Fluency Ability Research Articles

Contact Location and Neuropsychological Outcomes in Subthalamic Deep Brain Stimulation.

A host of influences contribute to cognitive and behavioral changes following deep brain stimulation. The location of the active cathode is likely an important variable but it has received little attention. To determine whether active contact location relative to the subthalamic nucleus and other neighboring structures is related to nonmotor outcomes. We identified a retrospective, cross-sectional sample of 46 patients who underwent subthalamic nucleus deep brain stimulation for treatment of idiopathic Parkinson's disease. T-tests or nonparametric equivalents were used to detect baseline differences between unilateral left, unilateral right, and bilateral surgical groups. Correlation and partial correlational analyses identified relationships between contact location variables and alterations in cognitive, mood, quality of life, motor, and disease variables. Medial contact locations within the left subthalamic nucleus were correlated with improvements in self-reported mood (r12 = -0.78, P= .001; 95% confidence interval [CI] = -0.43 to -0.93) but worsening semantic fluency (r26 = -0.38, P= .048; 95% CI = -0.01 to -0.66). Phonemic fluency worsened with more posterior left placement (r34 =0.35, P= .036; 95% CI =0.03 to 0.61). Memory outcome was related to right hemisphere stimulation voltage (r29 = -0.40, P= .022; 95% CI = -0.05 to -0.66), which is likely a proxy for variable electrode location. Location of the active contact is related to nonmotor outcomes, even in electrodes that are adequately placed. This is relevant to clinical care as there appears to be a trade-off between mood and fluency abilities that should be considered during surgical planning according to preoperative patient characteristics.

Cognitive predictors of sequential motor impairments in children with dyslexia and/or attention deficit/hyperactivity disorder

ABSTRACTThis study examined cognitive predictors of sequential motor skills in 215 children with dyslexia and/or attention deficit/hyperactivity disorder (ADHD). Visual working memory and math fluency abilities contributed significantly to performance of sequential motor abilities in children with dyslexia (N = 67), ADHD (N = 66) and those with a comorbid diagnosis (N = 82), generally without differentiation between groups. In addition, primary diagnostic features of each disorder, such as reading and inattention, did not contribute to the variance in motor skill performance of these children. The results support a unifying framework of motor impairment in children with neurodevelopmental disorders such as dyslexia and ADHD.

Executive, language, or both? An examination of the construct validity of verbal fluency measures

ABSTRACTThe purpose of the present study was to evaluate whether phonemic and semantic verbal fluency were more related to aspects of language processing than executive functioning (EF). An exploratory factor analysis was performed on a college-aged sample of 320 healthy participants using principle axis factoring and promax rotation on nine measures of EF. The first three factors, labeled: working memory, fluid reasoning, and shifting/updating, were extracted and used as latent executive variables. Participants were also split into low, medium, and high phonemic and semantic verbal fluency ability groups. Phonemic and semantic fluency correlated similarly across all three extracted EF factors and word knowledge. Using one-way analysis of variance (ANOVAs), there was a main effect for both phonemic and semantic verbal fluency groups and all outcome variables (i.e., the EF factors and word knowledge). Tukey HSD post hoc analyses showed that those in the low verbal fluency ability groups had significantly lower scores across all outcome measures compared to the high verbal fluency ability groups. Across all analyses, semantic fluency had stronger relations with the EF factors, signifying a large executive component involved in the task. Both phonemic and semantic fluency were similarly related to multiple dimensions of EF and word knowledge and should be considered executive language tasks.

