Free Recall Scores Research Articles

Subjective cognitive concerns differ by race/ethnicity among einstein aging study (EAS) participants: Implications for assessment and interpretation of self‐perceived cognitive functioning

AbstractBackgroundSubjective cognitive concerns (SCC) play an important role in the identification of preclinical dementia, especially among individuals who have experienced health disparities. It is critical to discern differential patterns of SCC endorsement among racially/ethnically diverse groups to enhance the ability to accurately capture current and future cognitive status. Moreover, it is important to determine whether the association of SCCs and objective neuropsychological test scores vary by racial/ethnic background.MethodUsing data from the EAS, a longitudinal community residing cohort aged 70+, SCCs were captured using an expanded version of the Cognitive Change Index (CCI‐40), which taps multiple cognitive domains. Objective cognition was measured using the FCSRT and tests from the Uniform Data Set, Neuropsychological Battery (UDSNB3.0). Linear regression models evaluated racial/ethnic differences in SCC at baseline. Additional models for objective cognition examined its association with SCC adjusting for racial/ethnic groups, and furthermore the interaction effects between race/ethnicity and SCC. Covariates included demographics, depressive symptoms, income, and co‐morbidities.ResultWe included 313 participants of non‐Hispanic (NH) White (47%), NH Black (40%) and Hispanic/Latino (13%) racial/ethnic groups who were not demented at baseline. NH Blacks and Hispanic/Latino participants reported significantly more SCC than NH Whites after adjusting for covariates. Higher CCI‐40 scores were associated with worse FCSRT free recall and Trail Making Test Part B performing, adjusting for race and other covariates. When interactions between race/ethnicity and CCI‐40 were included, higher levels of SCC were associated with lower MoCA and FCSRT free recall scores for NH Whites but not for NH Blacks.ConclusionStronger perceptions of self‐reported cognitive decline do not necessarily correspond to worse performance on memory and global cognitive tasks for all racial groups. Although racial/ethnic differences were found in levels of SCC, it is important to investigate factors that may influence self‐perceived cognitive functioning for specific groups (e.g., health status, social support), and the consequential impact on access to healthcare settings (where assessment and diagnosis typically occur). In addition, researchers should consider diversity variables when setting cut points on self‐report questionnaires to enhance diagnostic sensitivity and inform optimal assessment and monitoring needs.

Literacy, but not memory, is associated with hippocampal connectivity in illiterate adults

AbstractBackgroundThe role of hippocampal connectivity for good memory performance is well known in persons with high educational level. However, it is understudied the role of hippocampal connectivity in illiterate populations.MethodsThirty‐nine illiterate adults from Brazil underwent a literacy assessment, structural and resting state functional MRI and an episodic memory test (Free and Cued Selective Reminding Test). We correlated the hippocampal connectivity at rest with the free recall scores and the literacy scores. Analyzes were done in SPM 12, corrected for head motion and physiological BOLD signal.ResultsParticipants were most female (66%) and black (79%) and the mean age was 49 years‐old (±13.9). The mean score on free recall was 27.2 (±10.7) out of 48 points and the mean literacy score was 34.9 (±21.1) out of 100 points. The median hippocampal gray matter volume was 2.4 [0.9, 2.3]cm3 in the left and 2.1 [2.1, 2.4] cm3 in the right side. There was a significant connectivity between both hippocampi and the precuneus and the ventral medial prefrontal cortex. However, this connectivity did not correlate with episodic memory scores, but the right hippocampal connectivity correlated with the literacy scores (R2 = 0.13, p = 0.014, CI 1.0‐1.0). Furthermore, the hippocampal gray matter volume did not correlate with memory scores.ConclusionsAlthough we did not find a significant correlation between memory and the connectivity between both hippocampi and the precuneus and ventral medial prefrontal cortex, we found that this connectivity correlated with literacy scores on the right side. The lack of association with memory scores might be associated with low brain reserve in illiterate adults. The association between hippocampal connectivity and low literacy scores suggest a room for improvement if those adults learn how to read later in life.

