Memory Test Scores Research Articles

Assessing the Effect of Restudying Anatomy with Flashcards versus Handouts in Study Groups Equalized by Memory Test Scores

IntroductionRetrieval practice through testing can strengthen long‐term memory. Experimentally, this concept known as the “testing effect” has often been demonstrated using word pairs. As many health science students quiz with flashcards to enhance recall, can the testing effect be detected within the more complex study of anatomy? It was hypothesized that participants utilizing flashcards for review would score higher on tests than those restudying a handout.MethodsStudents were recruited from Pacific Northwest University of Health Sciences (PNWU). On day 1 of the study, subjects were given 3 memory tests (assessing memory of printed words, pictures, and spoken words), the scores of which were combined and used to assign participants to groups with approximately equal “memory.” Participants studied a handout on ruminant digestive anatomy, a topic novel to most students. After the initial study session, subjects were divided into a “flashcard group” (FG) or a “handout group” (HG) and reviewed the learned material via their assigned method. Participants then took a 15‐question test, indicating whether they were confident or not for each answer, and took a similar test 1 and 3 weeks later. Participants completed surveys on demographics, existing knowledge of ruminants and anatomical terms, wellness, and study behaviors on day 1 of the study. Data were analyzed using Mann Whitney U test, Fischer’s exact test, Pearson Correlation Coefficient, and repeated measures ANOVA using SPSSv25.0 software with p<0.05 considered statistically significant. This study was deemed exempt by PNWU IRB (#2021‐015).ResultsThough not statistically so, mean scores were higher in the FG than in the HG for each of the ruminant digestive anatomy assessments. For day 1 test score means (FG 10.67 ± 1.50 vs HG 9.00 ± 2.68), a large effect size (ηp2=0.16) was detected. While the FG started with more experience with anatomical terms (p=0.046), this experience was not significantly correlated with day 1 test scores (n=17). Though the FG tended to perform better on day 1 tests, the HG was more confident in their answer choices (mean confidence scores HG 10.00 ± 1.10 vs FG 7.78 ± 1.72), with a large effect size present (ηp2=0.38). Memory scores were not significantly different between the FG and the HG. Though not significant, most memory scores were negatively correlated with age. Sleep was negatively correlated with memory scores, which was significant for memory of printed words (r=‐0.56; p=0.019). Female memory scores consistently ranked higher than male scores.ConclusionsParticipants who restudied with flashcards tended to outperform those restudying handouts on tests covering a novel anatomy topic, suggesting that the testing effect may have occurred. Interestingly, the opposite pattern was seen in confidence, with those studying handouts seemingly more confident in their test answers. Utilizing memory test scores resulted in evenly distributed groups with respect to memory, and some intriguing potential differences were seen related to sleep on the night before day 1 of the study, age, and gender. This study was limited by a small sample size and should be expanded to further investigate the effect of various restudy techniques, such as using flashcards or handouts while learning anatomy.

The Associations of Meteorological and Environmental Factors with Memory Function of the Older Age in Urban Areas.

Individual, meteorological, and environmental factors are associated with cognitive function in older age. However, little is known about how meteorological and environmental factors interact with individual factors in affecting cognitive function in older adults. In the current study, we used mixed effects models to assess the association of individual, meteorological, and environmental factors with cognitive function among older adults in urban areas. Data from 2623 adults aged 60 to 91 years from 25 provinces (or autonomous regions/municipalities) from the China Family Panel Studies (CFPS) were used. We used the memory test in CFPS to measure memory function, while meteorological data from the daily climate data set of China’s surface international exchange stations, and the traffic and greening data compiled by the National Bureau of Statistics (NBS) of China, were used to assess meteorological and environmental factors. The ICC of the empty model indicated that 7.7% of the variation in memory test scores for the older adults was caused by provincial characteristics. Results showed that the temperature and relative humidity of provinces moderated the effect of gender on the memory function for the older urban adults. Specifically, in the high temperature areas, memory scores for females were higher than those of males, and in the middle humidity areas, memory scores were also higher for the females than those of males. This study explained how meteorological and environmental factors played roles in influencing demographic factors on memory function among older adults. Further research is needed to better define the role and potential mechanism of this moderation.

