue. Propensity score (PS) methods (given the observational design) and linear mixed models were employed to address study’s endpoints.Results: A total of 128 (86.5%) of MS patients fulfilled the PS criteria for analyses (72 in the PSAI group and 56 in the control group). Patients of tertiary education, longer disease duration, higher cognitive score and psychological distress were more likely to choose to participate in the PSAI group. PSAI patients were found with statistical significant beneficial changes in cognitive speed processing, verbal memory, stress, anxiety, depression and fatigue. Based on the numbers-needed-to-treat of the weighted data, PSAI was particularly effective in improving cognitive speed processing (NNT = 10) and stress (NNT = 12).Discussion: PSAI can benefit cognitive function and psychological distress in MS patients. Future studies should expand these results in randomized trials and by using longer follow-up and MS activity-related endpoints.Abbreviations: BICAMS: Brief International Cognitive Assessment for Multiple Sclerosis BVMT-R: Brief Visuospatial Memory Test Revised CVLT: California Verbal Learning Test DASS: Depression Anxiety Stress Scale EDSS: Expanded Disability Status Scale MS: Multiple Sclerosis NNT: Numbers Needed to Treat PS: Propensity Score PSAI: Pythagorean Self-Awareness Intervention RR: Relapsing Remitting SDMT: Symbol Digits Modalities Test VAS-PF: Visual Analogue Scale Physical Fatigue

Verbal Memory in Late-life Depressions and Normal Ageing

In the present article, authors analyze characteristics of verbal memory in late-life depressions and normal ageing. During last decades, the increase of frequency of affective disorders in depression spectrum in late age attracts attention of specialists. Memory is one of the most sensitive functions in late-life depressions. The maingoal of this research is to estimate verbal memory of senior patients with depression and normal persons. Two groups of participants, consisting of 197 patients with depressions of Scientific Center of Mental Health (Moscow) and 100 mentally healthy people participated in this research. Control and clinical groups were comparable by socio-demographical parameters. The results of two methods were interpreted: (1) memorization and delayed reproduction of five words; (2) naming of five sharp objects. In first method, the volume of first reproduction (FR), the number of material presentations required for memorization (N) and the volume of delayed reproduction (DR) were examined. In addition, the frequency of occurrence of various types of errors such as omissions, inert repetitions, impairments of order and of selectivity was estimated. In the second method were examined: presence of pauses, necessity of psychological assistance, such as verbal stimulation or clarification of the semantic field. Statistical analysis was made using SPSS Statistics and Microsoft office Excel 2007. The research results showed that patients with depression deal with offeredmethods worse than mentally healthy people do. In memorization of five words, volumes of FR and DR were lower and patients needed more repetitions to memorize. When analyzing age dynamic, negative changes in verbal memory were more evident in clinical group. When naming of five sharp objects, patients with depression made more pauses and needed more frequently clarification of semantic field or verbal stimulation.&#x0D; Keywords: verbal memory, normal ageing, late-life depressions, neuropsychology

Neuro-Metabolite Changes in a Single Season of University Ice Hockey Using Magnetic Resonance Spectroscopy