Abstract WP146: Predictors of Recovery From Acute Aphasia

Introduction: Making accurate predictions about a stroke patient’s language/speech-motor outcome and recovery potential is a challenge. We previously showed that a combined variable of lesion site and size pertinent to relevant white matter language structures, the Arcuate Fasciculus lesion load (AF-LL), correlated highly with measures of speech fluency in chronic aphasic patients (Marchina et al., 2011; Wang et al., 2013). However, studies in motor recovery and other domains have shown that behavioral measures in the acute stroke phase might be equal or better predictors of recovery compared to lesion measures. Whether or not any of these measures follow a proportional recovery rule, has not been established. Hypothesis: To evaluate whether acute aphasia measures (overall WAB score) and/or acute lesion measures (e.g., AF-Lesion Load) predict recovery from aphasia. Methods: Over a period of several years, patients presenting with acute aphasia were evaluated using a bedside version of the Western Aphasia Battery complemented by picture naming tests, automatic speech measures, and custom-made word/phrase spoken and sung test. A total of 100 acute patients were assessed of which 56 followed up at 3 months. Lesion maps drawn on diffusion-weighted images were used to calculate lesion loads of a probabilistic Arcuate Fasciculus (AF) tract derived from matched elderly healthy control subjects. Analyses included correlations between recovery potential and actual recovery and other predictors of 3 months outcome. AF-LL was regressed with the overall WAB score, measures of speech fluency and naming ability (using the Boston Naming Test). Results: The overall bedside WAB score in the acute stroke period was the best predictor of the overall WAB score at 3 months (R2=0.60). This predictor was slightly improved when a measure of speaking-singing dissociation was added to the model. Lesion-load of the AF was also a good predictor of WAB score at 3 months (R2=0.48), but did not improve outcome predictions of the WAB score by itself. Overall acute aphasic patients followed a proportional recovery rule, but only recovered about 56% of what was theoretically possible. Conclusion: Language and Speech-Motor Outcome after stroke can be predicted best by a bedside WAB score.

Cognitive Function Among Antiretroviral Treatment-Naive Individuals Infected With Human Immunodeficiency Virus Type 1 Subtype G Versus CRF02_AG in Nigeria.

Human immunodeficiency virus type 1 (HIV-1) subtype has been shown to be associated with disease progression. We compared cognitive function between individuals infected with HIV-1 subtype G and CRF02_AG in Nigeria. For this cross-sectional study, samples were analyzed from 146 antiretroviral-naive participants. Genotypic analysis of plasma HIV RNA was performed by nested polymerase chain reaction of protease and reverse transcriptase genes, and sequences were aligned with curated HIV-1 subtype references. Cognitive status was determined using demographically adjusted T scores and global deficit score (GDS) obtained from a comprehensive neuropsychological test battery. A total of 76 (52.1%) participants were infected with CRF02_AG, 48 (32.8%) with subtype G, and 22 (15.1%) with other HIV-1 strains. In a multivariable linear regression adjusting for plasma HIV RNA, CD4 count, and depression score, mean global T score was lower among subtype G-infected compared with CRF02_AG-infected participants (mean difference, -3.0 [95% confidence interval {CI}, -5.2, to -.7]; P = .011). Also, T scores were significantly lower among subtype G- than CRF02_AG-infected participants for the speed of information processing, executive function, and verbal fluency ability domains. Adjusting for similar variables in a logistic regression, the odds of global cognitive impairment (GDS ≥0.5) were 2.2 times higher among subtype G compared with CRF02_AG-infected participants (odds ratio, 2.2 [95% CI, .9-5.4]; P = .078). Cognitive performance was significantly worse among antiretroviral-naive individuals with HIV-1 subtype G vs CRF02_AG infection. Further studies are required to characterize the mechanistic basis for these differences.

