Classical Neuropsychological Tests Research Articles

Measurement invariance across countries of the Test of Memory Strategies (TMS): A contribution to the cross-national validity study

Previous literature showed a complex interpretation of recall tasks due to the complex relationship between Executive Functions (EF) and Long Term Memory (M). The Test of Memory Strategies (TMS) could be useful for assessing this issue, because it evaluates EF and M simultaneously. This study aims to explore the validity of the TMS structure, comparing the models proposed by Vaccaro et al. (2022) and evaluating the measurement invariance according to three countries (Italy, Spain, and Portugal) through Confirmatory Factor Analysis (CFA). Four hundred thirty-one healthy subjects (Age mean = 54.84, sd = 20.43; Education mean = 8.85, sd =4.05; M = 177, F = 259) were recruited in three countries (Italy, Spain, and Portugal).Measurement invariance across three country groups was evaluated through Structural Equation modeling. Also, convergent and divergent validity were examined through the correlation between TMS and classical neuropsychological tests. CFA outcomes suggested that the best model was the three-dimensional model, in which list 1 and list2 reflect EF, list 3 reflects a mixed factor of EF and M (EFM) and list4 and list5 reflect M. This result is in line with the theory that TMS decreases EF components progressively. TMS was metric invariant to the country, but scalar invariance was not tenable. Finally, the factor scores of TMS showed convergent validity with the classical neuropsychological tests.The overall results support cross-validation of TMS in the three countries considered.

Neurocognitive Assessment of Mathematics-Related Capacities in Neurosurgical Patients.

A precise neuropsychological assessment is of the utmost importance for neurosurgical patients undergoing the surgical excision of cerebral lesions. The assessment of mathematical abilities is usually limited to arithmetical operations while other fundamental visuo-spatial aspects closely linked to mathematics proficiency, such as the perception of numerical quantities and geometrical reasoning, are completely neglected. We evaluated these abilities with two objective and reproducible psychophysical tests, measuring numerosity perception and non-symbolic geometry, respectively. We tested sixteen neuro-oncological patients before the operation and six after the operation with classical neuropsychological tests and with two psychophysical tests. The scores of the classical neuropsychological tests were very heterogeneous, possibly due to the distinct location and histology of the tumors that might have spared (or not) brain areas subserving these abilities or allowed for plastic reorganization. Performance in the two non-symbolic tests reflected, on average, the presumed functional role of the lesioned areas, with participants with parietal and frontal lesions performing worse on these tests than patients with occipital and temporal lesions. Single-case analyses not only revealed some interesting exceptions to the group-level results (e.g., patients with parietal lesions performing well in the numerosity test), but also indicated that performance in the two tests was independent of non-verbal reasoning and visuo-spatial working memory. Our results highlight the importance of assessing non-symbolic numerical and geometrical abilities to complement typical neuropsychological batteries. However, they also suggest an avoidance of reliance on an excessively rigid localizationist approach when evaluating the neuropsychological profile of oncological patients.

Process models of verbal memory in cancer survivors: Bayesian process modeling approach to variation in test scores

ABSTRACT Introduction Verbal memory is a complex and fundamental aspect of human cognition. However, traditional sum-score analyses of verbal learning tests oversimplify underlying verbal memory processes. We propose using process models to subdivide memory into multiple processes, which helps in localizing the most affected processes in impaired verbal memory. Additionally, the model can be used to address score and process variability. This study aims to investigate the effects of cancer and its treatment on verbal memory, as well as provide a demonstration of how process models can be used to investigate the uncertainty in neuropsychological test scores. Method We present an investigation of memory process scores in non-CNS cancer survivors (n = 184) and no-cancer controls (n = 204). The participants completed the Amsterdam Cognition Scan (ACS), in which classical neuropsychological tests are digitally recreated for online at-home administration. We analyzed data from the ACS equivalent of a Verbal Learning Test using both traditional sum scores and a Bayesian process model. Results Analysis of the sum score indicated that patients scored lower than controls on immediate recall but found no difference for delayed recall. The process model analysis indicated a small difference between patients and controls in immediate retrieval from both the partially learned and learned states, with no differences in learning or delayed retrieval processes. Individual-level analysis shows considerable uncertainty for sum scores. Sum scores were more certain than single trials. Retrieval parameters also showed less uncertainty than learning parameters. Conclusion The Bayesian process model increased the informativity of Verbal Learning test data, by showing uncertainty of the traditional sum score measurements as well as how the underlying processes differed between populations. Additionally, the model grants insight into underlying memory processes for individuals and how these processes vary within and between them.