Predicting Verbal Learning and Memory Assessments of Older Adults Using Bayesian Hierarchical Models.

Verbal learning and memory summaries of older adults have usually been used to describe neuropsychiatric complaints. Bayesian hierarchical models are modern and appropriate approaches for predicting repeated measures data where information exchangeability is considered and a violation of the independence assumption in classical statistics. Such models are complex models for clustered data that account for distributions of hyper-parameters for fixed-term parameters in Bayesian computations. Repeated measures are inherently clustered and typically occur in clinical trials, education, cognitive psychology, and treatment follow-up. The Hopkins Verbal Learning Test (HVLT) is a general verbal knowledge and memory assessment administered repeatedly as part of a neurophysiological experiment to examine an individual’s performance outcomes at different time points. Multiple trial-based scores of verbal learning and memory tests were considered as an outcome measurement. In this article, we attempted to evaluate the predicting effect of individual characteristics in considering within and between-group variations by fitting various Bayesian hierarchical models via the hybrid Hamiltonian Monte Carlo (HMC) under the Bayesian Regression Models using ‘Stan’ (BRMS) package of R. Comparisons of the fitted models were done using leave-one-out information criteria (LOO-CV), Widely applicable information criterion (WAIC), and K-fold cross-validation methods. The full hierarchical model with varying intercepts and slopes had the best predictive performance for verbal learning tests [from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study dataset] using the hybrid Hamiltonian-Markov Chain Monte Carlo approach.

Analysis of the Relationship among Cognitive Impairment, Nutritional Indexes and the Clinical Course among COVID-19 Patients Discharged from Hospital-Preliminary Report.

Numerous data indicate the presence of cognitive impairment in people who have undergone COVID-19, often called COVID Fog (CF). This phenomenon persists even 6 months after infection, and its etiology and pathogenesis are not fully known. The aim of this article was to analyze the relationship among cognitive functioning, clinical data and nutrition indexes in patients discharged from the COVID-19 hospital of the Military Institute of Medicine, Warsaw, Poland. The sample comprised 17 individuals—10 women and 7 men, with ages of 65 ± 14 years. Cognitive impairment was measured with the use of the Montreal Cognitive Assessment (MoCA). The nutrition parameters included: hemoglobin, red blood cells, total cholesterol and its fractions, triglycerides, total protein, albumin, urea, creatinine, phosphates, calcium and sodium. The analysis showed that albumin concentration significantly correlated with the total MoCA score and especially with the short-term memory test score. Conversely, total cholesterol, and especially LDL concentrations, were highly and negatively associated with the MoCA score. In conclusion: markers of nutritional status are correlated with the severity of CF. Individuals with malnutrition or risk of malnutrition should be screened for CF. Further studies need to be performed in this area.

Diagnostic Utility of Hippocampal Volumetric Data in a Memory Disorder Clinic Setting.

Hippocampal volumetric data are widely used in research but are rarely examined in clinical populations in regard to aiding diagnosis or correlating with objective memory test scores. To replicate and expand on the few prior clinical examinations of the utility of hippocampal volumetric data. We evaluated MRI volumetric data to determine (a) the degree of hippocampal loss across diagnostic groups compared with a cognitively intact group, (b) if total or lateralized hippocampal volumes predict diagnostic group membership, and (c) how total and lateralized volumes correlate with memory tests. We retrospectively examined hippocampal volumetric data and memory test scores for 294 individuals referred to a memory clinic. Individuals with mild cognitive impairment or Alzheimer disease had smaller hippocampal volumes compared with cognitively intact individuals. The raw and normalized total and lateralized hippocampal volumes were essentially equal for predicting diagnostic group membership, and notably low hippocampal volumes evidenced greater specificity than sensitivity. All of the volumetric data correlated with the memory test scores, with the total and left hippocampal volumes accounting for the slightly more variance in the diagnostic groups. The diagnostic groups exhibited hippocampal volume loss, which can be a potential biomarker for neurodegenerative disease in clinical practice. However, solely using hippocampal volumetric data to predict diagnostic group membership or memory test failure was not supported. While extreme hippocampal volume loss was rare in the cognitively intact group, the sensitivity of these volumetric data suggests a need for supplementation by other tools when making a diagnosis.

Cognitive profile of people with mild behavioral impairment in Brain Health Registry participants.