Affective Theory of Mind as a residual ability to preserve mentalizing in amnestic Mild Cognitive Impairment: A 12-months longitudinal study.

Theory of Mind (ToM) decline has been outlined in people with amnestic Mild Cognitive Impairment (aMCI), but evidence from longitudinal studies is lacking. This longitudinal study aims to investigate changes in cognitive and affective ToM performance in an aMCI sample (n = 28; 14 females, mean age = 76.54 ± 4.35). Participants underwent two steps of neurocognitive evaluation, at the baseline (T1) and 12-month follow-up (T2), to obtain their global cognitive level and both affective (Reading the Mind in the Eyes test, ET) and cognitive (Strange Stories, SS) ToM profile. Then, participants were categorized into two groups based on ToM changes: people who worsened (ETΔ < 0; SSΔ < 0) and people who did not (ETΔ≥0; SSΔ≥0) at follow-up. Differences between groups in cognitive functions and ToM profiles at baseline have been investigated. Our results showed that 46% of subjects worsened in affective (ET) and 28% in cognitive (SS) ToM at follow-up. People who worsened in ET reported a statistically significantly higher performance in ET at baseline (p = 0.002) but not at follow-up than people who did not worsen. In contrast, subjects who worsened in SS showed a lower Immediate Free Recall (IFR, p = 0.026) and Delayed Free Recall (DFR, p = 0.028) score of the Free and Cued Selective Reminding test at baseline and at follow-up, a lower ET (p = 0.020) baseline score, a lower SS and MMSE level at follow-up than people who not worsened. About 71% of MCI subjects showed the same trend of evolution of the Mini-Mental State Examination and SS. Variables that significantly differed between groups have been inserted in a stepwise logistic regression to pilot explore predictors of affective and cognitive ToM evolution. Logistic regression showed ET at baseline (p = 0.015) as the only significant predictor of affective ToM evolution (R2 = 0.450), while both ET (p = 0.044) and memory performance (p = 0.045) at baseline significantly predicted cognitive ToM evolution (R2 = 0.746). In conclusion, our results support the role of affective ToM as a residual mentalizing ability in preserving the mentalizing level in people with aMCI.

Neural correlates of episodic memory in adults with Down syndrome and Alzheimer’s disease

BackgroundAdults with Down syndrome are at an ultra-high risk of developing early-onset Alzheimer’s disease. Episodic memory deficits are one of the earliest signs of the disease, but their association with regional brain atrophy in the population with Down syndrome has not been explored. We aimed to investigate the neuroanatomical correlates of episodic memory in adults with Down syndrome and symptomatic Alzheimer’s disease.MethodsSingle-center, cross-sectional study. A total of 139 adults with Down syndrome (85 asymptomatic and 54 with symptomatic Alzheimer’s disease) were included in the study (mean age 43.6 ± 10.9 years, 46% female). Episodic memory was assessed using the modified Cued Recall Test. Immediate (trial 1 free immediate recall, trial 3 free immediate recall, total free immediate recall score, and total immediate score) and delayed scores (free delayed recall score and total delayed score) were examined. Cortical thickness from magnetic resonance imaging was determined with surface-based morphometry using the FreeSurfer 6.0 software package. The clusters of reduced cortical thickness were compared between symptomatic and asymptomatic participants to create a cortical atrophy map. Then, the correlation between cortical thickness and the modified Cued Recall Test subscores were separately assessed in symptomatic and asymptomatic subjects, controlling for age, sex, and severity of intellectual disability.ResultsCompared with asymptomatic participants, those with symptomatic Alzheimer’s disease showed a pattern of cortical atrophy in posterior parieto-temporo-occipital cortices. In symptomatic subjects, trial 1 immediate free recall significantly correlated with cortical atrophy in lateral prefrontal regions. Trial 3 free immediate recall and total free immediate recall were associated with the most widespread cortical atrophy. Total immediate score was related to posterior cortical atrophy, including lateral parietal and temporal cortex, posterior cingulate cortex, precuneus, and medial temporal lobe areas. Delayed memory scores were associated with cortical atrophy in temporoparietal and medial temporal lobe regions. No significant relationships were observed between episodic memory measures and cortical atrophy in asymptomatic subjects.ConclusionsDifferent episodic memory measures were associated with cortical atrophy in specific brain regions in adults with Down syndrome and Alzheimer’s disease. These results overlap with those described in sporadic Alzheimer’s disease and further support the similarities between Down syndrome-associated Alzheimer’s disease and that in the general population.