MONITORING AND EVALUATION STUDENTS’ LEARNING ACHIEVEMENTS THROUGH THEIR LEARNING ACTIVITIES WITH THE STEM EDUCATION INSTRUCTIONAL METHOD FOR DEVELOPING THEIR CREATIVE THINKING ABILITIES AND THEIR ATTITUDES TOWARD SCIENCE OF SECONDARY STUDENTS AT THE 11TH GRADE LEVEL IN PHYSICS CLASSES

Educational management approaches that integrate knowledge in four subjects, including science, technology, engineering, and mathematics (STEM Education Method: STEME) to develop learning achievement, attitude, and creative thinking ability toward science of secondary students at the 11 th grade level in physics classes. The aims of this research study were to analyze of the processing performances and the performance results (E 1 /E 2 ) efficiency at the determining criteria as 75/7, to compare students’ learning achievements of their pretest and posttest assessments in cording in the STEME , to assess students’ responses of their creative thinking abilities with the STEME , to assess students’ perceptions of their science related attitudes with the STEME, to associated between students’ post learning achievements and their creative thinking abilities the STEME, and to associated between students’ post learning achievements and their science related attitudes with the STEME . The target group consisted of 72 secondary students in two physics classes from Borabu Wittayakhan School in the academic year of 2/2016. Using the instructional innovative lesson plans of the STEME on Eclectic and Magnetics Issue in 14 hours was administered, the 30-item Learning Achievement Test (LAT), the 24-item Creative Thinking Ability Assessment (CTAA); and the 8-item Test Of Science-Related Attitude (TOSRA) were assessed. Statistically significant was analyzed with the foundational and advance statistics. The Results of these research findings have found that: Students were evaluated to determine performance criteria with the efficiency of the processing performance and the performance results (E 1 /E 2 ) of 80.32 / 75.77 for the STEME innovation lesson plans, which was higher than standardized criteria of 75/75. Students’ learning achievements of their pretest ( = 15.77, S.D. = 2.24) and post-test ( = 19.87, S.D. = 3.26) and t-test = 20.42 were differentiated evidence at the 0.001 level, significantly. Students’ responses of their critical thinking abilities for the CTAA in fluency, flexibility, originality, and elaboration abilities, respectively, as a whole indicated at the high level ( = 3.67, S.D. = 0.83), and the Cronbach alpha reliability = 0.87 . Students’ perceptions of their attitudes toward science with the TOSRA indicated that α – reliability = 0.78, all on their average scores ranged from 3.31 to 3.90, as a whole indicated that a high level for their perceptions. Associations between students’ learning achievements of their post-test assessment indicated that 59% of the coefficient predictive value ( R 2 ) of the variance in students’ creative thinking abilities was attributable to their perceptions for the CTAA and the relationship between students' statistical achievements at the .001 level was significantly. Students’ learning outcomes of their post-test assessment, the R 2 value indicated that 51% of the variances in students’ perceptions to their science related attitude for the TOSRA, and the relationship between students' statistical achievements at the .001 level were significantly. Article visualizations:

Contribution of visuospatial attention, short-term memory and executive functions to performance in number interval bisection

Number interval bisection consists of estimating the mid-number within a pair (1–9=>5). Healthy adults and right-brain damage patients can show biased performance in this task, underestimating and overestimating the mid-number, respectively. The role of visuospatial attention during this task, and its interplay with other cognitive abilities (e.g., working memory) is still object of debate. In this study we explored the relation between visuospatial attention and individual differences in working memory and executive functions during number interval bisection. To manipulate the deployment of visuospatial attention, healthy participants tracked a dot moving to the left or moving to the right while bisecting numerical intervals. We also collected information concerning verbal and visuospatial short-term memory span, and concerning verbal and visuospatial fluency scores. Beside replicating what is typically observed in this task (e.g., underestimation bias), a correlation was observed between verbal short-term memory and bisection bias, and an interesting relation between performance in the number interval bisection, verbal short-term memory, and visuospatial attention. Specifically, performance of those participants with low verbal span was affected by the direction of the moving dot, underestimating at a larger extent when the dot moved leftward than rightward. Finally, it was also observed that participants’ verbal fluency ability contributed in the generation of biases in the numerical task. The finding of the involvement of abilities belonging to the verbal domain contributes to unveil the multi-componential nature of number interval bisection. Considering the debate on the nature of number interval bisection and its use in the clinical assessment of deficits following brain damage, this finding may be interesting also from a clinical perspective.