Dementia assessment includes cognitive and behavioral testing with informant verification. Conventional testing is resource-intensive, with uneven access. Online unsupervised assessments could reduce barriers to risk assessment. The aim of this study was to assess the relationship between informant-rated behavioral changes and participant-completed neuropsychological test performance in older adults, both measured remotely via an online unsupervised platform, the Brain Health Registry (BHR). Observational cohort study. Community-dwelling older adults participating in the online BHR. Informant reports were obtained using the BHR Study Partner Portal. The final sample included 499 participant-informant dyads. Participants completed online unsupervised neuropsychological assessment including Forward Memory Span, Reverse Memory Span, Trail Making B, and Go/No-Go tests. Informants completed the Mild Behavioral Impairment Checklist (MBI-C) via the BHR Study Partner portal. Cognitive performance was evaluated in MBI+/- individuals, as was the association between cognitive scores and MBI symptom severity. Mean age of the 499 participants was 67, of which 308/499 were females (61%). MBI + status was associated with significantly lower memory and executive function test scores, measured using Forward and Reverse Memory Span, Trail Making Errors and Trail Making Speed. Further, significant associations were found between poorer objectively measured cognitive performance, in the domains of memory and executive function, and MBI symptom severity. These findings support the feasibility of remote, informant-reported behavioral assessment utilizing the MBI-C, supporting its validity by demonstrating a relationship to online unsupervised neuropsychological test performance, using a previously validated platform capable of assessing early dementia risk markers.

Evaluation of cognitive deficits in patients infected with COVID-19.

COVID-19 infection can cause impairments in many cognitive areas. The aim of the present study was to evaluate the cognitive functions of patients who had been infected with COVID-19. The demographic and infection-related characteristics of patients who had been infected with COVID-19 were determined. Their cranial magnetic resonance imaging (MRI) and electroencephalography (EEG) findings were recorded. The Mini-Mental State Evaluation (MMSE), clock drawing test, forward and backward digit span tests, visual memory test, and Frontal Assessment Battery were applied to the patients. Finger agnosia and ideomotor apraxia were also determined. The study included 176 patients [100 female (56.8%), 76 male (43.2%), mean age 66.09±13.96 years]. About half of the patients were hospitalized for symptoms of COVID-19 infection (n=82, 46.6%). One third of these patients required intensive care (n=26, 14.8%). While 50 (45.9%) of the 109 patients diagnosed with dementia before infection were hospitalized, 32 (47.8%) of the 67 patients without a diagnosis of dementia required hospitalization (p=0.46). The most common neurological finding during COVID-19 infection was insomnia (n=36, 20.5%). The MMSE and visual memory test scores of the patients who were hospitalized for severe respiratory distress were lower than those whose treatment at home was completed (respectively 17.92±7.69/20.59±7.01, p=0.02; 2.53 ±1.73/3.69±2.80, p=0.01). The patients with moderate to severe cognitive impairment had significantly higher CRP levels at admission than the others (37.52±43.09/20.93±31.74, p=0.01, respectively). Cognitive damage in COVID-19 infection may be caused by ACE receptor density in the pial, hippocampal, and amygdala areas. In addition, the reason why people with severe dementia have a milder infection might be explained by the atrophy in these areas.

Digitally generated Trail Making Test data: Analysis using hidden Markov modeling.

The Trail Making Test (TMT) is a neuropsychological test used to assess cognitive dysfunction. The TMT consists of two parts: TMT‐A requires connecting numbers 1 to 25 sequentially; TMT‐B requires connecting numbers 1 to 12 and letters A to L sequentially, alternating between numbers and letters. We propose using a digitally recorded version of TMT to capture cognitive or physical functions underlying test performance. We analyzed digital versions of TMT‐A and ‐B to derive time metrics and used Bayesian hidden Markov models to extract additional metrics. We correlated these derived metrics with cognitive and physical function scores using regression. On both TMT‐A and ‐B, digital metrics associated with graphomotor processing test scores and gait speed. Digital metrics on TMT‐B were additionally associated with episodic memory test scores and grip strength. These metrics provide additional information of cognitive state and can differentiate cognitive and physical factors affecting test performance.

Immune protein levels in cerebrospinal fluid: Associations with memory scores across the AD spectrum.