Design and application of a game‐based WeChat mini‐program for screening cognitive impairments in Chinese older adults

AbstractBackgroundEarly screening for mild cognitive impairment (MCI) is the key method to prevent and delay dementia. Digital screening tools are more efficient than traditional paper‐and‐pencil cognitive assessments, and gamified versions would promote engagement and completion rates. We introduced here the design and development of the Game‐based Cognitive Assessment ‐ 3 Minute Version (G3) WeChat mini‐program for MCI screening in Chinese older adults.MethodG3 is a battery of three one‐minute digital games built within the WeChat platform. Developed based on the cognitive paradigm and classic neuropsychological tests such as Trail Making Test (TMT), the Silhouettes test, the Brief Visuospatial Memory Test‐Revised (BVMT‐R) test, and California Card Sorting Tests (CCST), the G3 mini‐games, “Number Ordering”, “Species Sorting”, and “Gold finding” would measure the computational and executive function, abstractive function and visual perception, memory, and attention, respectively. In each game, the difficulty will be automatically adjusted according to performance. G3 integrates users’ game scores, age, gender, and education levels, to generate a comprehensive assessment of cognitive function with results of the six cognitive domains (Figure 2).ResultAs of August 31, 2022, more than 11 million users have completed G3 tests, 85.38% of them are aged under 40, and 2.05% of them are aged over 60 (Figure 3). Although people in all age groups have desired to know their cognitive function, the number of users decreased as people aged. Among users aged 40‐70, more females than males participated in G3 games, indicating middle‐aged and older women paid more attention to cognitive function. Among users over 45 years old, those of lower education levels (primary school or no education), middle levels (middle or high school), and university degrees accounted for 2.93%, 32.4%, and 59.65% respectively. The completion rate of users aged over 45 is 92.28%, and those over 80 years exceeded 86%.ConclusionThe G3 was a battery of three novel 1‐minute game‐based digital cognitive tests. The process is simple, efficient, and interesting. It is a promising tool for self‐administering, advancing large‐scale community screening, and social education for MCI in Chinese older adults, warranting further clinical trials to validate its feasibility, sensitivity, and diagnostic value.

Design and application of a game‐based WeChat mini‐program for screening cognitive impairments in Chinese older adults

AbstractBackgroundEarly screening for mild cognitive impairment (MCI) is the key method to prevent and delay dementia. Digital screening tools are more efficient than traditional paper‐and‐pencil cognitive assessments, and gamified versions would promote engagement and completion rates. We introduced here the design and development of the Game‐based Cognitive Assessment ‐ 3 Minute Version (G3) WeChat mini‐program for MCI screening in Chinese older adults.MethodG3 is a battery of three one‐minute digital games built within the WeChat platform. Developed based on the cognitive paradigm and classic neuropsychological tests such as Trail Making Test (TMT), the Silhouettes test, the Brief Visuospatial Memory Test‐Revised (BVMT‐R) test, and California Card Sorting Tests (CCST), the G3 mini‐games, “Number Ordering”, “Species Sorting”, and “Gold finding” would measure the computational and executive function, abstractive function and visual perception, memory, and attention, respectively. In each game, the difficulty will be automatically adjusted according to performance. G3 integrates users’ game scores, age, gender, and education levels, to generate a comprehensive assessment of cognitive function with results of the six cognitive domains (Figure 2).ResultAs of August 31, 2022, more than 11 million users have completed G3 tests, 85.38% of them are aged under 40, and 2.05% of them are aged over 60 (Figure 3). Although people in all age groups have desired to know their cognitive function, the number of users decreased as people aged. Among users aged 40‐70, more females than males participated in G3 games, indicating middle‐aged and older women paid more attention to cognitive function. Among users over 45 years old, those of lower education levels (primary school or no education), middle levels (middle or high school), and university degrees accounted for 2.93%, 32.4%, and 59.65% respectively. The completion rate of users aged over 45 is 92.28%, and those over 80 years exceeded 86%.ConclusionThe G3 was a battery of three novel 1‐minute game‐based digital cognitive tests. The process is simple, efficient, and interesting. It is a promising tool for self‐administering, advancing large‐scale community screening, and social education for MCI in Chinese older adults, warranting further clinical trials to validate its feasibility, sensitivity, and diagnostic value.

