Digit Span Research Articles

A - 85 Age-Related Differences in Cognitive Mechanisms: Exploring the Role of Processing Speed in Working Memory and Prospective Memory

Abstract Objective Research links working memory (WM) and prospective memory (PM) on cognitively demanding tasks. Older adults demonstrate more frontal lobe activation than young adults during WM and PM tasks; however, the underlying mechanisms remain unclear. The current study hypothesized processing speed (PS) as a mediator between WM and PM with age cohort as a possible moderator. Method Healthy older adults (n = 80; age 60–89, M = 72.51, SD = 7.08) and young adults (n = 63; age 18–29, M = 19.27, SD = 2.12) were administered WAIS-IV Digit Span, WAIS-IV Coding, and the Virtual Kitchen Protocol for Prospective Memory. Results A moderated mediation model revealed that WM positively influenced PM (c:B = 0.69, p < 0.001) with a positive indirect relationship through PS among older adults (ab:B = 0.26, 95% CI [0.13, 0.43]), but not young adults (ab:B = −0.08, 95% CI [−0.19, 0.03]). Conclusion PS appears to play a significant role in older adults’ use of WM for PM but not in young adults. This could suggest that older adults recruit additional cognitive resources – those involved in PS – as a compensatory strategy for real-world PM tasks, which would support prior research indicating that diminished functioning in older adults results from reduced ability to redirect neurocognitive networks. Alternatively, age-related declines in PS could be a root cause underlying both worse WM and worse PM in older adults, as postulated by Salthouse. Future research would benefit from further differentiating the direction of influences between WM, PS, and PM in older adults.

B - 143 A Comparison of Structured Inventory of Malingered Symptomology (SIMS) Performance to Multiple Validity Measures in a Criminal Forensic Sample

Abstract Objective We compared valid or invalid SIMS performance to other performance and symptom validity measures. Methods Data from 119 forensic neuropsychological evaluations [competency (n = 106), forensic (n = 5), insanity (n = 5), commitment review (n = 2), and danger (n = 1)] were analyzed. Three chi-squares tests compared group membership (valid/invalid) for SIMS total score, affective (AF) subscore, or low intelligence (LI) subscore to a separate valid or invalid group membership based on MMPI-2-RF (VRIN-r and TRIN-r), WAIS-IV Reliable Digit Span, and WMT (IR, DR, and CONS) validity cutoff scores (74% failed >2 measures). Results Sample was predominately male (91.6%) and Caucasian (53.8%). Mean age was 35.1 years; mean education was 11.36 years. For SIMS total, 36% failed the SIMS but passed all other validity measures [χ 2(1) = 21.668; p < 0.001; V = 0.427] for a 64% concordance rate for overall valid performance. Individuals with valid scores on the SIMS AF subscale were likely (66%) to have valid performance on all other validity measures [χ 2(1) = 12.418; p < 0.001; V = 0.323]. Individuals with valid scores on the SIMS LI subscale were essentially at chance (52%) to have performed validly overall [χ 2(1) = 9.406; p = 0.002; V = 0.0.281]. Conclusions In this forensic criminal sample, a third of individuals failed the SIMS total score and AF subscale while having credible performance otherwise. Approximately half failed the LI subscale while passing other validity measures. Results suggest that SIMS performance is not strongly related to SVT measures that focuses on response consistency or PVT performance; there is still significant classification overlap. However, high base rate of PVT/SVT failure in this sample may limit generalizability.

An Examination of the Impact of Single Errors on Performance Validity Testing on Neuropsychological Performance: a Youth Athlete Cohort Study