Background: Previous research has shown evidence for transient neuronal loss after repetitive head impacts (RHI) as demonstrated by a decrease in N-acetylaspartate (NAA). However, few studies have investigated other neuro-metabolites that may be altered in the presence of RHI; furthermore, the relationship of neuro-metabolite changes to neurocognitive outcome and potential sex differences remain largely unknown.Objective: The aim of this study was to identify alterations in brain metabolites and their potential association with neurocognitive performance over time as well as to characterize sex-specific differences in response to RHI.Methods: 33 collegiate ice hockey players (17 males and 16 females) underwent 3T magnetic resonance spectroscopy (MRS) and neurocognitive evaluation before and after the Canadian Interuniversity Sports (CIS) ice hockey season 2011–2012. The MRS voxel was placed in the corpus callosum. Pre- and postseason neurocognitive performances were assessed using the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT). Absolute neuro-metabolite concentrations were then compared between pre- and postseason MRS were (level of statistical significance after correction for multiple comparisons: p < 0.007) and correlated to ImPACT scores for both sexes.Results: A significant decrease in NAA was observed from preseason to postseason (p = 0.001). Furthermore, a trend toward a decrease in total choline (Cho) was observed (p = 0.044). Although no overall effect was observed for glutamate (Glu) over the season, a difference was observed with females showing a decrease in Glu and males showing an increase in Glu, though this was not statistically significant (p = 0.039). In both males and females, a negative correlation was observed between changes in Glu and changes in verbal memory (p = 0.008).Conclusion: The results of this study demonstrate changes in absolute concentrations of neuro-metabolites following exposure to RHI. Results suggest that changes in Glu are correlated with changes in verbal memory. Future studies need to investigate further the association between brain metabolites and clinical outcome as well as sex-specific differences in the brain's response to RHI.

Ceramide Accumulation Is Associated with Declining Verbal Memory in Coronary Artery Disease Patients: An Observational Study.

Background:Biomarkers in cognitively vulnerable populations, like those with coronary artery disease (CAD), may inform earlier intervention in vascular neurodegeneration. Circulating ceramide C18:0 (CerC18:0) is associated with changes in verbal memory in early neurodegeneration and CAD progression.Objective:To investigate whether plasma CerC18:0 accumulation is associated with longitudinal declines in verbal memory performance in CAD.Methods:In addition to total CerC18:0, we assessed its relative abundance to its precursors as ratios: CerC18:0 to monohexosylceramide C18:0 (MHxCer18:0), CerC18:0 to sphingomyelin C18:0 (SM18:0), and CerC18:0 to sphingosine-1-phosphate (S1P). Verbal memory was assessed using the California Verbal Learning Test 2nd Ed. Using mixed models in 60 CAD participants, we evaluated associations between baseline CerC18:0 ratios and changes in verbal memory performance, adjusting for age, body mass index, and education. Given that cognitive decline is more rapid following onset of deficits, these associations were compared between those with possible mild vascular neurocognitive disorder (MVND).Results:Increased baseline CerC18:0 concentrations correlated with worse verbal memory performance over time (b[SE] = – 0.91[0.30], p = 0.003). Increased baseline CerC18:0/SM18:0 (b[SE] = – 1.11[`], p = 0.03) were associated with worse verbal memory performance over time. These associations were not mediated by whether or not patients had possible MVND at baseline.Conclusion:These findings support aberrant CerC18:0 metabolism as an early neurobiological change in vascular neurodegeneration. Future studies should measure enzymes responsible for conversion of sphingolipid precursors into CerC18:0 to assess enzymatic activity.

A decade of changes in brain volume and cognition.

Brain atrophy can occur several decades prior to onset of cognitive impairments. However, few longitudinal studies have examined the relationship between brain volume changes and cognition over a long follow-up period in healthy elderly women. In the present study we investigate the relationship between whole brain and hippocampal atrophy rates and longitudinal changes in cognition, including verbal episodic memory and executive function, in older women. We also examine whether baseline brain volume predicts subsequent changes in cognitive performance over a 10-year period. A total of 60 individuals from the population-based Women's Healthy Ageing Project with a mean age at baseline of 59years underwent 3T MRI. Of these, 40 women completed follow-up cognitive assessments, 23 of whom had follow-up MRI scans. Linear regression analysis was used to examine the relationship between brain atrophy and changes in verbal episodic memory and executive function over a 10-year period. The results show that baseline measurements of frontal and temporal grey matter volumes predict changes in verbal episodic memory performance, whereas hippocampal volume at baseline is associated with changes in executive function performance over a 10-year period of follow-ups. In addition, higher whole brain and hippocampal atrophy rates are correlated with a decline in verbal episodic memory. These findings indicate that in addition to atrophy rate, smaller regional grey matter volumes even 10years prior is associated with increased rates of cognitive decline. This study suggests useful neuroimaging biomarkers for the prediction of cognitive decline in healthy elderly women.