8 Computational Modeling of Memory Processes in non-CNS Cancer Survivors

Objective:Cognitive impairment is an often-overlooked issue that non-CNS cancer survivors face. Our current understanding of their issues is lacking, as traditional memory sum scores grant us little insight into the underlying cognitive processes of memory and its impairment. We can improve the informativity of memory impairment studies by isolating which cognitive processes are impaired.Participants and Methods:Participants were breast cancer survivors who received chemotherapy (n=68), and women controls (n=157). The participants completed the Amsterdam Cognition Scan (ACS), in which classical neuropsychological tests are digitally recreated for online at-home administration. Online administration reduces the burden on patients and allows for recording measurements with greater precision. The specific test used to illustrate the effectiveness of our computational modeling approach was the ACS equivalent of the Rey Auditory Verbal Learning Test, in which participants are tasked with recalling a list of 15 words five times. We formulated a Hierarchical Bayesian Cognitive Model to replace traditional sum scores and disentangle performance into the more theoretically meaningful concepts of 'memory storage’ and 'memory retrieval'.Results:A traditional analysis of the sum of trials 1-5 indicated no significant difference between patients and controls (t(223)=-0.99, p = 0.323), with a small effect size (Cohen’s d = -0.14).For the newly isolated cognitive process “memory storage”, a non-significant difference was found between patients and controls (d=0.10, 95% credible interval on Cohen’s d: [0.25, 0.43]). On the “memory retrieval” process, a medium significant difference was found between patients and controls (d = -0.57, 95% credible interval on Cohen’s d: [-1.00, -0.19]).Conclusions:The results indicate that the impaired memory processes in cancer patients are not a general impairment across all memory functions, but rather a selective impairment of memory retrieval. Our method of analysis revealed information that would have been left unnoticed had we relied on traditional sum over trials 1-5.

Screening for MCI in the Swedish H70 Birth Cohort Study using digital automatic speech biomarker tests for cognition and a machine Learning classifier

AbstractBackgroundEven if classic neuropsychological tests often have excellent psychometric properties to detect Mild Cognitive Impairment (MCI), they are not suitable for cost‐effective low‐burden screening at scale. Speech‐based digital biomarkers can be deployed in a highly automated fashion. We present the results of an MCI screening algorithm based on a digital Speech Biomarker for Cognition (SB‐C) in the Swedish H70 birth cohort study.MethodWe used a sample from the Swedish H70 Birth Cohort study (N = 404; 356 cognitively healthy (HC), 48 MCI). We automatically extract the SB‐C score and its subscores (executive function, memory, semantic memory, processing speed) from SVF and RAVLT speech recordings using ki:elements’ proprietary speech analysis pipeline including automatic speech recognition and feature extraction. We performed (1) inferential statistics comparing MCI and HC group based on the biomarker scores and (2) built a machine learning model to screen for MCI. For (1) we performed a non‐parametric Kruskal‐Wallis test to compare SB‐C scores of both HC and MCI groups to check for general feasibility. For (2), we trained a support vector machine model with class weights and leave‐one‐out cross validation to classify between MCI and HC using the SB‐C scores as input (overall score and the subscores).ResultThere was a group difference for the SB‐C aggregated cognition score between the groups (HC > MCI; χ2 = 45.9 (1), p <0.001; Figure 1), and also for the subscores (Table 2). To classify between MCI and HC, using a feature selection method, the best model was found for all the five biomarker scores selected with an Area Under Curve of 0.77 (Figure 2), a specificity of 0.77 and a sensitivity of 0.76 (Table 3).ConclusionWe found that a machine learning‐based screening algorithm based on the SB‐C can detect probable MCI patients in representative population sample of older people using a speech biomarker read‐out.