Abstract Performance validity tests (PVT) measure optimal cognitive effort (Sherman et al., 2023). As PVT scores decrease in adults, neuropsychological performance decreases systematically (Green, 2007). Similarly, evidence suggests that even a single error in PVTs influences overall cognitive performance (Erdodi et al., 2017). No studies have investigated this relationship between cognitive performance and PVT performance on multiple PVTs within a large pediatric sample. Youth athletes (n = 174; ages 8–16, M = 12.07) completed the Rey 15-Item test (RFIT), TOMM Trial 1, Reliable Digit Span (RDS), and a thorough neuropsychological battery. T-tests compared neuropsychological performance in youth who scored perfectly on the TOMM (n = 36) and RFIT (n = 90) to youth with single errors (TOMM, n = 28; RFIT, n = 26). A planned contrast analysis of neuropsychological performance was performed for RDS within score levels 6–11. On processing speed, delayed verbal memory, and working memory, the TOMM perfect score group performed better than the single error group (p’s < 0.05). On RFIT, the same relationship was seen on story memory, working memory and simple attention (p’s < 0.05). Perfect score groups scored higher on nearly all subtests (Hedge’s G’s = 0.20–0.60). Scores in perceptual reasoning, cognitive flexibility, processing speed, and visual memory increased as RDS scores increased by one point (p’s < 0.05). This study shows the impact of even subtle differences in effort on cognitive performance in youth. Measuring effort is critical in pediatric neuropsychology, and these results illustrate how important it may be to measure effort on a continuum in pediatrics, as opposed to using pass/fail cutoffs.

Enhancing visuo-spatial working memory: the role of visual support in preschoolers and adults

ABSTRACT Working memory is crucial in cognitive functioning, and environmental cues may enhance its performance. This study examines the role of visual support in promoting and aiding memory strategy. The aim was to determine whether visual placeholders can scaffold mnemonic processes for children and adults. Experiment 1 assessed the ability of 3.5 – to 6-year-olds to use visual support for visuo-spatial rehearsal, while Experiment 2 examined the influence of visual support in adults’ working memory. Children demonstrated improved recall with visual support, which could indicate the early use of visuo-spatial rehearsal strategies. Young adults, especially those with lower working memory spans, also benefited from visual placeholders, suggesting that environmental support promotes and scaffold strategy implementation. The findings revealed that visual support plays a role in enhancing working memory performance. It facilitates rehearsal strategies, benefiting individuals across the lifespan, especially those with less efficient mnemonic strategies.

Effects of a motor and cognitive training program on executive function and different biomarkers related to muscle-brain crosstalk in breast cancer survivors: 3-arm randomised controlled BRAINonFIT study protocol

IntroductionCancer-related cognitive impairment (CRCI) is a significant but often neglected issue for breast cancer survivors that reduces their quality of life. Physical exercise and cognitive training have emerged as promising strategies for CRCI; however, evidence regarding its effectiveness is still unknown. A recently developed motor-cognitive training (dual-tasks) is proposed to examine its efficacy on executive function, physical fitness, emotional symptomatology, and important muscle-brain crosstalk biomarkers. MethodsThe BRAINonFIT study is a randomised, controlled, longitudinal (20 weeks), three-arm, parallel study with a follow-up phase (12 weeks). Breast cancer survivors (stage I-IIIA) with completed chemotherapy are recruited from QuirónSalud Hospital in Seville. Principal outcomes are executive functions, measured by the Trail Making Test, Stroop and Digit Span Backwards; physical fitness, assessed by muscle strength, cardiorespiratory fitness, and body composition; and several muscle-brain biomarkers analysed by immunoenzymatic assay (ELISA). Secondary endpoints are memory function, intelligence, learning ability, self-reported cognitive function, and emotional symptomatology. Assessments take place after the enrolment (baseline; T1), after completing the interventions (5 months after baseline; T2), and after completing the follow-up period (8 months after baseline; T3). DiscussionGiven the importance of improving care for breast cancer survivors, this study will provide preliminary evidence for the effectiveness of cognitive-motor training (dual task) as a therapeutic strategy to improve CRCI. Moreover, addressing muscle-brain crosstalk by representative biomarkers will help to elucidate the underlying mechanisms by which this intervention may beneficially impact CRCI.ClinicalTrials.gov: NCT06073717

Acute caffeine administration impaired spatial working memory in habitual coffee/tea drinkers: A randomized, placebo-controlled, double-blind study