Neurocognitive functioning over the course of trauma-focused psychotherapy for PTSD: Changes in verbal memory and executive functioning.

Individuals with post-traumatic stress disorder (PTSD) have neurocognitive deficits in verbal memory and executive functioning. In this study, we examined whether memory and executive functioning changed over the course of treatment and which clinical variables were associated with change. Neuropsychological assessments were administered at baseline and endpoint of a randomized controlled trial as secondary outcome. Trauma survivors (n=88) diagnosed with PTSD received trauma-focused psychotherapy within a 17-week randomized controlled trial. Neuropsychological tests were the California Verbal Learning Test, Rivermead Behavioural Memory Test, Stroop Color Word Test, and Trail Making Test. Significant, small- to medium-sized improvements in verbal memory, information processing speed, and executive functioning were found after trauma-focused psychotherapy (Cohen's d 0.16-0.68). Greater PTSD symptom decrease was significantly related to better post-treatment neurocognitive performance (all p<.005). Patients with comorbid depression improved more than patients with PTSD alone on interference tasks (p<.01). No differences emerged between treatment conditions and between patients on serotonergic antidepressants and those who were not. This study suggests that neurocognitive deficits in PTSD can improve over the course of trauma-focused psychotherapy and are therefore at least partly reversible. Improvements over treatment are in line with previous neuropsychological and neuroimaging studies and effect sizes exceed those of practice effects. Future research should determine whether these changes translate into improved functioning in the daily lives of the patients. Patients with PTSD have difficulties performing verbal memory tasks (e.g., remembering a grocery list, recall of a story) and executive functioning tasks (e.g., shifting attention between two tasks, ignoring irrelevant information to complete a task). Verbal memory, information processing speed, and executive functioning significantly improved in patients with post-traumatic stress disorder over the course of trauma-focused psychotherapy. Improvements were equal in size for two different trauma-focused psychotherapies (Eye movement desensitization and reprocessing therapy and brief eclectic psychotherapy for PTSD). Medium-sized effects were found for recall of a story, whereas effects in other aspects of verbal memory, information processing speed, and executive functioning were small-sized. No causal attributions can be made because we could not include a control group without treatment for ethical reasons. Findings may be more reflective of patients who completed treatment than patients who prematurely dropped out as completers were overrepresented in our sample.

T188. Ceramide Accumulation is Associated With Declining Verbal Memory in Coronary Artery Disease Patients

Biomarkers in cognitively vulnerable populations like those with coronary artery disease (CAD) may inform earlier intervention in vascular neurodegeneration. Circulating ceramide C18:0 (CerC18:0) is associated with changes in verbal memory in early neurodegeneration and CAD progression. We hypothesized that plasma CerC18:0 and its accumulation in biosynthesis pathways (catabolism of sphingomyelin (SM), salvage from monohexosylceramides (MHx), formation from sphingosine-1-phosphate (S1P)) would be associated with declining verbal memory performance in CAD.

Mechanisms of functional improvement through cognitive rehabilitation in schizophrenia

Whereas the efficacy of cognitive rehabilitation in schizophrenia is widely known, studies examining mechanisms for functional improvement are still scarce. The aim of the study was to examine the mediational mechanisms through which cognitive rehabilitation improves functioning in schizophrenia. One hundred and eleven schizophrenia patients were randomly assigned to either a 4-month cognitive rehabilitation group or an active control group. Patients underwent a neurocognitive battery (including processing speed, verbal memory, working memory and executive functioning) and social cognition assessment (emotion perception, theory of mind and social perception). Functioning was assessed by the combined use of a performance-based instrument, the UCSD Performance-based Skills Assessment (UPSA) and an observer-rated instrument, the Global Assessment of Functioning (GAF). The trial was registered in clinicaltrials.gov (NCT02796417). Multiple mediational analyses revealed that the effect of cognitive rehabilitation on functional improvement was partially mediated by changes in processing speed and verbal memory, but not by the domains of social cognition and negative symptoms. More specifically, verbal memory partially mediated the treatment's effect on performance-based functioning (UPSA), whereas processing speed acted as a partial mediator for observer-rated functioning (GAF). The effect of rehabilitation on functioning did not take place through all the domains that showed significant improvement. Verbal memory and processing speed emerged as the most crucial factors. However, these complex interactions need further research.

