Measures Of Visual Memory Research Articles

Support for verbal memory reserve in women using an epigenetic marker of age acceleration

AbstractBackgroundTo determine whether characterizing men and women based on rates of biological aging indexed by DNA methylation “GrimAge” reflect differences on measures of verbal and non‐verbal memory.MethodCross‐sectional data from 1,930 adults aged 65 or older (mean age = 75, SD = 7.4, Male = 43%, non‐Hispanic White = 74.8%, non‐Hispanic Black = 13.5%, Hispanic = 9.6%, other race/ethnicity = 2.1%) were included. The standardized residual from regressing chronological age on the DNA methylation GrimAge clock as the measure of age acceleration. Slow and accelerated “DNAmGrimAgers” were defined as individuals below or above 1 SD of their sex‐specific GrimAge acceleration Mean, respectively. Individuals between these cutoffs were categorized as “normal agers” resulting in six different groups (i.e., 3 female and 3 male). Performances on measures of verbal and non‐verbal memory and processing speed were compared across these six different groups, controlling for education, depressive symptoms and chronological age. We reran analysis adjusting for processing speed.ResultWhen comparing men and women’s performances based on their matching DNAmGrimAge category, there was no difference in processing speed or visual memory (e.g., accelerated male DNAmGrimAgers performed similarly to accelerated female DNAmGrimAgers on speed). In contrast, women, regardless of their DNAmGrimAge category, outperformed men on verbal memory measures (in speed and non‐speed adjusted models). Additionally, while accelerated female DNAmGrimAgers had significantly lower memory performances compared to slow female DNAmGrimAgers, this group difference was no longer significant in the speed‐adjusted models.ConclusionWomen maintained a verbal memory advantage over men, despite different rates of age acceleration, which was not accounted for by faster processing speed. These findings strengthen prior support for verbal memory reserve that is specific to women. Thus, relying on verbal memory assessments in women at risk of Alzheimer’s disease (AD) may not be sensitive enough to detect hippocampal impairment in the earliest stages. However, performances on visual memory measures may be a more accurate representation of hippocampal function in women and should be included in assessments where AD is suspected.

Vitamin D is associated with visual memory in young northern adolescents

ABSTRACT Background Vitamin D status has been linked to visual memory in adults. We hypothesized a similar association in young adolescents. Methods Participants were 9–13 years. The Rey-Osterrieth Complex Figure Task (ROCF), Rey Auditory Verbal Learning Task (RAVLT), Digit Span (Forward, Backward), and verbal fluency task assessed visual and verbal learning/memory, attention/working memory, and executive functioning/language, respectively. An at-home, mail-in blood spot test assessed 25(OH)D levels. Results Participants (N = 56) were 10.7 ± 1.3 years, 61% females, 25(OH)D levels 84.2 ± 25 nmol/L(39.9 - 167.2 nmol/L) and 41% had insufficient vitamin D status (<75 nmol/L). Only measures of visual memory (ROCF-Recall, -%Recall of Copy) were significantly correlated with 25(OH)D, r = .34, p < .01 and r = .33, p < .01, respectively, and 25(OH)D remained a significant independent predictor on multiple regression analyses, which included age and sex.(ROCF-Recall overall model: Adj R2 = .24, p < .001; for 25(OH)D: p = .009; ROCF-%Recall of Copy overall model: Adj R2 = .20 p < .002; for 25(OH)D: p = .01). Individuals with sufficient vitamin D performed significantly better only on these measures (t-tests; ROCF-Recall, p = .016, d = 0.68; ROCF-%Recall of Copy, p = .022, d = 0.64). Despite moderate effect sizes (d = 0.4–0.5) in the Younger Age Group (9–10 years), only in the Older Age Group (11–13 years) was 25(OH)D significantly correlated with ROCF-Recall, r = .64, p = .0001 and ROCF-%Recall of Copy, r = .64, p = .0001, as well as working memory (Digit Span-Backward), Spearman’s r = .46, p = .013. Similarly, those in the Older Age Group with sufficient vitamin D performed significantly better on ROCF-Recall, p = .01, d = 1.07; and ROCF-%Recall of Copy, p = .009, d = 1.08. Conclusions Vitamin D insufficiency was common in young adolescents. Similar to adults, visual memory was better among participants with higher 25(OH)D and those with sufficient levels. This effect was especially pronounced among older participants, suggesting possible time- and/or age-related implications of vitamin D status on cognition.