BackgroundAlthough coffee consumption is widespread worldwide, a recent study showed that acute intake of caffeine negatively affects working memory (WM) performance on n-back tasks among habitual caffeine consumers. However, there is a scarcity of double-blind, placebo-controlled studies that assess the spatial WM (SWM) effects of caffeine using spatial span tasks. Therefore, the present study aimed examine the effects of acute caffeine administration (200 mg, PO) on SWM and verbal WM (VWM) among habitual caffeine consumers. MethodsThe effects of caffeine on working memory (WM) was evaluated through the administration of backward digit span and spatial span tasks under a delay-dependent condition (0, 4, 8, and 6 s) in a randomized, double-blind, placebo-controlled study involving 18 healthy participants. This data is derived from our previous published study. The total scores obtained and the maximum scores achieved were the primary outcome variables of the study. ResultsCaffeine had a significant impact on SWM (maximum obtained, p = 0.013; for total scored, p = 0.007) in a delay-independent manner. However, there were no significant main effects of caffeine on VWM (p = 0.82 for maximum obtained, p = 0.56 for total scored). ConclusionOverall, the present findings contradict the commonly held belief that caffeine improves cognitive performance and suggest that acute administration of caffeine may impair SWM in habitual coffee/tea drinkers. Clinical Trial Registration NumberCT-2018-CTN-02561 (Therapeutic Goods Administration Clinical Trial Registry) and ACTRN12618001292268 (The Australian New Zealand Clinical Trials Registry)

The Effect of Metacognitive Intervention on the Listening Performance and Metacognitive Awareness of High- and Low-Working Memory Capacity EFL Learners.

EFL listening comprehension has been a stark challenge for language learners, but little is known about the combined effect of individual differences, such as working memory capacity, and metacognitive intervention. Thus, the present experimental study investigates the effect of metacognitive intervention on the listening performance and metacognitive awareness of high- and low-WMC EFL learners. For this purpose, Oxford Placement Tests were distributed among 120 male Iranian EFL learners, of which 94 were identified as intermediate. Then, backward visual digit span tests were administered to measure their working memory capacity. Based on the median of all scores, 80 learners were selected and randomly assigned to two experimental groups and two control groups each with 20 participants. Next, their performance on the International English Language Testing System and the Metacognitive Awareness Listening Questionnaire was measured before and after the 8-session metacognitive intervention. Results showed that high-WMC experimental learners had a higher gain with a large effect size in terms of listening performance compared with all the other groups. In addition, the experimental group learners reported the significantly higher use of the metacognitive strategies with a moderate effect size. Interestingly, low-WMC learners' listening performance and metacognitive awareness also improved as a result of the intervention. Our findings bear pedagogical significance in that individual differences in WMC should be considered more in both EFL language classes and the future line of research involving the metacognitive intervention.

Eight brain structures mediate the age-related alterations of the working memory: forward and backward digit span tasks.

Working memory (WM) as one of the executive functions is an essential neurocognitive ability for daily life. Findings have suggested that aging is often associated with working memory and neural decline, but the brain structures and resting-state brain networks that mediate age-related differences in WM remain unclear. A sample consisting of 252 healthy participants in the age range of 20 to 70years was used. Several cognitive tasks, including the n-back task and the forward and backward digit span tests were used. Also, resting-state functional imaging, as well as structural imaging using a 3T MRI scanner, were performed, resulting in 85 gray matter volumes and five resting-state networks, namely the anterior and posterior default mode, the right and left executive control, and the salience networks. Also, mediation analyses were used to investigate the role of gray matter volumes and resting-state networks in the relationship between age and WM. Behaviorally, aging was associated with decreased performance in the digit span task. Also, aging was associated with a decreased gray matter volume in 80 brain regions, and with a decreased activity in the anterior default mode network, executive control, and salience networks. Importantly, the path analysis showed that the GMV of the medial orbitofrontal, precentral, parieto-occipital, amygdala, middle occipital, posterior cingulate, and thalamus areas mediated the age-related differences in the forward digit span task, and the GMV of superior temporal gyrus mediated the age-related differences in the backward digit span task. This study identified the brain structures mediating the relationship between age and working memory, and we hope that our research provides an opportunity for early detection of individuals at risk of age-related memory decline.