Coupled changes in hippocampal structure and cognitive ability in later life.

IntroductionThe hippocampus plays an important role in cognitive abilities which often decline with advancing age.MethodsIn a longitudinal study of community‐dwelling adults, we investigated whether there were coupled changes in hippocampal structure and verbal memory, working memory, and processing speed between the ages of 73 (N = 655) and 76 years (N = 469). Hippocampal structure was indexed by hippocampal volume, hippocampal volume as a percentage of intracranial volume (H_ICV), fractional anisotropy (FA), mean diffusivity (MD), and longitudinal relaxation time (T1).ResultsMean levels of hippocampal volume, H_ICV, FA, T1, and all three cognitive abilities domains decreased, whereas MD increased, from age 73 to 76. At baseline, higher hippocampal volume was associated with better working memory and verbal memory, but none of these correlations survived correction for multiple comparisons. Higher FA, lower MD, and lower T1 at baseline were associated with better cognitive abilities in all three domains; only the correlation between baseline hippocampal MD and T1, and change in the three cognitive domains, survived correction for multiple comparisons. Individuals with higher hippocampal MD at age 73 experienced a greater decline in all three cognitive abilities between ages 73 and 76. However, no significant associations with changes in cognitive abilities were found with hippocampal volume, FA, and T1 measures at baseline. Similarly, no significant associations were found between cognitive abilities at age 73 and changes in the hippocampal MRI biomarkers between ages 73 and 76.ConclusionOur results provide evidence to better understand how the hippocampus ages in healthy adults in relation to the cognitive domains in which it is involved, suggesting that better hippocampal MD at age 73 predicts less relative decline in three important cognitive domains across the next 3 years. It can potentially assist in diagnosing early stages of aging‐related neuropathologies, because in some cases, accelerated decline could predict pathologies.

Changes in verbal and visuospatial working memory from Grade 1 to Grade 3 of primary school: Population longitudinal study.

Adaptive working memory training is being implemented without an adequate understanding of developmental trajectories of working memory. We aimed to quantify from Grade 1 to Grade 3 of primary school (1) changes in verbal and visuospatial working memory and (2) whether low verbal and visuospatial working memory in Grade 1 predicts low working memory in Grade 3. The study design includes a population-based longitudinal study of 1,802 children (66% uptake from all 2,747 Grade 1 students) at 44 randomly selected primary schools in Melbourne, Australia. Backwards Digit Recall (verbal working memory) and Mister X (visuospatial working memory) screening measures from the Automated Working Memory Assessment (M=100; SD=15) were used to assess Grades 1 and 3 (ages 6-7 and 8-9years) students. Low working memory was defined as ≥1 standard deviation below the standard score mean. Descriptive statistics addressed Aim 1, and predictive parameters addressed Aim 2. One thousand seventy (59%) of 1802 Grade 1 participants were reassessed in Grade 3. As expected for typically developing children, group mean standard scores were similar in Grades 1 and 3 for verbal, visuospatial, and overall working memory, but group mean raw scores increased markedly. Compared to "not low" children, those classified as having low working memory in Grade 1 showed much larger increases in both standard and raw scores across verbal, visuospatial, and overall working memory. Sensitivity was very low for Grade 1 low working memory predicting Grade 3 low classifications. Although mean changes in working memory standard scores between Grades 1 and 3 were minimal, we found that individual development varied widely, with marked natural resolution by Grade 3 in children who initially had low working memory. This may render brain-training interventions ineffective in the early school year ages, particularly if (as population-based programmes usually mandate) selection occurs within a screening paradigm.