ObReco-2: Two-step validation of a tool to assess memory deficits using 360° videos.

Traditional neuropsychological evaluations are usually carried out using psychometric paper and pencil tests. Nevertheless, there is a continuous discussion concerning their efficacy to capture life-like abilities. The introduction of new technologies, such as Virtual Reality (VR) and 360° spherical photos and videos, has improved the ecological validity of the neuropsychological assessment. The possibility of simulating realistic environments and situations allows clinicians to evaluate patients in realistic activities. Moreover, 360° photos and videos seem to provide higher levels of graphical realism and technical user-friendliness compared to standard VR, regardless of their limitations in terms of interactivity. We developed a novel 360° tool, ObReco-2 (Object Recognition version 2), for the assessment of visual memory which simulates a daily situation in a virtual house. More precisely, patients are asked to memorize some objects that need to be moved for a relocation. After this phase, they are asked to recall them after 15 min and later to recognize them in the same environment. Here we present a first study about the usability of ObReco-2, and a second one exploring its clinical efficacy and updated usability data. We focused on Free Recall and Recognition scores, comparing the performances obtained by the participants in the standard and the 360° test. The preliminary results support the use of 360° technology for enhancing the ecological value of standard memory assessment tests.

Neuropsychological Profile of College Students Who Engage in Binge Drinking.

This study investigated the neuropsychological profile of college students who engage in binge drinking (BD) using comprehensive neuropsychological tests evaluating verbal/non-verbal memory, executive functions, and attention. Groups were determined based on scores on the Korean version of the Alcohol Use Disorder Identification Test (AUDIT-K) and Alcohol Use Questionnaire (AUQ). There were 79 and 81 participants in the BD and non-BD groups, respectively. We administered the Korean version of the California Verbal Learning Test (K-CVLT) and Rey-Osterrieth Complex Figure Test (RCFT) to evaluate verbal and non-verbal memory, respectively, and measured executive functions using the Wisconsin Card Sorting Test (WCST), Trail-Making Test, Controlled Oral Word Association Test and Stroop Color-Word Test. We administered the d2 test to evaluate attention. Neuropsychological performance was analyzed by multivariate analysis of variance. The BD group showed significantly poorer performance in the long-term free recall condition of the K-CVLT and delayed recall condition of the RCFT and completed significantly fewer categories on the WCST than the non-BD group. In addition, there were significant negative associations among the AUDIT-K total score, AUQ binge score, and long-term free recall score of the K-CVLT. There were significant negative associations between the total AUDIT-K score and delayed recall RCFT score, and between the total AUDIT-K total score and numbers of completed categories on the WCST. These results indicate that college students who participate in BD have difficulties with verbal/non-verbal memory and executive functions, and further suggest that excessive alcohol use could have detrimental effects on the hippocampal-prefrontal circuit even with a relatively short period of alcohol use.

Mind Maps: Processed as Intuitively as Thought? Investigating Late Elementary Students' Eye-Tracked Visual Behavior Patterns In-Depth.

In this study, 44 late elementary students’ visual behavior patterns when reading mind maps were investigated, more particularly, the intuitive processing nature of their visual characteristics, reading sequence and presentation mode (i.e., mind map before or after text). Eye-tracked data were investigated by means of static early attention and dynamic educational process mining (EPM) analysis and combined with learning performance and retrospective interview data. All students seem to struggle with the map’s radial structure during initial reading. Also, the picture’s position in the map diverts students from consecutively reading interconnected branches. EPM analyses revealed different reading patterns in proceeding reading behavior. Students receiving a text first, seem to grasp the radial structure slightly more and show higher information integration attempts. They also attained higher free recall and coherence scores. The study concludes with instructional design principles for urgently needed explicit visual literacy instruction in elementary grades.