Multimodal magnetic resonance longitudinal study on the deep gray matter in multiple sclerosis patients with teriflunomide

Disease-modifying therapies (DMTs) are used in an increasing number of patients with multiple sclerosis (MS). However, whether DMTs have intrinsic effects on deep gray matter (DGM) microstructure and atrophy is still poorly understood. In this study, we described the quantitative susceptibility values (QSV) and diffusion kurtosis imaging (DKI) metrics of DGM in relapsing–remitting MS (RRMS) patients and their association with cognitive deficits. We recruited 62 patients with RRMS receiving DMTs and 30 patients with RRMS not receiving DMTs underwent MRI on a 3T scanner. Fractional anisotropy (FA), kurtosis fractional anisotropy (KFA), mean diffusivity (MD), mean kurtosis (MK), QSV and volumes of bilateral caudate nucleus (CAU), amygdala (AMYG), putamen (PUT), hippocampus (Hipp), globus pallidus (GP) and thalamus (THA) were measured. Correlation analysis was performed between those image indexes with longitudinal significant changes and clinical neurological scores, including Expanded Disability Status Scale (EDSS), Digit Span Testand (DST), Symbol Digit Modalities Test (SDMT), Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Significant longitudinal increases in FA, KFA and MK values were found in both groups in bilateral CAU, AMYG, PUT, Hipp, GP and THA (all p < 0.005). MD values of the right of CAU in the two groups were significant longitudinal increase (p = 0.009, p = 0.047); MD values of the right of GP (p = 0.042), the left of THA (p = 0.003), the right of THA (p = 0.001) in treated MS were significant longitudinal decrease; There were no significant longitudinal changes between treated and untreated groups in normalized deep gray matter volume. For QSV, longitudinal increase in the right of PUT (p = 0.022) in the treated MS group and in the left of Hipp (p = 0.045) in the untreated MS group. The QSV and DKI measures were highly correlated with cognitive and disability tests. The treated RRMS patients showed different longitudinal changes of MD value and QSV with untreated in several DGM regions, and these differences were correlated with cognitive and microstructural integrity.

Cognitive functioning in adults with chronic insomnia disorder- A cross-sectional study.

Chronic insomnia, affecting 15.9% of the population, is characterized by sustained hyperarousal and heightened somatic, cognitive, and cortical activity. Despite its prevalence, the precise impact of chronic insomnia on cognitive domains, particularly attention, working memory, and executive function, remains inadequately understood. This study aims to systematically investigate the cognitive functioning of adults with chronic insomnia. A meticulously matched cohort of 80 participants, comprising 40 with chronic insomnia and 40 controls, participated in this cross-sectional study. The diagnosis followed strict criteria outlined in the International Classification of Sleep Disorders-3. Neuropsychological assessments, including the Digit Span Test, Stroop Test, and Trail Making Test, were employed to scrutinize attention, working memory, and executive function. Robust metrics, such as the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9), supported the investigative approach. Analysis revealed notable deficits in backward digit span, digit symbol substitution test, and Stroop Test (cards B and C) among chronic insomnia subjects compared to non-insomniac counterparts. Trail Making Test B indicated prolonged completion times in the chronic insomnia cohort. Despite comparable levels of anxiety and depressive symptoms, the chronic insomnia group exhibited higher ISI and PSQI scores, indicating the severity of their sleep disturbances. This cross-sectional analysis reveals cognitive deficits associated with chronic insomnia, specifically impacting attention, working memory, and executive function. Even with meticulous demographic controls, chronic insomnia leaves a discernible impact on cognitive functions. The study underscores the need for precise cognitive evaluations to reveal the latent impact of chronic insomnia, offering insights for targeted interventions.