Functional connectivity in resting state as a phonemic fluency ability measure

There is some evidence that functional connectivity (FC) measures obtained at rest may reflect individual differences in cognitive capabilities. We tested this possibility by using the FAS test as a measure of phonemic fluency. Seed regions of the main brain areas involved in this task were extracted from meta-analysis results (Wagner et al., 2014) and used for pairwise resting-state FC analysis. Ninety-three undergraduates completed the FAS test outside the scanner. A correlation analysis was conducted between the F-A-S scores (behavioral testing) and the pairwise FC pattern of verbal fluency regions of interest. Results showed that the higher FC between the thalamus and the cerebellum, and the lower FCs between the left inferior frontal gyrus and the right insula and between the supplementary motor area and the right insula were associated with better performance on the FAS test. Regression analyses revealed that the first two FCs contributed independently to this better phonemic fluency, reflecting a more general attentional factor (FC between thalamus and cerebellum) and a more specific fluency factor (FC between the left inferior frontal gyrus and the right insula). The results support the Spontaneous Trait Reactivation hypothesis, which explains how resting-state derived measures may reflect individual differences in cognitive abilities.

The Effects of Training on Computational Fluency and Working Memory on Students’ Achievement and Retention in Algebra

Many students, despite a good understanding of mathematical concepts, are hindered by simple calculations. Recent cognitive researches claimed that working memory which is the limited capacity system of the brain that allows simultaneous storage and processing of temporary information may be improved through trainings and, consequently, improved mathematics performance. The purpose of this study is to investigate the effect of the dual task training on computational fluency with a load of working memory task compared to the traditional basic mathematics drill on the students’ achievement and retention in high school algebra. This research made use of two randomly chosen intact groups of fourth year high school students who were given both pretest and posttest using three validated instruments. A 3-week follow-up test was administered to assess algebra retention. This study found that the students who received the dual task training have significantly higher gains in their computational fluency and working memory ability. However, both groups were comparable in terms of their algebra achievement and retention after the 6-week training. The computational fluency was also found to be a predictor of the students’ achievement and retention in algebra. Thus, the working memory training has no direct effect on the students’ algebra achievement but mediated the effect of computational fluency. A longer and uninterrupted experimental period is recommended for further studies with a focus on binary number tasks as this was found to predict computational fluency.

Executive functions, parental punishment, and aggression: Direct and moderated relations

ABSTRACTThe main focus of the current study was to assess whether executive functions (EFs) moderate the effect of parental punishment on adolescent aggression. The sample were 370 participants (53% girls, 47% boys) enrolled at secondary and higher secondary levels and ranged in age between 13–19 years (M = 15.5, SD = 1.3). Participants were assessed on a self-report measure of aggression and two punishment measures, in addition to a demographic sheet. Then, they were individually assessed on four tests taken from the Delis–Kaplan Executive Functions System (D-KEFS) namely Trial Making Test (TMT), Design Fluency Test (DFT), Color Word Interference Test (CWIT), and Card Sorting Test (CST) to assess cognitive flexibility, nonverbal fluency, inhibition, and problem-solving ability, respectively. Correlation coefficients indicated that all four executive functioning measures and the two punishment measures were significantly correlated with aggression. Moderation analysis indicated that all EFs moderated the relationship between physical punishment and aggression, and only inhibition and problem-solving ability, but not cognitive flexibility and nonverbal fluency, moderated the relations between symbolic punishment and aggression. The findings support the hypothesis that EFs are protective personal factors that promote healthy adolescent adjustment in the presence of challenging environmental factors.