Neurocognitive Assessment of Adults with Sickle Cell Disease: A Descriptive Study

Introduction: Sickle cell disease (SCD) causes devastating complications that can affect any organ in the body. Particularly, SCD can present with neurological complications of overt strokes, silent infarcts and cognitive impairment. As patients are living longer with SCD, cognitive functioning is an important aspect of their disease as deficits can impact education, employment, or adherence to medications. Most of the studies assessing cognitive impairment in this population have been in children with limited data on adults. This study explored the results of cognitive testing in adult patients with SCD when compared to normative data. This study also sought to determine any association between psychological factors (baseline anxiety and depression) as well as biological factors (i.e. hemoglobin levels).Methods: This was a cross-sectional study conducted at the Sickle Cell Center of Southern Louisiana in New Orleans.The study included adults with a diagnosis of sickle cell disease regardless of subtype who were over the age of 18. Patients were excluded if they were not able to physically complete the tasks. Executive function, memory, psychomotor speed, and memory were assessed using the following tasks from standardized pencil-and-paper cognitive tasks from the Cambridge Neuropsychological Automated Battery (CANTAB) test: Stocking of Cambridge (SOC),Delayed Matching to Sample (DMS), Paired Associates Learning (PAL), Motor Screening Task (MOT), Intra-Extra Dimensional Set Shift (IED), Spatial Working Memory (SWM). The Hospital Anxiety and Depression Subscale (HADS) clinical assessment tool was used to screen for anxiety and depression at the time of testing. A HADS score >8 denotes significant anxiety or depression.Results: A total of 22 patients (59% females, mean age 29.6±2.1 years) were included in this study. Attention and psychomotor speed were relatively preserved cognitive domains with 59.1% of patients scoring greater than 75 thpercentile relative to normative mean. Conversely, executive functioning often appeared impaired with 72.7% and 77.3% of patients scoring below 25 thpercentile in outcome measures of IED and SWM, respectively. Similarly, a significant percentage of patients scored below 25 thpercentile in outcome measures of visual memory, PAL and DMS, 63.6% and 45.4%, respectively. Fifteen participants (68%) screened positive for anxiety while two screened positive for depression. Patients with anxiety tended to perform worse on most cognitive tasks, although the differences in scores did not reach statistical significance. Additional analyses of association of biologic factors and neurocognitive functioning are currently underway.Discussion and Conclusion: Our results support that adults with sickle cell disease often suffer from cognitive deficits, which was expected based on pediatric studies demonstrating cognitive impairment in children with SCD. Interestingly, we observed a predominance of poor executive function over changes in attention and psychomotor speed in this study. This is in contrast with what providers familiar with “mini mental assessment” for dementia may expect. Typical dementia patients develop attention and memory changes before executive function is affected. Therefore, it is possible that cognitive impairment in SCD may go by unnoticed without proper testing. Additionally, in this cohort, anxiety was frequent and tended to associate with worse performance. Since this is a cross-sectional study, it is unclear whether cognition is progressively impaired over the years. Prospective studies are required to help determine whether and how fast progression occurs and what risk factors are implicated in the development and progression of cognitive impairment. Such deficits have been demonstrated to be associated with difficulties around employment and adherence to medication, which ultimately jeopardizes long term outcomes. Overall, we recommend neurocognitive and psychological evaluations as part of the routine care for adult SCD patients since abnormal findings seem common and may not be obvious without adequate testing for different domains. Treatment of anxiety disorder and cognitive rehabilitation may prove helpful to improve cognition in SCD patients. DisclosuresFertrin: Sanofi Genzyme: Consultancy, Membership on an entity's Board of Directors or advisory committees; Agios Pharmaceuticals: Consultancy, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Kruse-Jarres: Genentech/Roche: Speakers Bureau; Pfizer: Consultancy; CSL Behring: Consultancy; CRISPR: Consultancy; Biomarin: Consultancy; Genentech: Consultancy, Research Funding.