Corticosteroids use and neurocognitive functioning in patients with recurrent glioblastoma: Evidence from European Organization for Research and Treatment of Cancer (EORTC) trial 26101.

BackgroundIn patients with recurrent glioblastoma, corticosteroids are frequently used to mitigate intracranial pressure and to improve patient neurological functioning. To date, in these patients, no systematic studies have been performed to assess neurocognitive functioning (NCF) in relation to corticosteroid treatment.MethodsUsing baseline data (ie, prior to randomization) of European Organization for Research and Treatment of Cancer (EORTC) trial 26101, we performed regression analysis to assess the predictive value of corticosteroid intake on performance of the EORTC brain tumor clinical trial NCF test battery. The battery is comprised of the Hopkins Verbal Learning Test—Revised (HVLT-R), Controlled Oral Word Association Test (COWA), and Trail Making Test (A and B).ResultsOut of 321 patients, 148 (46.1%) were not using corticosteroids, and 173 were using dexamethasone (34.3%), methylprednisolone (9.7%), or other corticosteroids (9.9%). Patients on corticosteroids had worse performance on all neurocognitive tests. Regression analyses demonstrated a negative association between corticosteroids use and the HVLT-R free recall score (R2 change = 0.034, F change (1, 272) = 13.392, P < .001) and HVLT-R Delayed Recall score (R2 change = 0.028, F change (1, 270) = 10.623, P = .002). No statistically significant association was found for HVLT-R Delayed recognition, COWA, TMT part A and TMT part B (P > .05).ConclusionsGlioblastoma patients prescribed with corticosteroids show poorer memory functions, expressive language, visual-motor scanning speed, and executive functioning than patients not using corticosteroids. Furthermore, we found a negative association between corticosteroid intake and memory functions. The possibility of deleterious effects of corticosteroids on NCF should be considered during clinical decision making.

Middle Cerebellar Peduncle Lesions and Their Relation to Affective and Cognitive Impairment in Multiple Sclerosis

Background: Cerebellum has long been known to modulate not only motor coordination but also affective and cognitive functions. This study aimed to assess the impact of middle cerebellar peduncle (MCP) lesions on affective and cognitive function in patients with multiple sclerosis (MS). Methods: This was a cross-sectional study conducted on patients with relapsing-remitting MS (RRMS). All patients were subjected to 3-Tesla magnetic resonance imaging (3T MRI), brief international cognitive assessment for MS (BICAMS), and Depression, Anxiety, and Stress Score-21 (DASS-21) upon recruitment. Results: Of the 30 patients recruited, 33.3% and 36.7% had right and left MCP lesions, respectively. Patients with right MCP lesions had significantly worse symbol digit modality test (SDMT) scores (P=0.036), worse California verbal learning test (CVLT) immediate recall scores (P=0.011), and worse CVLT delayed free recall scores (P=0.049), whereas patients with left MCP lesions had lower DASS-21 scores (P&lt;0.005). On multivariate regression analysis, the presence of left MCP lesion was associated with an 8.9-point reduction in DASS-21 scores (CI: -16.985- -0.805, P=0.033), whereas right MCP lesions did not have an independent effect on BICAMS scores after adjustment for age and educational level. Conclusion: Left MCP lesions were associated with significantly lower DASS-21 scores, whereas none of the MCP lesions had an independent impact on cognition.

Safety, efficacy, and tolerability of memantine for cognitive and adaptive outcome measures in adolescents and young adults with Down syndrome: a randomised, double-blind, placebo-controlled phase 2 trial