Evaluation of cognitive deficits and limit of stability in chronic low back pain patients with and without fear-avoidance beliefs

ObjectiveThis study aimed to compare the cognitive performance and limit of stability parameters between chronic low back pain (CLBP) patients with and without fear-avoidance beliefs (FABs) and healthy control subjects. MethodsThirty-four CLBP patients with and without FABs and 17 healthy controls were recruited into the study. Three cognitive components, including working memory, attention, and problem-solving, were assessed using Wechsler's Digit Span subtest, the Tower of London test, and the Integrated Visual and Auditory Continuous Performance Test (IVACPT), respectively.The study assessed the limit of stability using MARS software. One-way ANOVA with Bonferroni-corrected post-hoc comparisons revealed between-group differences. Additionally, Hedge's g effect size was calculated. ResultsThere was no significant difference between CLBP patients with and without FABs in Wechsler's Digit span and the Tower of London test. However, CLBP patients with FABs had lower scores and slower reaction times in the IVACPT(p < 0.05).The statistical analysis of movement velocity during the limit of stability (LOS) tasks revealed no significant difference between chronic low back pain patients with and without fear-avoidance beliefs in all directions. However, CLBP patients with FABs exhibited significantly slower reaction times in the forward (p = 0.001), backward (p = 0.001), and right (p = 0.001) directions. ConclusionThe study indicates that chronic low back pain (CLBP) patients with FABs experience more pronounced cognitive impairments and balance disturbances compared to CLBP patients without FABs. These results underscore the significance of considering psychological factors when assessing the functional abilities of individuals with chronic low back pain.

Association between glymphatic dysfunction and neurocognitive decline in patients with frontal lobe epilepsy.

The glymphatic system is essential for the maintenance of brain homeostasis. It may be impaired in patients with epilepsy, but its association with neurocognitive function remains unknown. In this study, we aimed to elucidate the association between changes in the glymphatic system and neurocognitive function in individuals diagnosed with frontal lobe epilepsy (FLE). This retrospective case-control research engaged a group of patients with FLE and age-, sex-, and education-matched healthy volunteers. All participants were subjected to extensive neurocognitive assessments, complemented by structural and diffusion-weighted imaging. The "diffusion tensor imaging analysis along the perivascular space" (DTI-ALPS) index was computed to ascertain differences in glymphatic system function between the groups. Univariate and multivariate analyses were conducted to explore associations between DTI-ALPS, clinical characteristics in patients with FLE, and the neurocognitive test outcomes for both groups. Twenty-five patients [mean age ± standard deviation (SD): 26.28±8.12 years, 10 females] with FLE and 22 healthy control (HC) participants (average age ± SD: 25.86±6.15 years, 11 females) were included. The average ALPS-index in FLE group was significantly lower than that in HC group (1.387±0.127 vs. 1.468±0.114, P=0.026). Further, significant neurocognitive difference was noted in Trail Making Test (TMT), Stroop Color and Word Test (SCWT), Digit Span Test (DST) and similarity test (ST) between the two groups. ALPS-index scores exhibited a negative correlation with disease duration in patients with FLE (r=-0.415, P=0.039), and positive correlations with the Forward Digit Span Test (FDST, r=0.399, P=0.005) and Similarity Test (ST, r=0.395, P=0.006) in both groups. After adjusting for potential confounders, DTI-ALPS maintained a significant independent association with FDST and ST. The findings of the current study suggest a possible association between impairment in glymphatic function and FLE. Furthermore, results indicate that glymphatic dysfunction, as assessed via DTI-ALPS index, appears to be related to neurocognitive decline in FLE.

Executive functions and functioning in women with fibromyalgia.

Fibromyalgia (FM) is a chronic condition characterized by widespread pain that is associated with sleep, emotional, and cognitive disturbances, including in executive functions (EFs). To investigate the relationship between EFs and functionality in women with FM. The study included 17 women with FM, aged between 30 and 59 years, with no history of neurological disease. The EFs were assessed using the Digit Span Subtest (DS), Five Digit Test, Trail Making Test (TMT), Corsi Block-Tapping Task, Hayling Test (HT), and Verbal Fluency Task. Functionality was evaluated through the Fibromyalgia Impact Questionnaire. The Beck Depression Inventory, Hamilton Anxiety Rating Scale, and Brief Pain Inventory were used to measure depression, anxiety, and pain, which were controlled in the statistical analyses. The FM patients showed longer response latency on the HT and TMT. They made fewer errors on part B of the HT, and they performed worse on the DS backward and on the Corsi Block-Tapping Task forward and backward. There were moderate correlations in the expected direction between performance on the Corsi Block-Tapping Task backward and interference at work, as well as between the time to complete part B of the Trail Making Test - B (TMT-B) and fatigue. An unexpected relationship was found between errors on part B of the HT and interference at work. The results suggest lower efficiency in processes such as inhibitory control and cognitive flexibility, difficulties in working memory and non-executive processes such as processing speed. Even with pain, anxiety, and depression controlled, some relationships between EFs and functionality were observed, indicating that these symptoms do not fully explain this relationship. We suggest that cognition, particularly EFs, and broader measures of functionality be considered in the evaluation of FM.