Validation of the ki:e SB‐C a Novel Digital Speech Biomarker for Cognition in a Dutch Memory Clinic Population

AbstractBackgroundProgressive cognitive decline is the cardinal behavioral symptom in most dementia‐causing diseases such as Alzheimer’s disease. Whereas classic neuropsychological tests often have excellent psychometric properties to measure cognitive decline in dementia, there are scenarios in which they are less suitable. Speech‐based digital biomarkers can be deployed remotely and extracted in a highly automated fashion allowing solutions to scale. We present the validation of a novel digital Speech Biomarker for Cognition (SB‐C) in a Dutch memory clinic population containing patients with Mild Cognitive Impairment (MCI) and age‐ as well as education‐matched participants with Subjective Cognitive Decline (SCD).MethodThe ki:e SB‐C is a novel speech‐based cognitive composite score. The presented validation results are based on a sample that was not used when developing the SB‐C. Validation data has been collected from two age‐ and education‐matched groups: Normal Cognition but subjective cognitive decline (SCD; n = 48, 15 F), MCI (n = 48, 18 F). We automatically extract the SB‐C from SVF and AVLT speech recordings using our proprietary speech analysis pipeline including automatic speech recognition and feature extraction. Recordings were collected from a Dutch memory clinic population containing MCI and SCD participants. We performed (1) analytical and (2) clinical validation. For (1) we performed Spearman rank correlation between SB‐C score and anchor score Mini Mental State Examination (MMSE) to show that the algorithm is correctly measuring the concept of interest cognition. For (2) we performed a non‐parametric Kruskal‐Wallis test to compare SB‐C scores of both NC and MCI groups.ResultThe biomarker score SB‐C and MMSE were strongly correlated (r = 0.61, p < 0.001), such that lower MMSE scores are reflected in lower biomarker scores (compare also figure 1). Additionally, there was a very significant group difference for the SB‐C biomarker score between the NC and MCI group (NC > MCI; χ2 = 26.461 (1), p < 0.001).ConclusionThe ki:e SB‐C is a reliable score for cognition, showing convergent validity with the MMSE and separating well between MCI and SCD populations. The availability of valid digital speech biomarkers for cognition has great potential for decentralized clinical trials in dementia aetiologies and beyond.

Weakened Sustained Attention and Increased Cognitive Effort after Total Sleep Deprivation: A Virtual Reality Ecological Study

Total sleep deprivation (TSD) has a major impact on sustained attention as reported by previous studies that have investigated effects of TSD, however by using classical neuropsychological tests that lack ecological validity. To study the effects of TSD on daily-life activities, we carried out an ecological evaluation of sustained attention using a virtual reality task requiring driving along an unpredictable path. We enrolled 30 volunteers who underwent two experimental sessions: baseline (after normal sleep night) and after 36 h of total TSD. We assessed changes in sustained attentional performance by analysing the series of visuomotor adjustments while driving. After TSD, we found greater inaccuracy and longer attentional lapses. Furthermore, the visuomotor adjustments series exhibited higher long-range correlations (self-similarity) which has been associated with greater cognitive efforts. Sustained attention assessed by the ecological task requiring visuomotor coordination gets worse after 36 h of total TSD together with greater cognitive effort.