Alzheimer's disease (AD) is characterized by amyloid and tau aggregation. In addition, immune alterations are involved, perhaps with clinical stage-dependent effects. How cerebrospinal fluid (CSF) levels of immune system-related proteins associate with memory function in AD remains unknown. We studied this question across the AD clinical spectrum. We selected from ADNI and EMIF-AD MBD, 425 amyloid-positive (A+) individuals across clinical stages (preclinical, prodromal and dementia) and 102 amyloid-negative (A-) CN controls, with available CSF proteomics and memory scores. Memory test scores of word lists were Z-transformed based on controls (ADNI), or published norms (EMIF-AD). Proteins were measured in EMIF-AD with mass spectrometry (MS) (2537 proteins) and in ADNI by MS (142 proteins) and RBM (83 proteins). Of 165 proteins assessed in both cohorts, we selected 53 proteins associated with 'immune system process' in Gene Ontology (GOv2.1). We Z-transformed levels relative to controls in each cohort and pooled the datasets. For proteins showing an interaction with diagnosis on memory with p-value < 0.1, we analysed group-stratified associations in linear models (predictor: protein levels; outcome: memory scores; covariates: sex, age, years of education, diagnosis; p-value threshold: 0.05). We annotated memory-associated proteins for subcategories of the immune system process. We included 102 A- controls and 425 A+ individuals (preclinical AD: 105, prodromal AD: 183, and AD dementia: 137, Table 1). Eighteen proteins (34%) showed diagnosis-dependent memory associations, for which we performed stratified analyses. In the control group, higher levels of 4 proteins (22%) associated with worse memory (Figure 1-2). In preclinical AD, lower concentrations of 11 proteins associated with worse memory (Figure 1). These proteins were enriched for neutrophil degranulation. Of the 11 proteins, 2 were associated with memory in controls, but in an opposite direction. In prodromal AD, lower concentrations of 4 proteins associated with worse memory. No associations occurred in individuals with AD-type dementia, probably due to the low memory scores in this group (Figure 2). Our results suggest immune alterations affect memory function very early in AD. Further research is needed to clarify why in controls higher levels of immune proteins associate with lower memory function.

APOE ε4 predicts amyloid PET positive in amnesic subjective cognitive decline

AbstractBackgroundSubjective cognitive decline (SCD) has been considered as at risk state to progress to mild cognitive impairment(MCI) or Alzheimer's disease(AD). Apolipoprotein E e4 allele is a well‐known genetic risk for rapid deterioration of cognitive and dementia development. We investigated the effect of APOE ε4 on the brain amyloid pathology and other clinical features in the elderly with SCD.MethodOne hundred and nineteen elderly subjects, 60 or older, complaining of persistent cognitive decline, with 7% to 50% of the memory test score and over 7% of the other tests score were included through neuropsychological tests(Seoul neuropsychological battery, SNSB). Brain magnetic resonance imaging (MRI) volumetry, visual and standardized uptake value ratio (SUVR) analysis of 18F‐Florbetaben brain amyloid‐beta Positron Emission Tomography (PET) were performed. Demographics, physical data, social and physiological functions were also obtained.ResultOf the 119 SCD subjects, 26 (21.8%) had APOE ε4 and 26 (21.8%) had amyloid PET positive. Age was not different between two groups (70.9 V.S. 70.9, p=0.880). Test Z‐score was only marginally lower in Digit span test‐forward (p=0.053) in SCD with APOE ε4. Amyloid PET SUVR value was higher in SCD with APOE ε4 (1.2±0.2 V.S. 1.5±0.3, p=0.001). Regional brain volume including hippocampus and entorhinal cortex were not different in SPM based volumetric ananlysis. Korean_Everyday Cognition subscores, depression scores measured with Patient Health Questionnaire 9, sleep quality measured with Pittsburgh Sleep Quality Index total score, Body Mass Index, and gait speed were not different between two groups.ConclusionWith the baseline data, APOE ε4 was associated with decreased attention and higher brain amyloid accumulation in amnestic SCD. Longitudinal data will be needed to clarify whether APOE ε4 is associated with progression of cognitive dysfunction in SCD. This study was supported by a grant from the Ministry of Health and Welfare, HI18C0530.