Renewable fuels from CO2 using cheap efficient catalysts

Individual differences in the performance profiles of neuropsychologically-impaired patients are pervasive yet there is still no resolution on the best way to model and account for the variation in their behavioural impairments and the associated neural correlates. To date, researchers have generally taken one of three different approaches: a single-case study methodology in which each case is considered separately; a case-series design in which all individual patients from a small coherent group are examined and directly compared; or, group studies, in which a sample of cases are investigated as one group with the assumption that they are drawn from a homogenous category and that performance differences are of no interest. In recent research, we have developed a complementary alternative through the use of principal component analysis (PCA) of individual data from large patient cohorts. This data-driven approach not only generates a single unified model for the group as a whole (expressed in terms of the emergent principal components) but is also able to capture the individual differences between patients (in terms of their relative positions along the principal behavioural axes). We demonstrate the use of this approach by considering speech fluency, phonology and semantics in aphasia diagnosis and classification, as well as their unique neural correlates. PCA of the behavioural data from 31 patients with chronic post-stroke aphasia resulted in four statistically-independent behavioural components reflecting phonological, semantic, executive–cognitive and fluency abilities. Even after accounting for lesion volume, entering the four behavioural components simultaneously into a voxel-based correlational methodology (VBCM) analysis revealed that speech fluency (speech quanta) was uniquely correlated with left motor cortex and underlying white matter (including the anterior section of the arcuate fasciculus and the frontal aslant tract), phonological skills with regions in the superior temporal gyrus and pars opercularis, and semantics with the anterior temporal stem.

Predicting verbal fluency using Word Reading: Implications for premorbid functioning

ABSTRACTThe estimation of premorbid general intellectual functioning using word reading tests has a rich history of validation and is a common assessment practice for neuropsychologists. What is less well-researched is the approach used to estimate premorbid functioning of non-intellectual domains, such as executive functions, including verbal fluency. The current study evaluated this relationship with 41 adult college students who completed the Word Reading subtest of the Wechsler Individual Achievement Test-Second Edition (WIAT-II) and the Verbal Fluency test from the Delis–Kaplan Executive Function System (D-KEFS). Path analysis indicated that only Letter Fluency (a measure of phonemic fluency) was statistically significantly related to Word Reading and the relationship was somewhat weak. The relationship between Category Fluency (a measure of semantic fluency) and Category Switching (a measure of verbal fluency cognitive set-shifting) to Word Reading was nonsignificant. Participants also completed the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III), and as expected a strong relationship was found between Word Reading and the Verbal IQ (VIQ), Performance IQ (PIQ), and Full Scale Intelligence Quotient (FSIQ). Results of this study strongly suggest that caution be exercised when extrapolating an estimate of premorbid verbal fluency abilities from measures of word reading.

Using principal component analysis to capture individual differences within a unified neuropsychological model of chronic post-stroke aphasia: Revealing the unique neural correlates of speech fluency, phonology and semantics

Individual differences in the performance profiles of neuropsychologically-impaired patients are pervasive yet there is still no resolution on the best way to model and account for the variation in their behavioural impairments and the associated neural correlates. To date, researchers have generally taken one of three different approaches: a single-case study methodology in which each case is considered separately; a case-series design in which all individual patients from a small coherent group are examined and directly compared; or, group studies, in which a sample of cases are investigated as one group with the assumption that they are drawn from a homogenous category and that performance differences are of no interest. In recent research, we have developed a complementary alternative through the use of principal component analysis (PCA) of individual data from large patient cohorts. This data-driven approach not only generates a single unified model for the group as a whole (expressed in terms of the emergent principal components) but is also able to capture the individual differences between patients (in terms of their relative positions along the principal behavioural axes). We demonstrate the use of this approach by considering speech fluency, phonology and semantics in aphasia diagnosis and classification, as well as their unique neural correlates. PCA of the behavioural data from 31 patients with chronic post-stroke aphasia resulted in four statistically-independent behavioural components reflecting phonological, semantic, executive–cognitive and fluency abilities. Even after accounting for lesion volume, entering the four behavioural components simultaneously into a voxel-based correlational methodology (VBCM) analysis revealed that speech fluency (speech quanta) was uniquely correlated with left motor cortex and underlying white matter (including the anterior section of the arcuate fasciculus and the frontal aslant tract), phonological skills with regions in the superior temporal gyrus and pars opercularis, and semantics with the anterior temporal stem.