QOL-37. USE OF COMPUTERIZED NEUROPSYCHOLOGICAL MEASURES TO ASSESS COGNITIVE MORBIDITY IN CHILDREN UNDERGOING ACTIVE RADIATION THERAPY

Cognitive late effects of brain tumors and related treatments are well-established; however, limited information regarding changes in cognition during radiation therapy (RT) is available. Recent advances in computerized neuropsychological assessments for monitoring of acute and late treatment effects have been developed, though the feasibility of using these tools in a population undergoing active RT has limited empirical evidence. This study investigated performance of pediatric patients with brain tumors actively undergoing RT on the NIH Toolbox (N = 10; M age = 11.29 ± 3.35 years; 86% Caucasian; 86% female). Given significant individual variability, one-sample proportion tests were calculated to assess whether the proportion of patients with performances >1 standard deviation below the mean significantly differed from normative expectations. Of the 12 participants that were enrolled in the study, 10 completed the NIH Toolbox during active RT. Compared to normative expectations, a greater proportion of participants undergoing active RT exhibited deficits on measures of processing speed, working memory, and response inhibition (p=<.01). Differences between participants and normative expectations were not seen on measures of visual memory and vocabulary (p=>.05). Seventy-seven percent of recruited participants completed computerized assessment during active RT, suggesting reasonable feasibility within the small cohort recruited. Consistent with the literature regarding late effects of RT, performance on computerized measures of cognitive functioning mediated by processing speed and aspects of executive functioning were lower for patients undergoing active RT. Further investigation will focus on clarifying the trajectory of deficits across treatment course and comparing computerized measures to traditional neuropsychological measures.

Association Between Visual Memory and In Vivo Amyloid and Tau Pathology in Preclinical Autosomal Dominant Alzheimer's Disease.

Visual memory (ViM) declines early in Alzheimer's disease (AD). However, it is unclear whether ViM impairment is evident in the preclinical stage and relates to markers of AD pathology. We examined the relationship between ViM performance and in vivo markers of brain pathology in individuals with autosomal dominant AD (ADAD). Forty-five cognitively unimpaired individuals from a Colombian kindred with the Presenilin 1 (PSEN1) E280A ADAD mutation (19 carriers and 26 noncarriers) completed the Rey-Osterrieth Complex Figure immediate recall test, a measure of ViM. Cortical amyloid burden and regional tau deposition in the entorhinal cortex (EC) and inferior temporal cortex (IT) were measured using 11C-Pittsburgh compound B positron emission tomography (PET) and 11F-flortaucipir PET, respectively. Cognitively unimpaired carriers and noncarriers did not differ on ViM performance. Compared to noncarriers, carriers had higher levels of cortical amyloid and regional tau in both the EC and IT. In cognitively unimpaired carriers, greater cortical amyloid burden, higher levels of regional tau, and greater age were associated with worse ViM performance. Only a moderate correlation between regional tau and ViM performance remained after adjusting for verbal memory scores. None of these correlations were observed in noncarriers. Results suggest that AD pathology and greater age are associated with worse ViM performance in ADAD before the onset of clinical symptoms. Further investigation with larger samples and longitudinal follow-up is needed to examine the utility of ViM measures for identifying individuals at high risk of developing dementia later in life.

A-20 Do Children With LD and/or ADHD Differ at Baseline on a Pediatric Measure Used to Assess Concussion?

Abstract Objective To examine differences at baseline between children with ADHD and/or LD vs. children with neither ADHD/LD on 1) neurocognitive scores and 2) child- and parent-reported concussion symptoms. Method Retrospective data was obtained for 1856 children ages 5–11 who were assessed at baseline using ImPACT Pediatric. Groups were determined based on parent-reported diagnosis of their child at baseline (ADHD and/or LD vs. neither ADHD/LD), and groups were compared on the four factor scores: Sequential Memory, Word Memory, Visual Memory, and Rapid Processing and on child- and parent-reported concussion symptoms using a series of ANOVAs. Results ANOVAs revealed that children with ADHD and/or LD performed significantly worse than children without ADHD/LD on Sequential Memory (F(1,1845) = 69.86, p &amp;lt; .001)) and Word Memory (F(1,1853) = 10.36, p = .001)). In contrast, children with ADHD and/or LD performed significantly better on the neurocognitive measures of Visual Memory [(F(1,1845) = 4.94, p = .026)] and Rapid Processing [(F(1,1853) = 20.35, p &amp;lt; .001). Symptom reporting was significantly greater in the ADHD and/or LD group for both child (F(1,1853) = 30.21, p &amp;lt; .001) and parent (F(1,1853) = 34.64, p &amp;lt; .001) reported symptoms. Conclusions The current study demonstrated differences at baseline in children on neurocognitive performance and concussion symptom reporting based on diagnostic group. Analysis of symptom reporting suggested that children with pre-existing diagnoses of ADHD and/or LD and their parents may report concussion-like symptoms at baseline, prior to ever experiencing a concussion. This finding has clinical implications for interpretation of post-concussion symptoms without a baseline comparison in children with pre-existing diagnoses such as ADHD and/or LD.