Decision‐tree–testing cognition‐MRI associations to define and differentiate cognitive reserve and brain maintenance

AbstractBackgroundCognitive reserve (CR) and brain maintenance (BM) represent heuristic concepts defining general mechanisms that may underlie successful cognition in advanced age. However, a robust differentiation of both models employing a unified approach is lacking. Within the framework of a recent NIH‐funded study (R24‐AG061421) from the Reserve &amp; Resilience collaborative network (https://reserveandresilience.com/) we have proposed an iterative process (Figure 1) to help operationalizing and testing BM and CR definitions using longitudinal episodic memory (EM) and MRI (structural and functional) longitudinal assessments. The current study presents findings after analyzing data according to the first step of the proposed pipeline (Figure 1.1).MethodWe analyzed longitudinal (2‐3 observations) MRI‐derived hippocampal (HC) volumes calculated with FreeSurfer 6.0 (https://surfer.nmr.mgh.harvard.edu/) and EM from 356 individuals (age range: 60‐85 years at baseline, 56.2% female) from three different cohorts comprised within the European Lifebrain (https://www.lifebrain.uio.no/) consortia. To define EM, we used the mean of scaled visual and verbal memory tests scores. All the analytical procedures have been recently described (Gorbach et al., Alzheimers Dement. 2020;28;12(1):e12110).ResultAccording to the interarrival process step 1, we identified two groups: (i) BM pathway 1 (N = 99) in the first quadrant (positive change in EM and HC) and (ii) ‘deviant cases’ (N = 74) in the fourth quadrant (those with marked HC atrophy but stable EM, see Figure 2). There were no differences regarding education and mini mental state examination (MMSE) scores between the groups identified.ConclusionThe analysis of the associations between progressive EM and HC volume changes allowed us to initially differentiate a group of individuals with greater correspondence between the two measures across time (i.e., supporting the concept of BM) versus those where memory stability appears to progressively be decoupled from HC integrity (i.e., suggesting evidence of reserve/compensatory processes). Despite initial comparisons for education and global cognitive function did not reveal differences, further analyses including lifestyle engagement and functional MRI data information shall provide useful information towards a more precise characterization of CR and BM concepts.

Bilberry/red grape juice decreases plasma biomarkers of inflammation and tissue damage in aged men with subjective memory impairment \u2013a randomized clinical trial

BackgroundFew randomized clinical trials have explored the health effects of bilberries in humans. The aim was to test the effect of bilberry and red grape-juice consumption on visual memory, motor speed and dexterity as well as inflammatory and tissue damage biomarkers of plasma in aged men with subjective memory impairment.MethodsNine-week double-blind, placebo-controlled, dietary intervention study of aged men (n = 60, age ≥ 67 years) with subjective memory impairment randomized to consume a 50/50 mix of bilberry/red grape-juice or an iso-caloric placebo juice. A selection of Cambridge Cognition Test Battery (CANTAB), Grooved Pegboard tests and blood-sampling for biomarker analysis were performed before and after the intervention.ResultsCompared to placebo the selected memory and motor test scores were un-affected by the bilberry/red grape intervention. However, the plasma levels of tissue damage biomarkers decreased significantly more in the bilberry/red grape group. In particular lactate dehydrogenase (LDH) decreased from 362 U/L (median, baseline) to 346 U/L (median, post intervention) in the bilberry/red grape group. Also, several biomarkers of inflammation (EGF, IL6, IL9, IL10 and TNFα) decreased significantly more in the bilberry/red grape group. Furthermore, several plasma polyphenols; p-coumaric acid, hippuric acid, protocatechuic acid, 3HPAA and vanillic acid, increased significantly more in the bilberry/red grape group compared to placebo with the largest increase in p-coumaric acid with 116%; from 2.2 [1.0,5.5] to 4.7 [2.8,8.1] μM/L (median [95% CL]).ConclusionsThe results indicate that a nine-week bilberry/red grape juice intervention has no measurable effects on the selected memory scores in aged men experiencing memory problems but decreases the level of biomarkers of inflammation and tissue damage. Whether the dampening effects on inflammation and tissue damage biomarkers have relevance for neuroinflammatory brain pathology remains to be established.Trial registrationRegistration number (ClinicalTrials.gov: NCT00972972), September 9, 2009.