Down syndrome is a chromosomal disorder with considerable neurodevelopmental impact and neurodegenerative morbidity. In a pilot trial in young adults with Down syndrome, memantine (a drug approved for Alzheimer's disease) showed a significant effect on a secondary measure of episodic memory. We aimed to test whether memantine would improve episodic memory in adolescents and young adults with Down syndrome. We did a randomised, double-blind, placebo-controlled phase 2 trial with a parallel design, stratified by age and sex. Participants (aged 15-32 years) with either trisomy 21 or complete unbalanced translocation of chromosome 21 and in general good health were recruited from the community at one site in Brazil and another in the USA. Participants were randomly assigned (1:1) to receive either memantine (20 mg/day orally) or placebo for 16 weeks. Computer-generated randomisation tables for both sites (allocating a placebo or drug label to each member of a unique pair of participants) were centrally produced by an independent statistician and were shared only with investigational pharmacists at participating sites until unblinding of the study. Participants and investigators were masked to treatment assignments. Neuropsychological assessments were done at baseline (T1) and week 16 (T2). The primary outcome measure was change from baseline to week 16 in the California Verbal Learning Test-second edition short-form (CVLT-II-sf) total free recall score, assessed in the per-protocol population (ie, participants who completed 16 weeks of treatment and had neuropsychological assessments at T1 and T2). Linear mixed effect models were fit to data from the per-protocol population. Safety and tolerability were monitored and analysed in all participants who started treatment. Steady-state concentrations in plasma of memantine were measured at the end of the trial. This study is registered at ClinicalTrials.gov, number NCT02304302. From May 13, 2015, to July 22, 2020, 185 participants with Down syndrome were assessed for eligibility and 160 (86%) were randomly assigned either memantine (n=81) or placebo (n=79). All participants received their allocated treatment. Linear mixed effect models were fit to data from 149 (81%) participants, 73 in the memantine group and 76 in the placebo group, after 11 people (eight in the memantine group and three in the placebo group) discontinued due to COVID-19 restrictions, illness of their caregiver, adverse events, or low compliance. The primary outcome measure did not differ between groups (CVLT-II-sf total free recall score, change from baseline 0·34 points [95% CI -0·98 to 1·67], p=0·61). Memantine was well tolerated, with infrequent mild-to-moderate adverse events, the most common being viral upper respiratory infection (nine [11%] participants in the memantine group and 12 [15%] in the placebo group) and transient dizziness (eight [10%] in the memantine group and six [8%] in the placebo group). No serious adverse events were observed. Amounts of memantine in plasma were substantially lower than those considered therapeutic for Alzheimer's disease. Memantine was well tolerated, but cognition-enhancing effects were not recorded with a 20 mg/day dose in adolescents and young adults with Down syndrome. Exploratory analyses point to a need for future work. Alana Foundation. For the Portuguese translation of the abstract see Supplementary Materials section.

Hippocampal connectivity in illiterate adults from Brazil

AbstractBackgroundThe role of hippocampal connectivity for good memory performance is well known in persons with high educational level. However, it is understudied the role of hippocampal connectivity in illiterate populations.MethodsThirty‐nine illiterate adults underwent resting state functional MRI and an episodic memory test (Free and Cued Selective Reminding Test). We correlated the hippocampal connectivity at rest with the free recall scores. Analyzes were corrected for head motion and physiological BOLD signal.ResultsParticipants were most female (66%) and black (79%) and the mean age was 49 years‐old (±13.9). The mean score on free recall was 27.2 (±10.7) out of 48 points. We found a significant correlation between the hippocampus and the right parahippocampal gyrus, right insula and right basal ganglia. However, we did not find an association between the hippocampal connectivity and the memory scores.ConclusionsIlliterate adults have a significant correlation between the hippocampus and the right insula and basal ganglia. The lack of association with memory scores might be associated with low brain reserve in this group of individuals.