Visual Memory Test based on Snodgrass Pictures (VMT-SP): a New Neuropsychological Measure of Visual Memory on Children with Learning Disabilities

Visual memory can be defined as the ability to recall visual images in the form of objects events or words. Previous neuropsychological research on Learning Disabilities (LD) involving visual memory has been focused particularly on children who present nonverbal LD, and their scholar underachievement. Objective: This study aims to develop a visual memory test using recognisable objects and to determine their normative values and validity in a population of children with LD and in a control group. Methods and procedures: A total of 330 children participated in this study (7-14 years), 190 suffered of some kind of LD and 140 did not have any diagnosis. Visual Memory was assessed using a test (VMT-SP) based on Snodgrass Pictures (Snodgrass &amp; Vanderwart, 1980) composed of a short-term, long-term and a recognition assessment. Rey Complex Figure Test (RCFT) and Hooper Visual Organisation Test (HVOT) were used to assess validity. Results: Short-term, long-term recall and long-term recognition differed significantly between the LD children and the control group. Moreover, the scores were influenced by the age of the children (with a higher percentage of correct answers being given by the older children), gender, habitat and mother’s level of education. Finally, the test results were associated with other measures of visual memory. Conclusions: VMT-SP is a new clinical tool for assessing visual memory. We present evidence of its concurrent validity and applicability in the evaluation of children with LD.

Pilot investigation of the relationship between hippocampal volume and pattern separation deficits in multiple sclerosis

Memory impairment and hippocampal atrophy are common in multiple sclerosis (MS). In the present pilot study, we investigate whether the mnemonic process of pattern separation is impaired and a predictor of hippocampal volume in relapsing remitting MS. MS participants and healthy controls completed the Mnemonic Similarities Task (MST) along with traditional neurocognitive assessments of memory. 3T structural magnetic resonance imaging was used to estimate whole hippocampal volumes (main aim) and hippocampal subfield volumes (exploratory aim). Results revealed that pattern separation performance was worse for MS participants compared to healthy controls (Cohen's d = 0.96). For MS participants, hippocampal volume was more strongly related to pattern separation performance (r = 0.83) than a traditional neurocognitive measure of visual memory (r = 0.65); hippocampal volume was not related to a traditional neurocognitive measure of verbal memory in this sample. No brain-behavior correlations were significant in the healthy control group. Results of the exploratory analysis revealed relationships between pattern separation performance and subiculum, molecular layer, and CA1 hippocampal subfield volumes for MS participants only. Pattern separation assessed using the MST may be a sensitive cognitive-biomarker of memory dysfunction and changes in hippocampal volume in relapsing-remitting MS.

Age- and CGG repeat-related slowing of manual movement in fragile X carriers: A prodrome of fragile X-associated tremor ataxia syndrome?

Fragile X premutation carriers are at increased risk for fragile X-associated tremor ataxia syndrome (FXTAS), but to date we know little about prediction of onset and rate of progression and even less about treatment of this neurodegenerative disease. Thus, the longitudinal study of carriers, and the identification of potential biomarkers and prodromal states, is essential. Here we present results of baseline assessments from an ongoing longitudinal project. The cohort consisted of 73 men, 48 with the fragile X mental retardation 1 (FMR1) premutation (55-200 cytosine-cytosine-guanine or CGG repeats) and 25 well-matched controls (< 40 repeats) aged between 40 and 75 years. At enrollment, none met criteria for FXTAS or had any clinically significant tremor or ataxia by blinded neurological examination. The battery consisted of measures of visual memory, spatial working memory, response inhibition, motor speed and control, planning and problem solving, sustained attention, and a standardized movement disorder evaluation. Contrary to expectations, there were no significant differences between premutation carriers and controls on any measure of executive function. However, the premutation carriers had significantly longer manual movement and reaction times than controls, and the significant interaction between CGG repeat and age revealed the slowest movement times among older carriers with higher CGG repeat alleles. A subset of premutation carriers had marginally lower scores on the ataxia evaluation, and they performed no differently from controls on the parkinsonism assessment. Early-developing cerebellar or fronto-motor tract white matter changes, previously documented in MRI studies, may underlie motor slowing that occurs before clinically observable neurological symptoms associated with FXTAS. © 2018 International Parkinson and Movement Disorder Society.