Comparison of cognitive performance between patients with Parkinson\u2019s disease and dystonia using an intraoperative recognition memory test

Neuroscientific studies on the function of the basal ganglia often examine the behavioral performance of patients with movement disorders, such as Parkinson’s disease (PD) and dystonia (DT), while simultaneously examining the underlying electrophysiological activity during deep brain stimulation surgery. Nevertheless, to date, there have been no studies comparing the cognitive performance of PD and DT patients during surgery. In this study, we assessed the memory function of PD and DT patients with the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE). We also tested their cognitive performance during the surgery using a continuous recognition memory test. The results of the MoCA and MMSE failed to reveal significant differences between the PD and DT patients. Additionally, no significant difference was detected by the intraoperative memory test between the PD and DT patients. The intraoperative memory test scores were highly correlated with the MMSE scores and MoCA scores. Our data suggest that DT patients perform similarly to PD patients in cognitive tests during surgery, and intraoperative memory tests can be used as a quick memory assessment tool during surgery.

Effects of daytime hypercapnia on logical memory and working memory in patients with obstructive sleep apnea hypopnea syndrome

Objective: To investigate the effects of daytime hypercapnia on logical memory and working memory in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: This prospective study recruited patients complaining of snoring and diagnosed with OSAHS at the Sleep Center of the Second Affiliated Hospital of Soochow University from January to November 2020. Patients were assessed clinically and scored for their memory function. All patients underwent daytime transcutaneous carbon dioxide (PtcCO2) test, and overnight polysomnography (PSG). Logical memory was scored using the Logical Memory Test (LMT), while working memory was evaluated by Digit Span Test (DST) and Cambridge Neuropsychological Test Automated Battery (CANTAB) which included Pattern Recognition Memory (PRM), Spatial Span (SSP), and Spatial Working Memory (SWM). Patients were divided into the normocapnic group and the hypercapnic group using the daytime PtcCO2 test. The clinical and PSG parameters and the memory test scores between the two groups were compared. Binary logistic stepwise regression was conducted to identify risk factors of memory impairment in OSAHS patients. Results: Among the 123 enrolled OSAHS patients, 79 were normocapnic and 44 were hypercapnic. There was no significant difference in the general clinical parameters between the two groups. The snoring history in years in the hypercapnic group was longer than that in the normocapnic group (P<0.05). Compared with the normocapnic group, the apnea-hyponea index (AHI), oxygen desaturation index (ODI) and percentage of total sleep time with oxygen saturation level<90% (TS90) of the hypercapnic group were higher (all P<0.05), while other PSG parameters exhibited no statistically significant differences. There was no statistically significant difference in the immediate logical memory and PRM immediate accuracy rate between the two groups, while the delayed logical memory, verbal and spatial working memory, and executive function were worse in the hypercapnic group, as shown by lower total LMT scores, lower DST, lower SSP scores (all P<0.05), and higher between errors and strategy scores (P<0.01) of SWM in the hypercapnic group. Binary logistic stepwise regression showed that PtcCO2 ≥45 mmHg (1 mmHg=0.133 kPa, OR=3.055, 95%CI 1.359-6.868, P=0.007) and higher body mass index (BMI) (OR=1.132, 95%CI 1.005-1.275, P=0.041) were risk factors for poor performance in Digit Span Backwards Test. Therefore, PtcCO2 ≥45 mmHg was an independent risk factors for poor performance in delayed LMT, SSP, and between errors and strategy scores in SWM (OR=3.109, 3.941, 3.238 and 2.785, respectively, all P<0.05). Conclusion: Hypercapnia had negative impacts on logical memory and working memory of OSAHS patients, especially on the delayed logical memory, verbal working memory and spatial working memory impairment.

Do Memory Test Scores Improve After Organized Sport Activity?

Please enjoy Volume 7, Issue 1 of the JSMAHS. In this issue, you will find Professional, Graduate, and Undergraduate research abstracts, and case reports. Thank you for viewing this 7th Annual OATA Special Edition.