Grocery Shopping Has Become Complicated. Managing Dual-tasks in a Supermarket for Patients with Alzheimer’s Disease

The executive functions neuropsychological assessment with paper and pencil tests is particularly sensitive to the lack of ecological validity. If the purpose of the clinician is not to get a merely theoretical measure, but to assess the deficit impact on patient’s life, the classical tests for executive functions are not very informative. A more ecological measure could be provided by the direct observation of the patient in his daily life, but this practice is largely cost-demanding and difficult to implement. Moreover by assuming an enactive cognition approach, the role of interaction between the embodied behaviors and the affordances provided in the coupling with the environment in which the agent’s activity is placed remains unrevealed from classical neuropsychological tests. Recently, the introduction of virtual reality simulations in clinical neuropsychology seems to provide peculiar opportunities for the evaluation of the ecological impact of disease in neurological patients, while introducing new inputs for the research on embodied cognition and enactive knowledge acquisition. This contribution aims in analyzing how a virtual reality dual-task test, set in the scene of a supermarket, can be used to assess executive functions in adult/elderly population and in patients with Alzheimer disease. The results show that the test has convergent validity, compared to the Mini Mental State Evaluation and Tower of London tests and discriminant validity in identifying the degenerative disease, compared to healthy subjects matched for age, sex and education.

Physical Training In-Game Metrics for Cognitive Assessment: Evidence from Extended Trials with the Fitforall Exergaming Platform

Conventional clinical cognitive assessment has its limitations, as evidenced by the environmental shortcomings of various neuropsychological tests conducted away from an older person’s everyday environment. Recent research activities have focused on transferring screening tests to computerized forms, as well as on developing short screening tests for screening large populations for cognitive impairment. The purpose of this study was to present an exergaming platform, which was widely trialed (116 participants) to collect in-game metrics (built-in game performance measures). The potential correlation between in-game metrics and cognition was investigated in-depth by scrutinizing different in-game metrics. The predictive value of high-resolution monitoring games was assessed by correlating it with classical neuropsychological tests; the area under the curve (AUC) in the receiver operating characteristic (ROC) analysis was calculated to determine the sensitivity and specificity of the method for detecting mild cognitive impairment (MCI). Classification accuracy was calculated to be 73.53% when distinguishing between MCI and normal subjects, and 70.69% when subjects with mild dementia were also involved. The results revealed evidence that careful design of serious games, with respect to in-game metrics, could potentially contribute to the early and unobtrusive detection of cognitive decline.

Word Meaning Contributes to Free Recall Performance in Supraspan Verbal List-Learning Tests.

Supraspan verbal list-learning tests, such as the Rey Auditory Verbal Learning Test (RAVLT), are classic neuropsychological tests for assessing verbal memory. In this study, we investigated the impact of the meaning of the words to be learned on three memory stages [short-term recall (STR), learning, and delayed recall (DR)] in a cohort of 447 healthy adults. First, we compared scores obtained from the RAVLT (word condition) to those of an alternative version of this test using phonologically similar but meaningless items (pseudoword condition) and observed how each score varied as a function of age and sex. Then, we collected the participants’ self-reported strategies to retain the word and pseudoword lists and examined if these strategies mediated the age and sex effects on memory scores. The word condition resulted in higher memory scores than pseudoword condition at each memory stage and even canceled out, for the learning stage, the detrimental effect of age that was observed for the short-term and DR. When taking sex into account, the word advantage was observed only in women for STR. The self-reported strategies, which were similar for words and pseudowords, were based on the position of the item on the list (word: 53%, pseudoword: 37%) or the meaning of the item (word: 64%, pseudoword: 58%) and were used alone or in combination. The best memory performance was associated with the meaning strategy in the word condition and with the combination of the meaning and position strategies in the pseudoword condition. Finally, we found that the word advantage observed in women for STR was mediated by the use of the meaning strategy. The RAVLT scores were thus highly dependent on word meaning, notably because it allowed efficient semantic knowledge-based strategies. Within the framework of Tulving’s declarative memory model, these results are at odds with the depiction of the RAVLT as a verbal episodic memory test as it is increasingly referred to in the literature.