Left Hippocampal Dosimetry Correlates With Visual and Verbal Memory Outcomes in Pediatric Brain Tumor Survivors

The late neurocognitive effects of radiation therapy in the pediatric brain tumor population are well known. Here, we specifically investigate outcomes of verbal and visual memory in a cohort treated with proton radiotherapy (RT), as well as potential clinical and regional dosimetric predictors of these outcomes. We hypothesize that increased RT dose to the hippocampi will amount to decline in memory scores. Seventy pediatric brain tumor patients (median age at RT = 12.1, range = 5.0–22.5) treated with proton RT between 2002 and 2013 were identified as having baseline and follow-up evaluations of visual and verbal memory (Children’s Memory Scale [CMS] and/or Wechsler Memory Scale-third edition [WMS-III]) conducted at our institution, as well as available dosimetry plans. Hippocampi, temporal lobes, and whole brain contours were manually delineated for calculation of multiple dosimetric indices using MimVista 6.6.5. Univariate analysis was performed to determine clinical predictors of score decline or improvement, and multivariate linear regression using dosimetric indices and other clinical covariates (age, gender, baseline score, presence or absence of baseline neurologic symptoms, and time elapsed since RT) allowed calculation of models to predict follow-up memory scores. The median neurocognitive follow-up time was 3.0 years (range = 1.1 – 11.4 years), and 140 cognitive assessments—70 baseline and 70 latest follow-up—were included in the analysis. On histogram analysis, Delayed Verbal memory scores showed a statistically significant decline in the overall cohort (P = 0.01), but Immediate Verbal memory and both measures of visual memory did not. On univariate analysis, higher baseline scores (P < 0.001) and female gender (P = 0.034) were significant predictors of Delayed Verbal memory score decline at follow-up. On multivariate analysis, increased left hippocampal dosimetry was correlated with decline in all four measures, with the individual dosimetric components (left hippocampal V20GyE) of the Immediate Verbal and Delayed Visual memory models being statistically significant (P = 0.027 and P = 0.016, respectively). Additionally, male gender predicted higher Delayed Verbal memory scores (P = 0.035). Of the four memory subtests evaluated here, only Delayed Verbal memory declined, while others were relatively stable between baseline and patients’ most recent follow-up assessments. Given a correlation of hippocampal dosimetry and memory outcomes after RT and a modest effect size of RT dose in these multivariate models, hippocampal-sparing RT plans may assist pediatric brain tumor patients in preserving memory functions.

Effects of Recent Alcohol Consumption Level on Neurocognitive Performance in HIV+ Individuals.

Although HIV+ individuals may be at increased risk of alcohol-related cognitive impairment, the relations between drinking level and cognitive performance in these individuals are not well understood. We examined whether higher levels of recent drinking in HIV+ individuals were associated with poorer cognitive performance, particularly in executive functioning (EF) and memory. We administered a comprehensive cognitive battery to 120 seropositive subjects (101 men) who reported alcohol consumption in the preceding 90 days. Participants were excluded if they were seeking alcohol treatment or showed evidence of dementia. Using the computerized CogState battery, we measured performance in EF, verbal learning/memory, visual learning/memory, attention, working memory, and psychomotor speed. The computerized Iowa Gambling Task was used to assess decision-making. The HIV+ subjects showed significantly slower psychomotor speed than a normative sample. Although across most domains, neurocognitive performance in our sample was not significantly associated with recent alcohol consumption, performance on the CogState measures of visual memory and attention was significantly poorer with a higher level of drinking in the past 3 months and a current alcohol use disorder, respectively. Although cognitive weaknesses were detectable among these non-treatment-seeking HIV+ drinkers, the level of alcohol consumption was not a primary determinant of neurocognitive performance in this group. A comprehensive profile analysis may be most valuable for detecting cognitive strengths and weaknesses given the heterogeneity of this population. Longitudinal studies are needed to examine the potential additive or synergistic effects of heavy drinking and HIV seropositivity on cognitive performance.

Nonverbal Memory Capacity in Persons with Epilepsy Is Associated with Depression Rather than Anxiety.