The Impact of Transsphenoidal Surgery on Neurocognitive Function: A Systematic Review

Abstract Background Cognitive impairment following transsphenoidal surgery (TSS) among patients with pituitary tumors has been intermittently reported and is not well established. We performed a systematic review to summarize the impact of TSS on cognitive function. Methods We conducted a systematic search of the literature using the PubMed, Cochrane, and Embase databases through October 2014. Studies were selected if they reported cognitive status after surgery and included at least 10 adult patients with pituitary tumors undergoing either endoscopic or microscopic TSS. Results After removing 69 duplicates, 758 articles were identified, of which 24 were selected for full text review after screening titles and abstracts. After reviewing full texts, nine studies with a combined total of 682 patients were included in the final analysis. Eight studies were cross-sectional and one was longitudinal. These studies used a wide variety of neurocognitive tests to assess memory, attention and executive function post-operatively. Of the eight studies, six reported impairments in verbal and non-verbal memory post-operatively, while others found no association related to memory, and some reported an improvement in episodic, verbal, or logical memory. While four studies found an impaired association between TSS and attention or executive function, another four studies did not. Conclusion The current literature on cognitive impairments after TSS is limited and inconsistent. This review demonstrates that patients undergoing TSS may experience a variety of effects on executive function and memory post-operatively, but changes in verbal memory are most common.

Contribution of the Cholinergic System toVerbal Memory Performance in Mild Cognitive Impairment.

Acetylcholine is critically involved in modulating learning and memory function, which both decline in neurodegeneration. It remains unclear to what extent structural and functional changes in the cholinergic system contribute to episodic memory dysfunction in mild cognitive impairment (MCI), in addition to hippocampal degeneration. A better understanding is critical, given that the cholinergic system is the main target of current symptomatic treatment in mild to moderate Alzheimer’s disease. We simultaneously assessed the structural and functional integrity of the cholinergic system in 20 patients with MCI and 20 matched healthy controls and examined their effect on verbal episodic memory via multivariate regression analyses. Mediating effects of either cholinergic function or hippocampal volume on the relationship between cholinergic structure and episodic memory were computed. In MCI, a less intact structure and function of the cholinergic system was found. A smaller cholinergic structure was significantly correlated with a functionally more active cholinergic system in patients, but not in controls. This association was not modulated by age or disease severity, arguing against compensational processes. Further analyses indicated that neither functional nor structural changes in the cholinergic system influence verbal episodic memory at the MCI stage. In fact, those associations were fully mediated by hippocampal volume. Although the cholinergic system is structurally and functionally altered in MCI, episodic memory dysfunction results primarily from hippocampal neurodegeneration, which may explain the inefficiency of cholinergic treatment at this disease stage.

Changes in Neural Connectivity and Memory Following a Yoga Intervention for Older Adults: A Pilot Study.

Background: No study has explored the effect of yoga on cognitive decline and resting-state functional connectivity.Objectives: This study explored the relationship between performance on memory tests and resting-state functional connectivity before and after a yoga intervention versus active control for subjects with mild cognitive impairment (MCI).Methods: Participants ( ≥ 55 y) with MCI were randomized to receive a yoga intervention or active “gold-standard” control (i.e., memory enhancement training (MET)) for 12 weeks. Resting-state functional magnetic resonance imaging was used to map correlations between brain networks and memory performance changes over time. Default mode networks (DMN), language and superior parietal networks were chosen as networks of interest to analyze the association with changes in verbal and visuospatial memory performance.Results: Fourteen yoga and 11 MET participants completed the study. The yoga group demonstrated a statistically significant improvement in depression and visuospatial memory. We observed improved verbal memory performance correlated with increased connectivity between the DMN and frontal medial cortex, pregenual anterior cingulate cortex, right middle frontal cortex, posterior cingulate cortex, and left lateral occipital cortex. Improved verbal memory performance positively correlated with increased connectivity between the language processing network and the left inferior frontal gyrus. Improved visuospatial memory performance correlated inversely with connectivity between the superior parietal network and the medial parietal cortex.Conclusion:Yoga may be as effective as MET in improving functional connectivity in relation to verbal memory performance. These findings should be confirmed in larger prospective studies.