A video-game based cognitive training for breast cancer survivors with cognitive impairment: A prospective randomized pilot trial

IntroductionWe investigated whether a web-based cognitive training video game is an effective approach to improve cognitive decline in combination with our standard of care for rehabilitation of breast cancer (BC) patients. Materials and methodsSelf-selected BC patients between 18 and 71 years old complaining of disturbing cognitive impairment were studied. The patients received access to a web-based internet video game and online cognitive assessments (Aquasnap, Cambridge, MyCQ™). The early intervention group (n = 23) had a training program of 6 months of at least three times a week for a minimum of 60 min of game playing per week at home in addition to standard of care rehabilitation. The delayed intervention (n = 23) received standard of care for three months, followed by three months of similar MyCQ training. Outcome measures were the MyCQ (sub)scores and Activity of Daily Life (ADL), mood, subjective cognition and functional cognitive status measured by classic neuropsychological tests. ResultsAt baseline the means for CFQ (a measure of self-reported cognitive failure), anxiety, PSQI and self-reflectiveness were beyond normal range in both groups. CFQ improved significantly better in the intervention group (p = 0.029). Combining the evolution over time in the entire population a significant improvement was seen for overall MyCQ score, level of fear, physical and emotional role limitation, and health change (all p < 0.05), but self-reflectivess deteriorated (p < 0.05)). Significant differences in the various MyCQ subtests over time were: improved speed in choice reaction time, visual memory recognition, N back 1 and 2, coding, trail making test B, improved accuracy of N back 1 and 2 (all p < 0.05). ConclusionA program of cognitive training improves cognitive functioning over time. “Aquasnap” has a beneficial effect on the perception of subjective cognitive functioning (CFQ) but the exact role of video gaming in this process remains uncertain.

Components of executive function model regional prefrontal volumes.

Designed to measure a diversity of executive functioning (EF) through classical neuropsychological tests, the Delis-Kaplan Executive Function Scale (D-KEFS) allows for the investigation of the neural architecture of EF. We examined how the D-KEFS Tower, Verbal Fluency, Design Fluency, Color-Word Interference, and Trail Making Test tasks related to frontal lobe volumes, quantifying the regional specificity of EF components. Adults from the Nathan Kline Institute-Rockland Sample (NKI-RS), an open-access community study of brain development, with complete MRI (3T scanner) and D-KEFS data were selected for analysis (N = 478; ages 20-85). In a mixed-effects model predicting volume, D-KEFS task, D-KEFS score, region of interest (ROI; 13 frontal, 1 occipital control), were entered as fixed effects with intercepts for participants as random effects. "Unitary" EF (aggregate of D-KEFS scores) was positively associated with superior frontal, rostral middle frontal, and lateral orbitofrontal volumes; a negative association was observed with frontal pole volume (| z-score slope | range = 0.040 to 0.051). "Diverse" EF skills (individual D-KEFS task scores) were differentially associated with two or three ROIs, respectively, but to a stronger extent (| z-score slope | range = 0.053 to 0.103). The neural correlates found for the D-KEFS support the prefrontal modularity of both unitary (aspects of EF ability common to all tasks) and diverse EF. Our findings contribute to emerging evidence that aggregate measurements of EF may serve broader but less robust frontal neural correlates than distinct EF skills. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Serum BDNF and GDNF in Chinese male patients with deficit schizophrenia and their relationships with neurocognitive dysfunction