Efficacy of acetylcholinesterase inhibitors for cognitive impairment in multiple sclerosis: A systematic review and meta-analysis

Background &amp; Objective: Multiple Sclerosis (MS) is a chronic demyelinating condition characterized by a myriad of neurologic deficits. The prevalence rate of Cognitive impairment (CI) ranges from 40 to 60 percent among community-dwelling individuals with MS. Cholinergic dysfunction is one of the different mechanisms proposed to cause CI, supporting the use of acetylcholinesterase inhibitors (AChEIs) in certain conditions. The study aims to determine the safety and efficacy of acetylcholinesterase inhibitors in multiple sclerosis patients with cognitive impairment through a review of randomized clinical trials. Methods: Using the updated PRISMA guidelines, we searched MEDLINE by PubMed, Cochrane Central Register for Controlled Trials (CENTRAL), ClinicalTrials. gov website, Google Scholar, and HERDIN Database for relevant studies until November 15, 2022. Results: A total of 73 records were identified and five studies were included in the analysis. Pooled evidence shows that AchEIs (donepezil 10 mg/day or rivastigmine 10 mg/day for 12 to 14 weeks) did not significantly improve Paced Auditory Serial Addition Test (PASAT) score for information processing and sustained attention and the Selective Reminding Test (SRT) score for verbal memory. Another study using the Weschler Memory Scale (WMS) also did not show significant improvement in their scores. However, a recent trial that used the Everyday memory questionnaire (EMQ), prospective and retrospective memory questionnaire (PRMQ), and the Digit span test (DST) showed significant difference between pre- and post-intervention mean scores in the donepezil group (p&lt;0.001). The physical and mental health scores of the Multiple Sclerosis Quality of Life questionnaires (MSQOL) significantly improved in MS patients receiving donepezil. Both donepezil and rivastigmine were associated with non-serious adverse events. Conclusion: The use of AchEIs among MS patients does not significantly improve objective measures of cognition but has positive impact on subjective scales of cognition (EMQ and PRMQ). AchEIs were shown to improve patients’ quality of life. AchEIs are safe and well tolerated among MS patients.

Differential Effects of Continuous Theta Burst Stimulation over the Bilateral and Unilateral Cerebellum on Working Memory.

Recent functional MRI studies have implicated the cerebellum in working memory (WM) alongside the prefrontal cortex. Some findings indicate that the right cerebellum is activated during verbal tasks, while the left is engaged during visuospatial tasks, suggesting cerebellar lateralization in WM function. The cerebellum could be a potential target for non-invasive brain stimulation (NIBS) to enhance WM function in cognitive disorders. However, the comprehensive influence of cerebellar lateralization on different types of WM and the effect of stimulation over the unilateral or bilateral cerebellum remain uncertain. This study was to investigate the cerebellum's functional lateralization and its specific impact on various aspects of WM in a causal manner using unilateral or bilateral cerebellar continuous theta burst stimulation (cTBS), a form of inhibitroy NIBS. Twenty-four healthy participants underwent four sessions of cTBS targeting the left, right, or bilateral Crus I of the cerebellum, or a sham condition, in a controlled cross-over design. WM performance was assessed pre- and post-stimulation using neuropsychological tests, including the 3-back task, spatial WM task, and digit span task. Results indicated that cTBS over the bilateral and right cerebellum both led to a greater improvement in 3-back task performance compared to sham stimulation. Additionally, active cTBS over the bilateral cerebellum yielded better performance in the spatial WM task than sham stimulation. However, no significant differences were observed between stimulation conditions for the auditory digit span task. This study may provide novel causal evidence highlighting the specific involvement of the right and bilateral cerebellum in various types of WM. Specifically, the right cerebellum appears crucial for updating and tracking 3-back WM content, while spatial WM processes require the coordinated engagement of both cerebellar hemispheres.