Epilepsy is characterized by repeated epileptic seizures, which are manifested in various ways and depend on the location and size of foci in the brain. Long-term seizures with secondary generalization can cause memory problems. Numerous studies demonstrate the connection of memory damage and lateralization in medial temporal lobe epilepsy (TLE). However, the results were not always consistent with the material-specific memory model. A possible explanation for these inconsistent data is the insufficient control of psychological variables that can affect memory. In most of the previous studies in persons with epilepsy, they were not controlled for their emotional states such as anxiety and depression. We used the Rey Complex Figure Test (RCFT) as a measure of visual memory, Beck's depression inventory as a measure of depressive symptoms, and the State-Trait Anxiety Inventory as a measure of anxiety in 57 consecutive participants. Our aim was to investigate whether there is difference in visual memory with respect to the left and right TLE, and whether the participants of different gender with higher anxiety and depression rates would achieve different results on visual memory. Persons with lower levels of depression achieved better scores in the Immediate and Delayed recall subtests of the RCFT. We also explored the potential gender differences. Testing differences between the persons with higher and lower anxiety levels did not reveal any significant differences in any of the measures tested.

Visual memory profile in 22q11.2 microdeletion syndrome: are there differences in performance and neurobiological substrates between tasks linked to ventral and dorsal visual brain structures? A cross-sectional and longitudinal study.

BackgroundChildren affected by the 22q11.2 deletion syndrome (22q11.2DS) have a specific neuropsychological profile with strengths and weaknesses in several cognitive domains. Specifically, previous evidence has shown that patients with 22q11.2DS have more difficulties memorizing faces and visual-object characteristics of stimuli. In contrast, they have better performance in visuo-spatial memory tasks. The first focus of this study was to replicate these results in a larger sample of patients affected with 22q11.2DS and using a range of memory tasks. Moreover, we analyzed if the deficits were related to brain morphology in the structures typically underlying these abilities (ventral and dorsal visual streams). Finally, since the longitudinal development of visual memory is not clearly characterized in 22q11.2DS, we investigated its evolution from childhood to adolescence.MethodsSeventy-one patients with 22q11.2DS and 49 control individuals aged between 9 and 16 years completed the Benton Visual Retention Test (BVRT) and specific subtests assessing visual memory from the Children’s Memory Scale (CMS). The BVRT was used to compute spatial and object memory errors. For the CMS, specific subtests were classified into ventral, dorsal, and mixed subtests. Longitudinal data were obtained from a subset of 26 patients and 22 control individuals.ResultsCross-sectional results showed that patients with 22q11.2DS were impaired in all visual memory measures, with stronger deficits in visual-object memory and memory of faces, compared to visuo-spatial memory. No correlations between morphological brain impairments and visual memory were found in patients with 22q11.2DS. Longitudinal findings revealed that participants with 22q11.2DS made more object memory errors than spatial memory errors at baseline. This difference was no longer significant at follow-up.ConclusionsIndividuals with 22q11.2DS have impairments in visual memory abilities, with more pronounced difficulties in memorizing faces and visual-object characteristics. From childhood to adolescence, the visual cognitive profile of patients with 22q11.2DS seems globally stable even though some processes show an evolution with time. We hope that our results will help clinicians and caregivers to better understand the memory difficulties of young individuals with 22q11.2DS. This has a particular importance at school to facilitate recommendations concerning intervention strategies for these young patients.

Comparison between objective measures and parental behavioral rating scales of memory and attention in pediatric endocrinology patients

ABSTRACTBehavioral rating scales represent one potential method for screening of cognitive functioning in routine clinical care. It is not yet known if objective performance based measures and behavioral rating scales of cognitive functioning completed by parents yield similar information in pediatric endocrinology patients. The purpose of the present study was to evaluate the associations between performance-based measures and behavioral rating scales of memory and attention/concentration completed by parents of pediatric patients with Type 1 Diabetes or obesity. The sample consisted of 73 pediatric patients with Type 1 Diabetes or obesity (BMI > 95th percentile) ages 6–16 years (mean age = 12.29 years) referred to an outpatient pediatric endocrinology clinic. Youth were administered the Wide Range Assessment of Memory and Learning (WRAML-2). Parents completed the Child Behavior Checklist (CBCL) and the PedsQL Cognitive Functioning Scale. Pearson's Product Moment Correlations were examined among the performance-based measures and behavioral rating scales. Results: All intercorrelations between the performance-based measures and behavioral rating scales completed by parents were in the small range. The only statistically significant (P < 0.05) and approaching medium correlation was between the PedsQL Cognitive Functioning Scale and WRAML-2 Verbal Memory Index (r = 0.28). On behavioral rating scales and performance-based measures of visual memory and attention/concentration, our sample exhibited greater difficulties than healthy youth from previously published data (P < 0.05). One possible explanation for our findings is that behavioral rating scales of attention/concentration and memory completed by parents measure different aspects of cognitive functioning than performance based measures in pediatric patients with Type 1 Diabetes or obesity.