Cognitive performance predictors of incident motoric cognitive risk syndrome

AbstractBackgroundMotoric cognitive risk syndrome (MCR) is a gait based pre‐dementia syndrome that builds on operational definitions of mild cognitive impairment (MCI), and is associated with increased risk for Alzheimer’s Disease and other types of dementia. Declines in cognitive function associated with risk of developing MCR have not been established. We aimed to examine the association between cognitive performance on tests of memory and executive function (EF) and related processes and risk of incident MCR.MethodOf the 541 non‐demented participants (aged 65+) in a community‐based cohort, at baseline 22 met criteria for MCR, 58 for MCI, and 17 met criteria for both MCR and MCI, and were excluded from the analyses. Cognitive performance was measured using seven tests: the free recall score from the Free and Cued Selective Reminding Test, Figure Recall from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Story Recall from the RBANS, Category Fluency, Controlled Oral Word Association Test, Digit Symbol Substitution test and Trail Making Test part B. A confirmatory factor analysis indicated that these cognitive tests fell into two categories of cognitive function: memory and EF and related processes. Cox proportional hazard models adjusted for age, sex and education was used to examine the association between cognitive test performance and incident MCR in 444 participants. For the purpose of comparison, we also examined the association between cognitive performance and MCI.ResultOver a mean follow‐up of 3.0 years, 37 participants developed incident MCR and 69 incident MCI. Performance on tests of EF and related processes was associated with risk for MCR (adjusted hazard ratios (aHR) ranging from 0.96 to 0.99). One memory test (free recall) was associated with risk of MCR (aHR: 0.94, 95% Confidence Interval: 0.89‐0.99). Performance on all tests of memory (aHR ranging from 0.81 to 0.92) and EF and related processes (HR ranging from 0.94 to 0.99) was associated with increased risk of MCI.ConclusionCognitive performance on tests of EF and related processes are associated with increased risk of MCR. This may be indicative of a distinct underlying pathology in patients who are at risk of MCR.

Cognitive decline as an outcome and marker of progression toward dementia, in early preventive trials.

Recent Food and Drug Administration guidance endorses cognitive assessment as a possible primary endpoint for early trials for Alzheimer's disease but emphasizes the need for certainty regarding the relationship with progression to dementia. We compared the validity of the 2-year change (Y0-Y2) of 11 markers of neuropsychological and functional abilities for the prediction of incident dementia over the following 3 years (Y2-Y5), in 860 subjects aged 70 years or older, who consulted for memory loss and were included in the "GuidAge" prevention trial. The Free and Cued Selective Reminding Test-Free Recall (FCSRT-FR) score showed the most predictive 2-year change (area under the curve=0.72 95% confidence interval=0.64;0.81). Changes in other subscores of the FCSRT, verbal fluencies tasks, and composite cognitive score were also significantly predictive. Conversely, 2-year change of Mini-Mental State Examination, Trail Making test (TMT)-A, TMT-B, Clinical Dementia Rating Sum of Boxes, and Instrumental Activities of Daily Living scores did not significantly predict occurrence of dementia. The FCSRT, the Fluency Task, and the composite cognitive score appear to be good cognitive markers of progression toward dementia in early prevention trials.

Novel characterization of the relationship between verbal list-learning outcomes and hippocampal subfields in healthy adults.

The relationship between hippocampal subfield volumetry and verbal list‐learning test outcomes have mostly been studied in clinical and elderly populations, and remain controversial. For the first time, we characterized a relationship between verbal list‐learning test outcomes and hippocampal subfield volumetry on two large separate datasets of 447 and 1,442 healthy young and middle‐aged adults, and explored the processes that could explain this relationship. We observed a replicable positive linear correlation between verbal list‐learning test free recall scores and CA1 volume, specific to verbal list learning as demonstrated by the hippocampal subfield volumetry independence from verbal intelligence. Learning meaningless items was also positively correlated with CA1 volume, pointing to the role of the test design rather than word meaning. Accordingly, we found that association‐based mnemonics mediated the relationship between verbal list‐learning test outcomes and CA1 volume. This mediation suggests that integrating items into associative representations during verbal list‐learning tests explains CA1 volume variations: this new explanation is consistent with the associative functions of the human CA1.

Associative Learning of New Word Forms in a First Language (L1) and Haptic Referents in a Single-Day Experiment.

This study focused on the associative learning of new word forms in the first language and haptic stimuli. In this study, healthy Japanese participants performed three-step tasks. First, participants made nine subjective evaluations of haptic stimuli using five-point semantic differential scales (e.g., regarding stickiness, scored from 1 (not sticky) to 5 (sticky)). Second, the participants carried out learning and recognition tasks for associative pairs of new (meaningless) word forms in their first language (Japanese) and haptic stimulus (H condition), and performed learning and recognition tasks for new (meaningless) word forms only (W condition). The order of conditions was counterbalanced among participants. Third, participants performed free recall tasks. The results of the recognition tasks showed that the proportions and response times of the W condition were better and faster, respectively, than those of the H condition. Furthermore, preference of haptic features negatively correlated with free recall scores of the H condition; however, there was no significant difference between the free recall scores of the H and W conditions. Our results suggest that new word forms were learned better than associative pairs of new word forms and haptic stimuli in a single day of learning. Furthermore, the free recall performance of word forms associated with haptic features could also be affected by their subjective evaluation (preference).