Profile of Neurocognitive Functioning in Adults Infected with HIV

Abstract Since the very beginning of the course of infection, HIV enters into the CNS and it is reflected through neurological disorders. The aim of this study was to assess and subsequently compare the neurocognitive functioning of treatment-naive adults with HIV Stage I, II & peer control. Cross-sectional Case-control study design was followed. 22 adults (11 in stage I and 11 in stage II) with HIV infection and 11 adults as matched control were administered various standardised neuropsychological tests assessing cognitive functions like verbal fluency, executive functions, memory and visuo-spatial ability. Data were analysed by computing Kruskal Wallis one way ANOVA by ranks and post-hoc analysis (with the help of Mann Whitney U Test). Results showed that adults with HIV infected had poorer performance on most measures of memory functioning, visuo-spatial ability, verbal fluency and some measures of frontal lobe functioning in comparison to the matched peer control group. Those with stage II HIV had more compromised functions than those in stage I HIV in overall frontal lobe functioning along with inhibitory control, conceptualization, mental flexibility and sensitivity to interference.

発達性読み書き障害児群における語流暢性課題成績

先行研究では，発達性読み書き障害児/者の語音想起力を語流暢性課題にて検討した報告が散見されるが，現在も一定の見解にはいたっていない．本研究では，日本語話者で言語発達障害のない発達性読み書き障害典型群と特異的言語障害の併存が認められる発達性読み書き障害群に対して語流暢性課題を実施し，発達性読み書き障害児の語音想起力について検討した．対象児は小学校1，3，5年生の発達性読み書き障害児63名（典型例50名，特異的言語障害併存例13名）と通常学級在籍児151名である．語頭音を「あ」と「か」に指定した語流暢性課題を実施した．通常学級在籍児群と比較して全学年で語頭音指定語流暢性課題の成績が低かったのは，発達性読み書き障害/特異的言語障害併存群のみであった．語流暢性課題の成績には音声言語の発達が関与しており，言語発達障害のない典型的な発達性読み書き障害児は，語流暢性課題では問題を示さないと考えられた．

Spontaneous activity in the precuneus predicts individual differences in verbal fluency in cognitively normal elderly.

The precuneus is 1 of the major cortical hubs and plays an important role in normal aging and verbal fluency processing. The main aim of present study was to investigate how intrinsic brain activity in the precuneus at rest predicts individual differences in verbal fluency ability among elderly adults. Regional amplitude of low-frequency fluctuations (ALFF) analysis and a correlation-based functional connectivity (FC) approach were used to analyze data acquired from 101 cognitively normal elderly. ALFF in the precuneus declined with normal aging and was significantly correlated with individual differences in performance on the verbal fluency test (VFT). Specifically, ALFF in the precuneus was reduced in elderly with high fluency (HF) ability compared with those with low fluency (LF) ability. In addition, the HF individuals displayed increased functional connectivity of the precuneus with the lateral temporal area and prefrontal lobe, including the inferior frontal, medial frontal, superior temporal, middle temporal, and superior frontal gyri. Spontaneous activity in the precuneus could predict individual differences in verbal fluency processing. Our results suggest that spontaneous activity in the precuneus is an indicator of aging-related changes in semantic verbal fluency processing, or even a potential biomarker for the early detection of semantic verbal fluency deterioration.