Greater memory impairment in dementing females than males relative to sex-matched healthy controls

ABSTRACTPreviously we demonstrated sex differences in episodic memory in healthy elderly and suggested that normative data be separated by sex. The present study extended the exploration of sex differences on memory measures into two clinical populations, mild cognitive impairment (MCI) and Alzheimer’s disease (AD). Seventy-six subjects with MCI and 101 subjects with AD diagnosed by a multidisciplinary team were included. These two groups were also compared to a group of 177 healthy elderly control participants. Sex differences on the Rey Auditory Verbal Learning Test (RAVLT; total and delayed recall) raw scores and Brief Visuospatial Memory Test–Revised (BVMT–R) were demonstrated within the healthy but not the MCI or AD groups. Calculating z scores by sex for both dementing groups based on the healthy controls suggested a larger performance gap between healthy and dementing women than between healthy and dementing men. MCI females were on average 0.48 standard deviations lower for total verbal learning compared to healthy female controls than were MCI males when compared to healthy male controls. For verbal delayed recall the gap was even larger (SD = 1.09). Similarly, on the BVMT–R, a measure of visual memory, the difference was 0.60 standard deviations for total visual learning and 0.99 standard deviations for delayed recall. This same sex difference, with females showing greater impairment compared to the controls group than did the males, was also present within the AD group. The greater memory impairment in dementing females rather than males when compared to sex-matched healthy controls was unlikely to be due to more severe illness since females performed equivalently to males on the Clinical Dementia Rating Scale, Mini-Mental Status Examination, and Dementia Rating Scale, and were also similar for age, education, and apolipoprotein status. The present study suggested relatively greater memory impairment in females with MCI or AD than in controls.

Cognitive effects of deep brain stimulation in patients with obsessive-compulsive disorder.

Deep brain stimulation (DBS) is a promising treatment for treatment-refractory obsessive-compulsive disorder (OCD). However, the effects of DBS on cognitive functioning remain unclear. Therefore, we aimed to assess cognitive safety of DBS for treatment-refractory OCD and the association between clinical changes and cognitive functioning. Patients with treatment-refractory OCD treated with DBS targeted at the nucleus accumbens (NAcc) were compared with a control group of 14 patients with treatment-refractory OCD treated with care as usual. We assessed cognitive functioning at baseline, 3 weeks postoperatively and following 8 months of DBS. We compared change in clinical symptoms with cognitive changes. There were 16 patients in the DBS group and 14 patients in the control group. Three weeks postoperatively, the DBS group showed a significantly reduced performance on measures of visual organization and verbal fluency and a trend toward reduced performance on measures of visual memory and abstract reasoning. Cognitive functioning was found to be stable on all other measures. After 8 months of DBS, reduced performances persisted, except for a significant improvement in verbal fluency. Cognitive functioning in all other domains remained unaffected. We found no correlation between improvement of clinical symptoms and cognitive changes. A limitation of this study was its relatively small sample size. Deep brain stimulation targeted at the NAcc may be considered a safe method in terms of cognition because cognitive functioning was unaffected on most neuropsychological measures. Nevertheless, we observed some minor reduced performance on specific measures of executive functioning that were possibly associated with surgical intervention. Our results suggest that severity of OCD symptoms is independent of cognitive functioning.

PATTERNS OF CLINICALLY SIGNIFICANT COGNITIVE IMPAIRMENT IN HOARDING DISORDER.

