Cognitive Neuropsychological Approach Research Articles

Contribution of the Cognitive Approach to Language Assessment to the Differential Diagnosis of Primary Progressive Aphasia

Diagnosis of primary progressive aphasia (PPA) is essentially based on the identification of progressive impairment of language abilities while other cognitive functions are preserved. The three variants of PPA are characterized by core and supportive clinical features related to the presence or absence of language impairment in different linguistic domains. In this article, we review the cognitive neuropsychological approach to the assessment of PPA and its contribution to the differential diagnosis of the three variants. The main advantage of this assessment approach is that it goes beyond the mere description and classification of clinical syndromes and identifies impaired and preserved cognitive and linguistic components and processes. The article is structured according to the main language domains: spoken production, language comprehension, and written language. Each section includes a brief description of the cognitive processes involved in the assessment tasks, followed by a discussion of typical characteristics for each PPA variant and common pitfalls in the interpretation of the results. In addition, the clinical benefit of the cognitive neuropsychological approach for the behavioral management of PPA is briefly sketched out in the conclusion.

Non-word writing does not require the phonological output buffer: Neuropsychological evidence for a direct phonological-orthographic route.

What is the route that is used for writing non-words to dictation? Does it have to pass through phonological output?Two possibilities are found in the literature. In one, writing non-words requires access from the phonological input buffer to the phonological output buffer and from there, via phoneme-to-grapheme conversion, to the orthographic output buffer. The second approach maintains that writing non-words can proceed directly from the phonological input buffer to the orthographic output buffer. In this study, we discriminate between these two options using a cognitive neuropsychological approach. Specifically, we present a multiple case study of 24 individuals with a developmental impairment to the phonological output buffer, who nevertheless show unimpaired non-word writing. These data lead to the conclusion that the phonological output buffer is not necessary when writing non-words and that writing non-words to dictation can proceed directly from the phonological input buffer to the orthographic output buffer. We suggest thatthe cognitive assumption that non-word writing proceeds through the phonological output buffer may have resulted from graphic conventions and the depiction of the lexical processing model: in the common depiction of the model drawing a line through the phonological output buffer is visually simpler than a direct line (which would require lines to cross or long bypass lines).

Single-case cognitive neuropsychology in the age of big data

ABSTRACTHistorically, single-case studies of brain-damaged individuals have contributed substantially to our understanding of cognitive processes. However, the role of single-case cognitive neuropsychology has diminished with the proliferation of techniques that measure neural activity in humans. Instead, large-scale informatics approaches in which data are gathered from hundreds of neuroimaging studies have become popular. It has been claimed that utilizing these informatics approaches can address problems found in single imaging studies. We first discuss reasons for why cognitive neuropsychology is thought to be in decline. Next, we note how these informatics approaches, while having benefits, are not particularly suited for understanding functional architectures. We propose that the single-case cognitive neuropsychological approach, which is focused on developing models of cognitive processing, addresses several of the weaknesses inherent in informatics approaches. Furthermore, we discuss how using neural data from brain-damaged individuals provides data that can inform both cognitive and neural models of cognitive processing.

Rehabilitation Treatment In Aphasia Caused By Stroke(Review)

Aphasia is a relatively common language disorder, occurring in about 25% of all stroke patients. The ultimate aim of aphasia treatment is to improve patients oral and written language abilities and to facilitate their participation in everyday communication. Over the last decades, a range of approaches in aphasia therapy have been introduced, based on cognitive neuropsychological models, psycholinguistic theories, and socio-pragmatic approaches. In view of the range of different approaches and findings of therapy studies, the challenge for therapists is to decide which approach is the most appropriate one for an aphasic individual at a specific stage of recovery.The Findings showed that, therapy plan for aphasic individuals involves selecting the therapeutic approach most appropriate for dealing with a particular type of disorder, degree of severity, stage of recovery and the extent of the patient's participation in social life. A framework of aphasia treatment is outlined which considers the rehabilitation process at the various stages of recovery, and Different approaches are combined into a comprehensive treatment regimen which differentiates three stages of recovery: the acute, post-acute, and chronic stage. Also ,The intensive therapy in the treatment of language disorders have a great effect, and Brain imaging studies have shown that the linguistic reorganization of a damaged brain is aided by intensive speech therapy even in the chronic phase.