Relationships between cognitive function, seizure control, and self-reported leisure-time exercise in epilepsy

Exercise may be a strategy for improvement of cognitive deficits commonly present in people with idiopathic generalized epilepsies (IGE). We investigated the relationship between cognition and level of physical exercise in leisure (PEL) in people with IGE who have been seizurefree for at least 6 months (IGE−) as compared to those who have not been seizurefree (IGE+) and healthy controls (HCs). We hypothesized that higher level of physical exercise is associated with better cognitive functioning in patients with IGE and HCs, and that seizure control affects both PEL levels and cognitive functioning in patients with IGE.We recruited 75 participants aged 18–65: 31 people with IGE (17 IGE−, 14 IGE+) and 44 HCs. Participants completed assessments of quality of life (SF-36), physical activity levels (Baecke questionnaire and International Physical Activity Questionnaire (IPAQ)) and cognition (Montreal Cognitive Assessment (MoCA), Hopkins Verbal Learning Test – Revised (HVLT), and flanker task). Group differences (HCs vs. IGE; HCs vs. IGE+ vs. IGE−) were assessed. Pearson correlations examined linear relationships between PEL and cognitive performance.Groups were similar in age and sex. Compared to HCs, patients with IGE had higher body mass index, fewer years of education, and consistently scored worse on all measures except flanker task accuracy on incongruent trials. When examining IGE− and IGE+ subgroups, compared to HCs, both had higher body mass index, and fewer years of education. Healthy controls scored significantly better than one or both of the IGE groups on SF-36 scores, PEL levels, IPAQ activity level, MoCA scores, HVLT learning and long-delay free-recall scores, and flanker task accuracy on congruent trials. Among patients with IGE, there were no significant differences between age of epilepsy onset, duration of epilepsy, number of anti-seizure drugs (ASDs) currently being used, or the group distribution of type of IGE. In the combined sample (IGE+, IGE− and HCs), PEL positively correlated with MoCA scores (Pearson’s r = 0.238; p = 0.0397) and with flanker task accuracy on congruent trials (Pearson’s r = 0.295; p = 0.0132).Overall, patients with IGE performed worse than HCs on cognitive and physical activity measures, but the cognitive impairments were more pronounced for IGE+, while physical exercise levels were less for patients with IGE regardless of seizure control. While positive relationships between leisure-time PEL and cognitive performance are promising, further investigations into how exercise levels interact with cognitive functioning in epilepsy are needed.

The Rey 15-Item Memory Test in US veterans

ABSTRACT Introduction: The Rey 15-item Test is a public-domain, memory-based performance validity test, frequently used in clinical settings. Various efforts have been made to modify the test to make it more sensitive and more robust to effects of lower education and intelligence. The most promising of these is the addition of a recognition trial to the existing free recall paradigm. Method: The present study explored the use of the Rey-15 + Recognition Trial in a sample of 155 younger U.S. military veterans seen for evaluation of mild traumatic brain injury or attention deficit hyperactivity disorder (50 cases classified as invalid, 105 classified as valid). Results: Optimal classification accuracy was obtained on the Combination index (cutoff ≤23, sensitivity = 50%, specificity = 95%) and the Recognition Hits score (cutoff ≤11, sensitivity = 52%, specificity = 93%). The Free Recall score had somewhat lower sensitivity when a similar 95% specificity threshold was set (cutoff ≤11, 38% sensitivity). A qualitative error score used in previous studies did not improve classification accuracy. Conclusions: The Rey-15 + Recognition Trial proved to be effective, with particular advantage bestowed by the recognition trial. Implications of these findings in the context of the study’s clinical sample of military veterans and in the broader literature are discussed.