Working memory of young school-age learners acquiring L2 English morphology: An experimental exploratory lab study with structured input intervention

The aim of this pre-/posttest design lab case study is to find possible interactions between working memory (WM) effects and the effectiveness of structured input among 10-11-year-olds with first language (L1) German children. The target feature is the simple English past tense. The WM capacity was assessed via three span tasks: listening (LST), reading (RST), and a digit span task (DST). Second language (L2) learners' WM scores for all three span tasks were included as continuous predictors in the mixed model analysis. Assessment entailed sentence-level interpretation tasks yielding accuracy scores with reaction times, and a gap-filling production task with accuracy scores. Regarding interpretation, results varied. L2 learners with high DST scores outperformed learners with low DST scores in terms of accuracy. A mixed model analysis including reaction times did not improve the model's fit. Regarding production, the WM did not prove to be a predictor for the accuracy effects. However, L2 learners with early age of onset English (AOE) showed significant improvement over time and L2 learners with late AOE showed no effect at all. We conclude that instruction with structured input is effective regardless of the WM score, and its effects are retained over a 3 weeks' delayed period.

Involvement of cognitive abilities in the occurrence of fractures in fallers aged 55 years or older: a cross-sectional study

BackgroundBoth bone fragility and poor cognitive functions are known to contribute to fracture occurrence, but it remains unclear whether their contribution is independent of each other and which cognitive dysfunctions are most involved. This study aimed to clarify the involvement of various cognitive abilities in fall-related fractures among community-dwelling fallers aged 55 and over, and to determine whether poor cognitive abilities is a risk factor independent of bone fragility.MethodsIn a cross-sectional study, we collected sociodemographic and medical data, including bone mineral density (BMD), and performed cognitive and mobility assessments in 189 individuals with a history of fall in the previous year.ResultsFallers with a fracture had poorer cognitive and mobility performance than non-injured fallers. Multivariate regressions revealed that cognition, BMD and other risk factors were independently associated with fracture among all participants (OR = 1.04, 95% CI = 1.01–1.08, p = 0.034 for completion time on part A of the Trail Making Test [TMT-A], and OR = 0.53, 95% CI = 0.33–0.84, p < 0.001 for BMD), particularly in women (OR = 0.77, 95% CI = 0.60–0.98, p = 0.039 for backward digit span score, and OR = 0.43, 95% CI = 0.25–0.75, p = 0.001 for BMD).ConclusionThus, poor cognition, especially poor processing speed and working memory, is associated with an increased risk of fracture in fallers, particularly in women, regardless of BMD or other fracture risk factors. Hence, an in-depth cognitive evaluation should enhance the detection of fallers at risk of fracture, particularly in the absence of signs of osteoporosis, and thus ensure the best possible prevention.

Dose Response of Transcranial Photobiomodulation on Cognitive Efficiency in Healthy Older Adults: A Task-Related Functional Near-Infrared Spectroscopy Study.