Clarifying the latent structure and correlates of somatic symptom distress: A bifactor model approach.

Distressing somatic symptoms are ubiquitous both in mental disorders and medical diseases. From a psychometric perspective, the structure of somatic symptom distress is unclear, and little is known about the strengths of associations to related constructs, such as health anxiety and somatosensory amplification. To clarify the structure of somatic symptom distress and to explore associations to health anxiety, somatosensory amplification, and functional somatic syndromes, data sets of 2 samples of college students from Germany (N = 1,520) and Switzerland (N = 3,053) were investigated with confirmatory factor analysis with robust estimation. A bifactor model (with 1 general and 4 orthogonal specific symptom factors-gastrointestinal, fatigue, cardio-pulmonary, and pain symptoms) revealed the best model fit. Medium-sized associations were found among latent factors of general somatic symptom distress, health anxiety, and depression. First evidence for the construct validity of the latent variables within the proposed bifactor structure was gained by observing (a) strong associations between the general somatic symptom distress factor and somatosensory amplification and (b) significant associations between both the general somatic symptom factor as well as the symptom-specific factors with functional somatic syndromes. The results offer a theoretically and psychometrically plausible model for the structure of somatic symptom distress and suggest a distinction between cognitive-affective and sensory aspects of symptom perception. The findings are compatible with current cognitive psychological and neuropsychological approaches to symptom perception and imply that somatic symptom distress is a multidimensional phenomenon that is both strongly linked to but also clearly separable from related constructs.

Developmental disorders: what can be learned from cognitive neuropsychology?

The discipline of cognitive neuropsychology has been important for informing theories of cognition and describing the nature of acquired cognitive disorders, but its applicability in a developmental context has been questioned. Here, we revisit this issue, asking whether the cognitive neuropsychological approach can be helpful for exploring the nature and causes of developmental disorders and, if so, how. We outline the key features of the cognitive neuropsychological approach, and then consider how some of the major challenges to this approach from a developmental perspective might be met. In doing so, we distinguish between challenges to the methods of cognitive neuropsychology and those facing its deeper conceptual underpinnings. We conclude that the detailed investigation of patterns of both associations and dissociations, and across both developmental and acquired cases, can assist in describing the cognitive deficits within developmental disorders and in delineating possible causal pathways to their acquisition.

Cognitive neuropsychological approach to aphasia treatment: Implications for evidence-based clinical practice. Commentary on Laine and Martin, “Cognitive neuropsychology has been, is, and will be significant to aphasiology”

In their target article for this Aphasiology forum Matti Laine and Nadine Martin (2012) support the continued relevance of cognitive neuropsychology (CNP) in aphasia research and clinical aphasiolo...

Cognitive neuropsychology has been, is, and will be significant to aphasiology

Background: In recent years some critical voices have been raised in regard to the significance of cognitive neuropsychology (CNP) to the study of brain and mind. Given the central role of language disorders in CNP research, it is time to consider the relevance of this research approach in aphasiology. Aims: We analyse the main points of criticism raised against the CNP research approach, evaluate the significance of this approach to the study of acquired language disorders, and make some suggestions concerning further development of the field. Main Contribution: The main points of criticism against CNP (reliance on single-case studies; single-minded hunt for dissociations; emptiness of theorising) have been important long-term concerns but do not take into account the fact that, during its history of circa four decades, the CNP approach has diversified. There are thus CNP studies that rely on case series analyses, focus on error analyses rather than mere dissociations, or employ computational modelling rather than the “boxes-and-arrows” models of the mental architecture. The CNP approach to cognition and its disorders is thus applicable to different research questions and theoretical stances, providing experimental rigour to single-case patient studies. With regard to clinical applications in aphasia diagnostics and treatment, the CNP approach provides a richer view on the strengths and weaknesses of a patient's cognitive-linguistic abilities. Conclusions: We believe that CNP case studies continue to be an important source of information for generating hypotheses and providing converging evidence for research on the mind and on the brain. However, there is a need for further research development especially in computational modelling of language processes, their impairments, and recovery. This research is expected to provide further benefit to clinical diagnostics and treatment of aphasia.

Cognitive Structure of Writing Disorders in Russian: What Would Luria Say?