Association between sleep disorders and cognitive dysfunctions in non-demented patients with advanced Parkinson\u2019s disease

BackgroundParkinson’s disease (PD) is increasingly recognized as a multidimensional disorder, characterized by several non-motor symptoms, including disturbances of sleep and cognition. Current studies on the relationship between sleep problems and neuropsychological functions, mainly conducted in early to moderate PD patients, outline mixed results. In this study, we analysed the relationship between subjectively reported sleep alterations and cognitive functions in a large cohort of 181 advanced PD patients.MethodsAll consecutive, non-demented, advanced PD patients candidates for device-aided therapy completed two self-administered sleep questionnaires—the Parkinson’s Disease Sleep Scale (PDSS-2) and the Epworth Sleepiness Scale (ESS)—and underwent a comprehensive battery of neuropsychological tests encompassing five cognitive domains (reasoning, memory, attention, frontal executive functions, and language).ResultsPatients showed mild to moderate sleep problems (PDSS-2 score: 23.4 ± 1.2) and mild daytime sleepiness (ESS 8.6 ± 5.1). A significant correlation was found between PDSS-2 total score and non-verbal reasoning, as well as attentive skills, executive functions, and language abilities. No correlations were found between sleep measures and memory tests scores. Patients with clinically relevant sleep disturbances performed worse on attention, executive functions, and language. No significant correlations were found between daytime sleepiness and any neuropsychological test.ConclusionsIn advanced PD patients, sleep disturbances selectively correlate with specific neuropsychological functions and not with short-term memory and consolidation. Even if confirmations by means of longitudinal studies are needed, our observations suggest the importance of considering treatment of sleep disturbances to minimize their potential impact on cognition.

Using functional connectivity models to characterize relationships between working and episodic memory.

IntroductionWorking memory is a critical cognitive ability that affects our daily functioning and relates to many cognitive processes and clinical conditions. Episodic memory is vital because it enables individuals to form and maintain their self‐identities. Our study analyzes the extent to which whole‐brain functional connectivity observed during completion of an N‐back memory task, a common measure of working memory, can predict both working memory and episodic memory.MethodsWe used connectome‐based predictive models (CPMs) to predict 502 Human Connectome Project (HCP) participants' in‐scanner 2‐back memory test scores and out‐of‐scanner working memory test (List Sorting) and episodic memory test (Picture Sequence and Penn Word) scores based on functional magnetic resonance imaging (fMRI) data collected both during rest and N‐back task performance. We also analyzed the functional brain connections that contributed to prediction for each of these models.ResultsFunctional connectivity observed during N‐back task performance predicted out‐of‐scanner List Sorting scores and to a lesser extent out‐of‐scanner Picture Sequence scores, but did not predict out‐of‐scanner Penn Word scores. Additionally, the functional connections predicting 2‐back scores overlapped to a greater degree with those predicting List Sorting scores than with those predicting Picture Sequence or Penn Word scores. Functional connections with the insula, including connections between insular and parietal regions, predicted scores across the 2‐back, List Sorting, and Picture Sequence tasks.ConclusionsOur findings validate functional connectivity observed during the N‐back task as a measure of working memory, which generalizes to predict episodic memory to a lesser extent. By building on our understanding of the predictive power of N‐back task functional connectivity, this work enhances our knowledge of relationships between working memory and episodic memory.

Effects of a Combined Motor Imagery and Action Observation Intervention on Vascular Cognitive Impairment: A Randomized Pilot Study.

The aim of the study was to identify the effects of combined motor imagery and action observation therapy on vascular cognitive impairment. Thirty vascular cognitive impairment patients were randomly assigned into three groups. Cognitive training group was given conventional cognitive training, motor imagery + action observation group was treated with motor imagery and action observation therapy, and mixed therapy group was given conventional cognitive training and motor imagery + action observation therapy, for 8 wks continuously. The Montreal Cognitive Assessment Scale, Rivermead Behavioral Memory Test, and event-related potential were used to evaluate the cognitive function at baseline, 4- and 8-wk posttreatment, and 1-mo follow-up. There were significant time × group interactions in Montreal Cognitive Assessment Scale (F6,4.20 = 8.38, P < 0.001), event-related potential latent period (F6,294.24 = 5.10, P < 0.001), event-related potential amplitude (F6,1.68 = 23.08, P < 0.001), and Rivermead Behavioral Memory Test (F6,312.61 = 5.42, P < 0.001). Intragroup comparisons showed that Montreal Cognitive Assessment Scale and Rivermead Behavioral Memory Test scores and event-related potential amplitude increased significantly (P < 0.05), and event-related potential latency decreased significantly (P < 0.05) in all groups. Intergroup comparisons showed that the changes of all outcomes in mixed therapy group were greater than those in cognitive training and motor imagery + action observation group (P < 0.05) after treatment. These results suggest that the combination of cognitive training with motor imagery and action observation therapy is an effective treatment on cognitive function in people with vascular cognitive impairment.