Effects of Noise and Serial Position on Free Recall of Spoken Words and Pupil Dilation during Encoding in Normal-Hearing Adults.

This preliminary study assessed the effects of noise and stimulus presentation order on recall of spoken words and recorded pupil sizes while normal-hearing listeners were trying to encode a series of words for a subsequent recall task. In three listening conditions (stationary noise in Experiment 1; quiet versus four-talker babble in Experiment 2), participants were assigned to remember as many words as possible to recall them in any order after each list of seven sentences. In the two noise conditions, lists of sentences fixed at 65 dB SPL were presented at an easily audible level via a loudspeaker. Reading span (RS) scores were used as a grouping variable, based on a median split. The primacy effect was present apart from the noise interference, and the high-RS group significantly outperformed the low-RS group at free recall measured in the quiet and four-talker babble noise conditions. RS scores were positively correlated with free-recall scores. In both quiet and four-talker babble noise conditions, sentence baselines after correction to the initial stimulus baseline increased significantly with increasing memory load. Larger sentence baselines but smaller peak pupil dilations seemed to be associated with noise interruption. The analysis method of pupil dilation used in this study is likely to provide a more thorough understanding of how listeners respond to a later recall task in comparison with previously used methods. Further studies are needed to confirm the applicability of our method in people with impaired hearing using multiple repetitions to estimate the allocation of relevant cognitive resources.

The Free and Cued Selective Reminding Test Predicts Braak Stage.

Background:The ultimate validation of a clinical marker for Alzheimer’s disease (AD) is its association with AD neuropathology.Objective: To identify clinical measures that predict pathology, we evaluated the relationships of the picture version of the Free and Cued Selective Reminding Test (pFCSRT + IR), the Mini-Mental State Exam (MMSE), and the Clinical Dementia Rating scale Sum of Boxes (CDR-SB) to Braak stage.Methods:315 cases from the clinicopathologic series at the Knight Alzheimer’s Disease Research Center were classified according to Braak stage. Boxplots of each predictor were compared to identify the earliest stage at which decline was observed and ordinal logistic regression was used to predict Braak stage.Results: Looking at the assessment closest to death, free recall scores were lower in individuals at Braak stage III versus Braak stages 0 and I (combined) while MMSE and CDR scores for individuals did not differ from Braak stages 0/I until Braak stage IV. The sum of free recall and total recall scores independently predicted Braak stage and had higher predictive validity than MMSE and CDR-SB in models including all three.Conclusion:pFCSRT + IR scores may be more sensitive to early pathological changes than either the CDR-SB or the MMSE.

Retention of Biomedical Knowledge in Medical Students Predicts USMLE Step 1 Scores.

This article was migrated. The article was marked as recommended. Introduction Medical students are tasked with learning a vast amount of medical knowledge prior to sitting for the USMLE Step 1 exam, a portion of which is either forgotten or becomes inaccessible to memory following each exam. In this study we examined whether accessibility and retention of 1 st-year biochemistry content predicts performance on high stakes exams such as USMLE Step1. Methods First-year medical students were retested on a subset of biochemistry final exam items 10.5 months after sitting for the original exam. Retention was measured as a percentage of the original final exam score. Availability of information was measured with cued recall (i.e., selecting from a list the multiple-choice distractors), while accessibility of information was captured through free recall (without the aid of multiple choice distractors). Results As expected, we found that free recall rates were much lower than cued recall rates, but that students who scored higher on Step 1 had a smaller gap between cued and free recall scores, demonstrating a greater ability to access information than lower-scoring students. Importantly, we also demonstrate that higher-scoring students retained a higher percentage of the original biochemistry material than lower-performing students after 10.5 months, and that the amount information retained in memory was associated with higher scores on Step 1, demonstrating the potential importance of teaching medical school content with the intention of making it stick, especially in students who are not as strong academically. Conclusion The methods employed in this study are straightforward and can be used to compare retention and accessibility of information across medical school courses, and may serve as a guide to curriculum and pedagogical improvements.