Acquired disorders of writing in the Russian language have been reported for more than a century. The study of these disorders reflects the history of Russian neuropsychology and is dominated by the syndrome approach most notably by the writings of Luria. Indeed, our understanding of acquired dysgraphia in Russian speakers is conceptualized according to the classical approach in Modern Russia. In this review, we describe the classical approach and compare it to the cognitive neuropsychological models of writing disorders that are developed to explain dysgraphia in English and in other Western European languages. We argue that the basic theoretical assumptions of the two approaches – cognitive and classical or syndrome approach – share similarities. It is therefore proposed that identification of acquired cases of dysgraphia in Russian could potentially benefit from taking the cognitive neuropsychological perspective. We also conclude that adopting elements of the syndrome approach would substantially enrich the understanding of acquired dysgraphia since these offer an insight into processes not described in the cognitive neuropsychological approach.

Cognitive structure of writing disorders in Russian: what would Luria say?

Acquired disorders of writing in the Russian language have been reported for more than a century. The study of these disorders reflects the history of Russian neuropsychology and is dominated by the syndrome approach most notably by the writings of Luria. Indeed, our understanding of acquired dysgraphia in Russian speakers is conceptualized according to the classical approach in Modern Russia. In this review, we describe the classical approach and compare it to the cognitive neuropsychological models of writing disorders that are developed to explain dysgraphia in English and in other Western European languages. We argue that the basic theoretical assumptions of the two approaches – cognitive and classical or syndrome approach – share similarities. It is therefore proposed that identification of acquired cases of dysgraphia in Russian could potentially benefit from taking the cognitive neuropsychological perspective. We also conclude that adopting elements of the syndrome approach would substantially enrich the understanding of acquired dysgraphia since these offer an insight into processes not described in the cognitive neuropsychological approach.

Conception and creativity – a cognitive neuropsychology approach

Exploring the superior cognitive processes through cognitive neuropsychology methods, seconded by the technique offered by the functional neuroimaging, provides interesting hypotheses on the relationship between perception, abstraction and conception. The ability to form metaphors or, in other words, to synthesize information and to create a pattern is the result of a connectivity established between different cerebral areas and represents the basis of the creative process.

Cognitive Neuropsychology of HIV-Associated Neurocognitive Disorders

Advances in the treatment of the human immunodeficiency virus (HIV) have dramatically improved survival rates over the past 10 years, but HIV-associated neurocognitive disorders (HAND) remain highly prevalent and continue to represent a significant public health problem. This review provides an update on the nature, extent, and diagnosis of HAND. Particular emphasis is placed on critically evaluating research within the realm of cognitive neuropsychology that aims to elucidate the component processes of HAND across the domains of executive functions, motor skills, speeded information processing, episodic memory, attention/working memory, language, and visuoperception. In addition to clarifying the cognitive mechanisms of HAND (e.g., impaired cognitive control), the cognitive neuropsychology approach may enhance the ecological validity of neuroAIDS research and inform the development of much needed novel, targeted cognitive and behavioral therapies.

Cognitive neuropsychological approaches to word production in aphasia: Beyond boxes and arrows

Background: The cognitive neuropsychological approach aims to describe aphasic disorders of word production by identifying the specific cognitive process(es) that are impaired in each individual. This approach is becoming increasingly influential in the assessment, investigation, and treatment of word production difficulties in aphasia. The classical cognitive neuropsychological approach, with its signature box‐and‐arrow diagrams, is now highly familiar to most aphasiologists. However, more recent theoretical innovations are much less widely known. There is a need for an up‐to‐date review that summarises the current thinking in this field in a way that is accessible to non‐specialists. This article is adapted from material to appear in the forthcoming book Cognitive Neuropsychology: Exploring the Mind Through Brain Dysfunction by C. E. Wilshire, to be published by Psychology Press. The author would like to thank Kate Smith for her feedback on an earlier version of the manuscript and for her assistance in preparing the manuscript. I am especially grateful to Kate for creating the figures that appear in this article. Aims: The present article reviews recent theoretical innovations in the cognitive neuropsychology of word production. It aims to demonstrate how these have led to a more dynamic view of word production that emphasises processes rather than representations, and offers new ways of understanding the diversity of word production impairments seen in aphasia. Main Contribution: Starting from the earliest box‐and‐arrow theories, the article describes how cognitive neuropsychological accounts of aphasic word production have evolved as a result of cross‐pollination from other fields, particularly cognitive psychology. Through the use of specific examples, the review outlines some of the ways in which newer theoretical accounts for particular types of disorders differ from more classical explanations. The article also discusses some recent empirical approaches that have been inspired by the new theoretical accounts, including computer simulation studies of patterns of naming errors. It also illustrates how the tighter relationship between theories of normal and impaired language processing has increased the potential contribution of aphasia studies to language research more generally. The review closes with a discussion of some current and future issues in the cognitive neuropsychology of language, including those relating to the degree of discreteness/continuity in the language system, and the relationship between production and comprehension in aphasia. It also comments upon some recent research regarding the role of sentence‐level and other contextual factors in word production, which may lead to a better understanding of the kinds of language production difficulties that are observed in nonfluent aphasia. Conclusions: The argument that emerges from the review is that more recent cognitive neuropsychological approaches to word production disorders cannot be understood as mere extensions or refinements of the classical box‐and‐arrow theories. Rather, they offer a fundamentally different view of word production, and this has important implications for both researchers and practitioners in the field.