The cognitive characteristics of individuals with hoarding disorder (HD) are not well understood. Existing studies are relatively few and somewhat inconsistent but suggest that individuals with HD may have specific dysfunction in the cognitive domains of categorization, speed of information processing, and decision making. However, there have been no studies evaluating the degree to which cognitive dysfunction in these domains reflects clinically significant cognitive impairment (CI). Participants included 78 individuals who met DSM-V criteria for HD and 70 age- and education-matched controls. Cognitive performance on measures of memory, attention, information processing speed, abstract reasoning, visuospatial processing, decision making, and categorization ability was evaluated for each participant. Rates of clinical impairment for each measure were compared, as were age- and education-corrected raw scores for each cognitive test. HD participants showed greater incidence of CI on measures of visual memory, visual detection, and visual categorization relative to controls. Raw-score comparisons between groups showed similar results with HD participants showing lower raw-score performance on each of these measures. In addition, in raw-score comparisons HD participants also demonstrated relative strengths compared to control participants on measures of verbal and visual abstract reasoning. These results suggest that HD is associated with a pattern of clinically significant CI in some visually mediated neurocognitive processes including visual memory, visual detection, and visual categorization. Additionally, these results suggest HD individuals may also exhibit relative strengths, perhaps compensatory, in abstract reasoning in both verbal and visual domains.

A haplotype of the norepinephrine transporter gene (SLC6A2) is associated with visual memory in attention-deficit/hyperactivity disorder

Attention-deficit/hyperactivity disorder (ADHD) is a common heritable childhood-onset psychiatric disorder with impaired visual memory. Based on the evidence from treatment effect of atomoxetine, which interacts directly with the norepinephrine transporter, on visual memory in children with ADHD, this study examined the linkage disequilibrium structure of the norepinephrine transporter gene (SLC6A2) and the association between SLC6A2 and ADHD and visual memory, a promising endophenotype for ADHD. This family-based association sample consisted of 382 probands with DSM-IV ADHD and their family members (n=1298 in total) of Han Chinese in Taiwan. Visual memory was assessed by the Pattern Recognition Memory (PRM) and Spatial Recognition Memory (SRM) tasks of the Cambridge Neuropsychological Test Automated Battery (CANTAB). We screened 21 polymorphisms across SLC6A2 and used the Family-Based Association Test (FBAT) to test the associations of SLC6A2 polymorphisms with ADHD and the PRM and SRM measures. In haplotype analyses, a haplotype rs36011 (T)/rs1566652 (G) was significantly associated with ADHD (minimal p=0.045) after adjustment for multiple testing. In quantitative analyses, this TG haplotype also demonstrated significant associations with visual memory measures, including mean latency of correct responses in PRM (minimal p=0.019), total correct responses in PRM (minimal p=0.018), and total correct responses in SRM (minimal p=0.015). Our novel finding of the haplotype rs36011 (T)/rs1566652 (G) as a novel genetic marker involved in both ADHD disease susceptibility and visual memory suggests that allelic variations in SLC6A2 could provide insight into the pathways leading from genotype to phenotype of ADHD.

Comparison of Credible Patients of Very Low Intelligence and Non-Credible Patients on Neurocognitive Performance Validity Indicators

The purpose of this archival study was to identify performance validity tests (PVTs) and standard IQ and neurocognitive test scores, which singly or in combination, differentiate credible patients of low IQ (FSIQ ≤ 75; n = 55) from non-credible patients. We compared the credible participants against a sample of 74 non-credible patients who appeared to have been attempting to feign low intelligence specifically (FSIQ ≤ 75), as well as a larger non-credible sample (n = 383) unselected for IQ. The entire non-credible group scored significantly higher than the credible participants on measures of verbal crystallized intelligence/semantic memory and manipulation of overlearned information, while the credible group performed significantly better on many processing speed and memory tests. Additionally, credible women showed faster finger-tapping speeds than non-credible women. The credible group also scored significantly higher than the non-credible subgroup with low IQ scores on measures of attention, visual perceptual/spatial tasks, processing speed, verbal learning/list learning, and visual memory, and credible women continued to outperform non-credible women on finger tapping. When cut-offs were selected to maintain approximately 90% specificity in the credible group, sensitivity rates were highest for verbal and visual memory measures (i.e., TOMM trials 1 and 2; Warrington Words correct and time; Rey Word Recognition Test total; RAVLT Effort Equation, Trial 5, total across learning trials, short delay, recognition, and RAVLT/RO discriminant function; and Digit Symbol recognition), followed by select attentional PVT scores (i.e., b Test omissions and time to recite four digits forward). When failure rates were tabulated across seven most sensitive scores, a cut-off of ≥ 2 failures was associated with 85.4% specificity and 85.7% sensitivity, while a cut-off of ≥ 3 failures resulted in 95.1% specificity and 66.0% sensitivity. Results are discussed in light of extant literature and directions for future research.

Minding the Aging Brain: Are We Ready for Personalized Medicine?

Minding the Aging Brain: Are We Ready for Personalized Medicine?