The importance of working memory capacity for improving speech in noise comprehension in children with hearing aid

BackgroundOne of the most common complaints of hearing aid users is difficulty in receiving speech in noise which is very important for all hearing impaired specially children with limited auditory and language experiences. Since working memory plays a significant role in speech perception, especially in challenging auditory situations such as background noise, it is likely that differences in its performance and capacity may impair the ability to understand speech in noise in hearing aid users. Therefore, we aimed to compare memory capacity between two groups of children using hearing aids in both ears, who differed only in the ability to understand speech in noise. MethodsIn this cross-sectional study, 31 children with moderate to severe hearing impairment and the same medical and demographical conditions that using bilateral hearing aids, were examined. These students were divided into two groups according to the scores obtained in speech comprehension as follows: group one (high performance) included students whose SNR loss score in BKB-Speech In Noise test was equal or less than 7, and group two (low performance) included students whose SNR loss score was more than 7. Then, the scores of auditory working memory tests were examined in these two groups. ResultsThe scores of two working memory tests of forward and backward digit span between the two groups no differed significantly based on statistical findings (P = 0.06). But The score of working memory test of non-word repetition differed significantly between the two groups (P = 0.03) A significant correlation was found between the scores of speech comprehension in noise test and working memory tests, including forward (P = 0.004) and backward digit (P = 0.002) span tests and non-word repetition test (P = 0.000) in all subjects. ConclusionThe significant correlation founded between speech perception in noise scores and working memory span, indicating the importance of working memory capacity in the ability to understand speech in noise in children with hearing aids.

Macrophage migration inhibitory factor as a potential novel biomarker for cognitive function in patients with first-episode schizophrenia.

Cognitive impairment is prevalent in schizophrenia. Macrophage migration inhibitory factor which is released into the circulation under stress or inflammation, is associated with cognition and also plays an important role in immunity. However, no study has investigated the relationship between macrophage migration inhibitory factor and cognitive function in first-episode schizophrenia patients at baseline or after treatment. This study investigated the pre- and post-risperidone treatment correlations between serum macrophage migration inhibitory factor levels and cognitive function in first-episode schizophrenia patients. A total of 83 first-episode schizophrenia patients who received risperidone monotherapy and 57 healthy controls - matched for sex, age, smoking status, education (years), marital status and waist-to-hip ratio - were included. Macrophage migration inhibitory factor levels were measured before and 10 weeks after treatment in the patient group and at baseline in the controls. Pre- and post-treatment cognitive functions in patients were assessed using the MATRICS Consensus Cognitive Battery. At baseline, macrophage migration inhibitory factor levels were significantly higher in first-episode schizophrenia patients than those in healthy controls (p < 0.01) and decreased in patients after 10 weeks of risperidone treatment compared with baseline (p < 0.05). The MATRICS Consensus Cognitive Battery total score and the sub-scores for the Trail Making Test, Symbol Coding, Letter Number Sequence, Maze and Brief Visuospatial Memory Test-Revised improved significantly after risperidone treatment. After controlling for age, sex, education, waist-to-hip ratio and smoking status, partial correlation analysis showed a positive correlation between baseline macrophage migration inhibitory factor levels and patients' baseline MATRICS Consensus Cognitive Battery verbal memory scores (r = 0.29, p = 0.01). Macrophage migration inhibitory factor changes correlated negatively with verbal memory changes (r = -0.26, p = 0.04). Multiple linear regression analysis identified a definite correlation between the changes in word memory test score and macrophage migration inhibitory factor level (β = -0.09, p = 0.04). Macrophage migration inhibitory factor may be involved in the process of cognitive impairment in first-episode schizophrenia and repair mechanisms following risperidone treatment.