A cognitive neuropsychological approach to false memory: Korsakoff patients and the DRM paradigm

Although false memories have been studied extensively within the field of cognitive psychology, the role of cognitive neuropsychology in false memory research has been rather limited. Therefore, the present article aims at giving an integrated overview of both the neuropsychological study of amnesia and research on false memories. After considering some of the most important predecessors in the study of memory distortions/illusions, a list-learning paradigm designed to elicit and investigate false memories is described (i.e., the DRM paradigm), and theoretical accounts for the phenomenon are provided. Subsequently, the neuropsychological framework is presented, with an emphasis on Korsakoff patients’ performance in the earlier described paradigm. Several experimental manipulations, as well as the results, are discussed and interpreted in the light of both encoding and retrieval factors. (Netherlands Journal of Psychology, 64: 96-111.)

Taking the Perspective of the Other Contributes to Awareness of Illness in Schizophrenia

Two approaches dominate research on the lack of awareness of illness that characterizes schizophrenia. The "deficit" approach uses standardized neuropsychological batteries to identify the neural underpinnings of intact insight; the "nondeficit" approach investigates the psychological defense mechanisms that motivate denial of illness. We adopt, instead, a cognitive neuropsychological approach to model the cognitive processes which underpin insight and which might be either damaged (because of neuropathology) or not used (because of motivational forces). We conceive of these processes in terms of a metacognitive capacity "to see ourselves as others see us." We predict that a general difficulty with adopting other mental perspectives (with "seeing the world as others do"), indexed by performance deficits on theory of mind (ToM) tasks, will impair insight in schizophrenia. Thirty schizophrenic patients (also assessed for insight) and 26 healthy controls completed a battery of ToM tasks which varied presentation modality, response mode and instruction type (picture sequencing, joke appreciation and story comprehension tasks). While patients performed more poorly than controls on all ToM tasks, impairment in patients was not concordant across tasks. ToM scores from the picture sequencing and joke appreciation tasks, and not the story comprehension task, intercorrelated significantly in patients and predicted insight. Findings support the view that insight relies upon a cognitive capacity to adopt the other perspective, which, if intact, contributes to the metacognitive capacity to reflect upon "one's own" mental health from the other perspective. Findings also suggest that the nature of perspective-taking difficulty which disrupts insight in schizophrenia is best revealed using ToM tasks with "indirect" instructions.

Le XXI e siècle sera neuropsychologique ou ne sera pas !

This article reviews how neuropsychology, in the French-speaking world, has evolved as a discipline focused on research, teaching and clinical work. The article targets the last 30 years as this corresponds to the time at which the Société de Neuropsychologie de Langue Française (French-Speaking Neuropsychological Society) was created. The review addresses how the cognitive neuropsychology approach and the advent of brain imaging have shaped the field of neuropsychology in recent years. It presents the status of the discipline in the main French-speaking countries (where neuropsychology is currently developed) including France, Belgium, Switzerland and Canada. It also analyzes a number of indicators that reflect the vitality of the discipline and its cohesion as a science and as a clinical domain. These indicators include the creation of specialized journals, organization of scientific meetings, accessibility to training programs in neuropsychology, development of discipline-oriented clinical programs, and the increase in scientific productivity. The Quebec academic environment is used as an illustration, whereby structured clinical doctoral training programs that meet national standards in neuropsychology were implemented to train clinical neuropsychologists. Finally, the authors emphasize the major role that the discipline is likely to play at different levels of society in the near future.