Abstract TMP120: Race and Sex Differences in the Trajectory of Cognitive Decline After Incident Stroke

Background and Objectives: Race and sex differences in the trajectory of survivors’ cognitive changes after stroke are uncertain. We measured changes in cognitive function associated with incident stroke and variability by race (black vs white) and sex, controlling for prestroke cognitive trajectories. Methods: Prospective study of 654 survivors of incident stroke and 22,969 stroke-free participants aged ≥45 years without baseline cognitive impairment from the REGARDS cohort enrolled 2003-2007 and followed through September 30, 2014. Median follow-up was 7.3 years. Changes in global cognition (Six-Item Screener [SIS]; range, 0-6; primary outcome), new learning, verbal memory, and executive function (Word-List Learning, Word-List Delayed Recall, and Animal Fluency Test) were measured using a regression discontinuity analytic approach, where the acute effect of stroke was estimated as the difference in the expected cognitive level on the day of the stroke from the modeled trajectory of cognitive functioning before the stroke and the trajectory of cognitive functioning after the stroke. These trajectories of post-baseline cognitive function were estimated after adjustment for calendar time and baseline values of socio-demographics, vascular risk factors, clinical factors, baseline cognitive score, and random effects for intercept and slope. Results: After stroke, acute declines in global cognition were greater in men compared with women (P=0.003) and also greater in blacks compared with whites (P=0.03) (Figure). Adjusted declines in SIS scores were 0.22 points (95% CI, 0.14 to 0.31) in black men, 0.13 points (95% CI, 0.06 to 0.20) in white men, 0.10 points (95% CI, 0.02 to 0.18) in black women, and 0.01 points (95% CI, -0.06 to 0.09) in white women. Secondary cognitive assessments did not differ significantly by race or sex. Conclusion: The acute declines in global cognition after stroke are greater in men compared with women and in blacks compared with whites.

Effects of Age, APOE ε4, Cognitive Reserve and Hippocampal Volume on Cognitive Intervention Outcome in Amnestic Mild Cognitive Impairment

Here we studied intervention outcome and potential predictors for cognitive intervention effects in patients with amnestic mild cognitive impairment (aMCI), a population at risk of Alzheimer’s disease. We included 100 aMCI patients (cognitive intervention group, n=69; active control group, n=31) that underwent a previously established 6-month group-based multicomponent cognitive intervention or an active control condition. As a primary endpoint we defined changes in global cognition (Alzheimer’s Disease Assessment Scale – Cognitive Subscale, ADAS-Cog). Secondary endpoints were changes in verbal and visual episodic memory (California Verbal Learning Test, CVLT; Face Name Learning Test, FNL). Overall, we found no improvements in our primary outcome ADAS-Cog. Group by time interactions were found for CVLT learning (p=0.031), with improvements in the intervention group and deteriorations in the control group. The intervention group deteriorated in FNL learning (p=0.001) and the control group deteriorated in FNL recall (p=0.048). The main focus of the study was, however, whether intervention outcome was predicted by factors that are known to affect disease progression. As predictors we selected age, APOE carrier status, cognitive reserve, and hippocampal volume. In linear regression analyses, lower hippocampal volume predicted deteriorations in ADAS-Cog (p=0.035) and CVLT recall (p=0.016), whereas younger age (p=0.011) and APOE e4 non-carrier status (p=0.024) predicted improvements in CVLT learning. Lower cognitive reserve predicted deteriorations in FNL recall (p=0.008). Regarding the modest intervention effects, our results challenge a general recommendation of cognitive interventions in aMCI. Rather, our findings suggest that younger patients, APOE e4 non-carriers, and patients with higher CR and higher hippocampal volume have a higher likelihood to benefit from a cognitive intervention, which could be useful for the selection of patients for future intervention trials.