BackgroundTo measure the serum levels of brain-derived neurotrophic factor (BDNF) and glial cell line-derived neurotrophic factor (GDNF) in deficit schizophrenia (DS), in order to examine the association between these two neurotrophic factors (NFs) and cognitive performance.MethodsA total of 109 male patients [51 DS and 58 non-deficit schizophrenia (NDS)] with schizophrenia and 40 sex and age matched healthy controls (HC) participated in this study. Processing speed, attention, executive function, and working memory of all subjects were assessed by means of a battery of classical neuropsychological tests. Serum BDNF and GDNF levels were measured simultaneously using a double-antibody sandwich enzyme-linked immunosorbent assay (ELISA).ResultsThere were significant differences in the overall cognitive test scores between three groups (all p < 0.001). Serum BDNF levels were significantly lower in patients (DS and NDS) than in HC (p < 0.001). Furthermore, BDNF levels were lower in the DS compared to the NDS group, although not significantly. However, there was no difference in the GDNF levels between patients (DS and NDS) and HC. GDNF levels were positively correlated with scores of Stroop words only (r = 0.311, p = 0.033), Stroop colors only (r = 0.356, p = 0.014) and Stroop interference (r = 0.348, p = 0.016) in DS group.ConclusionSerum BDNF may be an unsuitable biomarker for DS, despite a significant decrease in schizophrenia patients. The different neurocognitive performance between the DS and NDS patients indicates that DS may be a separate clinical entity of schizophrenia. Finally, higher serum GDNF levels are associated with better cognitive performance in DS patients, indicating a possible neuroprotective function in DS.

Cognitive functions in young adults with generalized anxiety disorder

BackgroundAnxiety and worry are central symptoms of Generalized Anxiety Disorder (GAD) that have been theorized to negatively impact cognitive functions. However, most of the research has focused on threat-related or emotionally-charged stimuli, and a surprisingly small number of investigations examined ‘cold’ cognitive functions using classic neuropsychological tests. Such investigations are particularly important given that some theoretical models suggest compensatory mechanisms associated with anxiety that in certain circumstances may result in intact performance. The aim of the present study is to assess the neuropsychological profile associated with GAD, using a comprehensive neuropsychological battery. MethodsA sample of 23 college students meeting criteria for DSM-5 GAD and 20 control participants completed a psychometrically valid comprehensive computerized neuropsychological battery and clinical questionnaires. ResultsThe GAD sample presented with significantly elevated symptomatic rates of anxiety, worry, depression and stress. However, no significant differences were found on any neuropsychological outcome measures or domain indexes. Effect sizes were small, some of which favored the GAD sample. ConclusionDespite substantial psychopathological burden, GAD exhibited intact cognitive functioning. These results support the Cognitive Control Theory of Anxiety, suggesting that elevated primary anxiety may not impact ‘cold’ cognitive functions in the absence of threat or substantial cognitive load. Given that this is one of the only studies employing a comprehensive neuropsychological battery in GAD, more research is needed in this population to replicate these results and to examine the impact of anxiety on cognitive functions at varying degrees of cognitive load in this population.

New Trends in Episodic Memory Assessment: Immersive 360° Ecological Videos.

How best to measure memory in a reliable and valid way has been intensely debated in neuropsychological literature. Specifically, classical neuropsychological tests often fail to predict real-life performance or capture the multifaceted nature of memory function. To solve these issues, there has been a growing emphasis on the use of more ecological memory assessment. In this scenario, several virtual reality based tools have been developed to evaluate memory function. The aim of the current perspective is to discuss critically the possibilities offered for episodic memory assessment by one of the most innovative trends in the technology field, i.e., 360° videos. Immersivity, egocentric view and realism appear to be crucial features of 360° videos enabling them to enhance the ecological validity of classical assessment tools of memory abilities.

Effects of aging on memory strategies: a validation of the Portuguese version of the Test of Memory Strategies

Objective: Previous literature has shown that executive functions (EF) are related to performance in memory tasks. The fact that there are no psychometric tests that evaluate these two constructs simultaneously led a group of researchers to develop the Test of Memory Strategies (TSM). Given the potential importance of this instrument for neuropsychological evaluation, in this study, we aimed to evaluate the psychometric properties of the TMS in Portuguese sample. We also examined the effect of aging by exploring profiles of performance on the TMS, comparing young and elderly healthy subjects. Method: Total of 135 healthy participants were submitted to a neuropsychological assessment and were divided into four age groups: a group of young adults (25–35 years) and three groups of older individuals (aged 60–69 years, 70–79 years, and 80 or more years). Results: Findings supported the reliability of the TMS scores, based on analyses of internal consistency. As expected, factor analysis of the TMS scores revealed that the test yielded two factors, one capturing EF and the other memory. Correlations with classic neuropsychological tests supported convergent and discriminant validity of the TMS scores. The elderly groups presented more difficulties in creating and mobilizing memory strategies when compared with a younger group, after controlling for the influence of education, although both groups presented increases in performance throughout the five TMS subscales. Conclusions: The findings suggest that the TMS is an adequate measure to assess memory and EF, simultaneously, presenting adequate psychometric properties for a Portuguese sample.