Deficient relational binding processes in adolescents with psychosis: Evidence from impaired memory for source and temporal context

Introduction. Findings from the literature consistently revealed episodic memory deficits in adolescents with psychosis. However, the nature of the dysfunction remains unclear. Based on a cognitive neuropsychological approach, a theoretically driven paradigm was used to generate valid interpretations about the underlying memory processes impaired in these patients. Methods. A total of 16 inpatient adolescents with psychosis and 19 individually matched controls were assessed using an experimental task designed to measure memory for source and temporal context of studied words. Retrospective confidence judgements for source and temporal context responses were also assessed. Results. On word recognition, patients had more difficulty than controls discriminating target words from neutral distractors. In addition, patients identified both source and temporal context features of recognised items less often than controls. Confidence judgements analyses revealed that the difference between the proportions of correct and incorrect responses made with high confidence was lower in patients than in controls. In addition, the proportion of high-confident responses that were errors was higher in patients compared to controls. Conclusions. These findings suggest impaired relational binding processes in adolescents with psychosis, resulting in a difficulty to create unified memory representations. Our findings on retrospective confidence data point to impaired monitoring of retrieved information that may also impair memory performance in these individuals.

Central and Peripheral Agraphia in Alzheimer's Disease: From the Case of Auguste D. to a Cognitive Neuropsychology Approach

Since the observation of Auguste D. by Alöis Alzheimer, it is an acknowledged fact that writing is one of the cognitive functions that are weakened early in Alzheimer's disease (AD). This study aimed to examine the cognitive nature of this disorder and question the hypothesis of a standard progression (Platel et al., 1993) from lexical to other central and more peripheral processes. A large group of mild to moderate AD patients (n = 59) and a group of healthy elderly controls were submitted to an extensive assessment of both the central and peripheral components of writing. A comparison of groups indicated that AD patients performed more poorly than controls on a wide range of writing measures. It revealed a predominantly lexical disorder, but also found evidence of associated disorders located at different stages in the spelling system (phonological route, graphemic buffer, allographic store, graphic motor patterns). A multiple single-case analysis, using a specific methodology, allowed us to delimit individual profiles of agraphia. It revealed a wide variety of agraphia syndromes, including a far from negligible number of patients with selective damage to one of the central or peripheral components, as well as patients with multiple writing impairments. A positive correlation was observed between the severity of the dementia and spelling/writing measures (lexical and allographic). This study does not support the hypothesis of a uniform progression. Rather, it points to heterogeneous profiles of agraphia and suggests that the first signs of writing impairment in AD stem from changes at different points in the broad anatomical network subserving spelling and writing abilities.

Cognitive neuropsychological approaches in aphasia therapy

認知神経心理学的アプローチでは，一般認知理論を基礎に据えることによって演繹的に症候や治療方法を検討することができる。本稿では，失語症治療における音韻的，意味的，さらに統語的側面の障害を特異的に検出する課題の成績を検討し，それぞれの分野の治療方法を紹介した。

Contributions and limitations of the cognitive neuropsychological approach to treatment: Illustrations from studies of reading and spelling therapy

Background : Cognitive neuropsychological research is focused on improving the understanding of cognitive processes and representations underlying normal tasks such as reading and spelling, on the basis of impaired performance of these tasks after brain damage. Functional architectures of cognitive tasks developed through this approach have often assisted speech-language pathologists and other therapists in understanding the task to be treated, and in identifying the impaired and spared components of the task to be treated in each individual with brain damage. Aims : To review the benefits and limitations of this approach, focusing on illustrations from treatment of reading and spelling, and to provide ideas about how the limitations might be addressed. Contributions : We provide examples that demonstrate how disruption of particular cognitive functions in the process of reading or spelling might be identified and rationally treated. Additionally, we provide some illustrations of how limitations of this approach might be addressed by considering evidence from cognitive neuroscience regarding neural mechanisms of recovery and learning. Conclusions : Insights from cognitive neuropsychology should be integrated with insights from neuroscience in developing rehabilitation strategies.