The role of working memory and verbal fluency in autobiographical memory in early Alzheimer's disease and matched controls

Retrieval of autobiographical memories (AMs) is important for “sense of self”. Previous research and theoretical accounts suggest that working memory (WM) and semantic and phonemic fluency abilities facilitate the hierarchical search for, and reliving of past, personal events in the mind's eye. However, there remains a lack of consensus as to the nature of the relationships between these cognitive functions and the truly episodic aspects of AM. The present study therefore aimed to explore the associations between these variables in a sample with a wide range of cognitive abilities. The study incorporated a between-groups component, and a correlational component with multiple regression. Participants with Alzheimer's disease (n=10) and matched healthy controls (n=10) were assessed on measures of semantic and episodic AM search and retrieval, auditory and spatial WM, and semantic and phonemic fluency. The AD group produced less episodic AM content compared to controls. Semantic fluency predicted episodic AM retrieval independent of age effects but there were no significant relationships between measures of phonemic fluency, WM and episodic AM. The results suggest that the ability to maintain hierarchical search of the semantic knowledge-base is important for truly episodic reliving, and interventions for people with AM impairment might therefore benefit from incorporating structured, individualised external memory-aids to facilitate AM search and retrieval.

Do Dispositional Characteristics Influence Reading? Examining the Impact of Personality on Reading Fluency

Previous research demonstrates specific relationships between personality traits and general academic performance. In addition, research studies have demonstrated relationships among personality and variables related to reading fluency (i.e. speed, accuracy, automaticity, and prosody). However, little investigation has examined specific links between personality and reading fluency. The researchers hypothesized that there is a direct relationship between personality and reading fluency when accounting for cognitive ability. Findings indicate that the personality trait of openness is a positive predictor of reading fluency ability even when accounting for variance associated with cognitive ability.

Interacting effects of age and time of day on verbal fluency performance and intraindividual variability

We explored the effects of age and time of day (TOD) on verbal fluency ability with respect to performance level and intraindividual variability (IIV). Verbal fluency, which involves complex cognitive operations, was examined in 20 older (mean age = 72.8 years) and 20 younger (mean age = 24.2 years) adults with test start time alternating between morning and evening across four days. Older adults generated more words in the morning and younger adults more in the evening, corresponding with self-report peak TOD. Age by TOD interactions were also observed across fluency tasks on the number of switches among subcategory exemplars during word generation and on the IIV observed in switching behavior. Older adults exhibited greater variability in switching in the evening than in the morning, whereas younger adults showed the opposite pattern. These findings demonstrate that processes involving energization (initiating and sustaining) and attentional control may be particularly sensitive to age differences in TOD influences on cognition.

Cognitive and Brain Structural Changes in a Lung Cancer Population

No study has examined structural brain changes specifically associated with chemotherapy in a lung cancer population. The aim of this cross-sectional study was to assess differences in brain structure between small-cell lung cancer patients (C+) following chemotherapy, non-small-cell lung cancer patients (C-) before chemotherapy and healthy controls (HC). Twenty-eight small-cell lung cancer patients underwent a neuropsychological assessment and a structural magnetic resonance imaging, including T1-weighted and diffusion tensor imaging to examine gray matter density and white matter (WM) integrity, respectively, 1 month following completion of platinum-based chemotherapy. This group was compared with 20 age and education-matched non-small-cell lung cancer patients before receiving chemotherapy and 20 HC. Both C+ and C- groups exhibited cognitive impairment compared with the HC group. The C+ group performed significantly worse than HC in verbal fluency and visuospatial subtests; C- performed significantly worse than both C+ and HC in verbal memory. Voxel-based morphometry analysis revealed lower gray matter density in the insula and parahippocampal gyrus bilaterally, and left anterior cingulate cortex in C+ compared with HC. Diffusion tensor imaging indices showed focal decreased WM integrity in left cingulum and bilateral inferior longitudinal fasciculus in the C+ group and more widespread decreased integrity in the C- group compared with the HC group. This study demonstrates that lung cancer patients exhibit cognitive impairment before and after chemotherapy. Before the treatment, C- showed verbal memory deficits as well as a widespread WM damage. Following treatment, the C+ group performed exhibited lower visuospatial and verbal fluency abilities, together with structural gray matter and WM differences in bilateral regions integrating the paralimbic system.