Alzheimer's disease has become increasingly prevalent among the older population, leading to significant social and economic burdens. Transcranial photobiomodulation (tPBM) has shown promise as a cognitive intervention for enhancing cognitive efficiency in healthy older adults, and individuals with mild cognitive impairment and Alzheimer's disease. However, determining the optimal tPBM dosage is crucial for ensuring effective and efficient intervention. This study aimed to compare the effects of different dosages in a single tPBM session on cognitive efficiency in healthy older adults. In this randomized controlled trial, 88 healthy older participants were assigned to either a single dose (irradiance = 30 mW/cm2, fluence = 10.8 J/cm2; n = 44) or a double dose (irradiance = 30 mW/cm2, fluence = 21.6 J/cm2; n = 44) tPBM session. Cognitive efficiency was assessed using functional near-infrared spectroscopy during a visual working memory span task. The single dose group exhibited significantly greater cognitive efficiency enhancement, indicated by a more pronounced reduction in oxygenated hemoglobin during a challenging task level (span level 9) (p = 0.021, d = 0.50), and better working memory task performance (p = 0.045, d = 0.31). Furthermore, participants with better visuospatial abilities demonstrated greater improvement after a single dose (r = -0.42, p = 0.004). In contrast, participants with varying cognitive function did not exhibit additional benefits from a double dose (r = -0.22-0.15, p = 0.16-0.95). These findings suggest that higher tPBM dosages may not necessarily result in superior cognitive improvement in older adults.

The relationship between cognitive function and functional capacity, and cognitive reserve and reaction time in patients with multiple sclerosis.

Cognitive dysfunction is frequently seen in multiple sclerosis (MS). However, there are conflicting findings regarding the factors it is associated with. To investigate the relationship between aerobic capacity, strength, disability, depression, fatigue, and cognitive reserve and function. The mobile applications Trail Making Test (TMT A-B), Digit Span Test (DST), Visuospatial Memory Test (VSMT), and Tap Fast were used in the cognitive function evaluation. Functional performance was assessed with the 6-minute walk test (6MWT), 5-Time Sit-to-Sand (5STS) test, and grip strength. Cognitive Reserve Index (CRI), Beck Depression Inventory, Fatigue Severity Scale (FSS), and Nottingham Health Profile were also used. A significant difference was found between the MS and control groups only in the 6MWT, STS-5, grip strength, TMT, VSMT, and Tap Fast. Good correlation was found between the TMT-A and 6MWT and physical mobility. A fair correlation was shown between grip strength, energy, and pain status. A good correlation was found between TMT-B and 6MWT, and a fair relationship with disability, cognitive reserve, and pain. Good correlation was observed between the DST and 6MWT, left grip strength, pain, and energy status; fair correlations were found between right grip strength, cognitive reserve, and physical mobility. Good correlation was found between the VSMT and energy. A fair relationship between disability, cognitive reserve, and pain was demonstrated. Good correlation was observed between the Tap Fast score and disability, 5STS, FSS, energy, and physical mobility. A fair relationship was found between pain and social isolation. It has been shown that cognitive performance in MS is related to disability, functional performance, cognitive reserve, fatigue, and general health. NCT06084182.

Can volumetric magnetic resonance imaging evaluations be helpful in the follow-up of cognitive functions in cognitively normal Parkinson's disease patients?

In this study, besides the evaluation of gray and white matter changes in cognitively normal Parkinson's disease (PD-CN) patients with volumetric magnetic resonance imaging (MRI) parameters, it was tried to show that some neuropsychological tests may be impaired in PD-CN patients. Twenty-six PD-CN patients and 26 healthy elderly (HC) participants were included in the current study. Global cognitive status was assessed using the mini-mental state examination (MMSE), and the Montreal cognitive assessment scale (MoCA). Attention and executive functions were evaluated using the Wechsler memory scale-revised (WMS-R) digit span test and trail making test (TMT) part A and part B, the Stroop test, semantic and phonemic fluency tests, and clock drawing test. Magnetic resonance imaging (MRI) was acquired according to the Alzheimer's disease neuroimaging initiative (ADNI) protocol. There were no significant differences among groups regarding age, sex, handedness, and years of education. In the comparison of the PD-CN group and the HC group, there was a statistical decrease in the total animal scores, lexical fluency, TMT part A and TMT part B scores in the PD-CN group. Subcortical gray matter volumes (GMV) were significantly lower in PD-CN patients. The PD-CN group had a significantly reduced total volume of right putamen and left angular gyrus compared to that in the HC group. We observed that putamen and angular gyrus volumes were lower in PD-CN patients. On the other hand, TMT part B may be a useful pretest in detecting the conversion of mild cognitive impairment in PD. Significant MRI volumetric measurements and neuropsychological test batteries can be helpful in the clinical follow-up in PD-CN patients.