Cognitive Vulnerability in Aging May Be Modulated by Education and Reserve in Healthy People.

Aging is related to a deterioration of cognitive performance and to multiple alterations in the brain. Even before the beginning of a noticeable cognitive decline, the framework which holds cognitive function experiences these alterations. From a system-vulnerability point of view of cognition, the deterioration associated with age would be the collection of repercussions during a life. Brain function and structure are modified in a multidimensional way, which could concern different aspects like structural integrity, functional activity, connectivity, or glucose metabolism. From this point of view, the effects of aging could affect the most brain systems and their functional activity. In this study, we analyze the functional development of three cognitive domains in relation to aging, educational level, and cognitive reserve (CR). A total of 172 healthy subjects were divided into two age groups (young and old), and completed a battery of classic neuropsychological tests. The tests were organized and analyzed according to three cognitive domains: working memory and flexibility, visuoconstructive functions, and declarative memory. Subjects also completed a questionnaire on CR. Results showed that the performance in all cognitive domains decreased with age. In particular, tests related to working memory, flexibility, and visuoconstructive abilities were influenced by age. Nevertheless, this effect was attenuated by effects of education, mainly in visuoconstructive domain. Surprisingly, visual as well as verbal memory tests were not affected either by aging, education, or CR. Brain plasticity plays a prominent role in the aging process, but, as other studies have shown, the plasticity mechanism is quite different in healthy vs. pathological brains. Moreover, this plasticity brain mechanism could be modulated by education and CR. Specially, cognitive domains as working memory, some executive functions and the visuoconstructive abilities seem to be modulated by education. Therefore, it seems to be crucial, to propose mechanisms of maintenance of a healthy and enriched brain, since it promotes auto-regulatory mechanisms of well-aging.

Comparison of the clinical and cognitive features of genetically positive ALS patients from the largest tertiary center in Serbia.

Discovering novel mutations in C9orf72, FUS, ANG, and TDP-43 genes in ALS patients arises necessities for better clinical characterizations of these subjects. The aim is to determine clinical and cognitive profile of genetically positive Serbian ALS patients. 241 ALS patients were included in the study (17 familiar and 224 apparently sporadic). The following genes were analyzed: SOD1, C9orf72, ANG, FUS, and TDP-43. An extensive battery of classic neuropsychological tests was used in 27 ALS patients (22 SOD1 positive and 5 SOD1 negative) and 82 healthy controls (HCs). Overall 37 (15.4%) of 241 ALS patients carried mutations in tested genes-among 17 familiar ALS patients 16 (94.1%) were positive and among 224 apparently sporadic 21 (9.4%) had causative mutation. Mutations in SOD1 gene were the most common, representing 27 (73.0%) of all genetically positive ALS patients. The main clinical characteristics of SOD1 positive patients were: spinal onset in lower extremities, common sphincter and sensitive disturbances, and dysexecutive syndrome. Within SOD1 positive patients, we noticed somewhat earlier onset in patients with A145G, sensory and sphincter disturbances were dominant in patients with L144F, while D90A patients had significant sensory involvement. SOD1 negative group consisted of ten (27.0%) patients (six C9orf72, two ANG, one TDP-43, and one patient baring triple FUS, C9orf72 expansion, and ANG variants). Bulbar involvement and more extensive neuropsychological impairment (including executive, visuospatial, and memory difficulties) were the main features of SOD1 negative cohort. Our results suggest that meaningful clinical suspicion of certain ALS genotype might be made based on thorough clinical evaluation of patients.