Modified Wisconsin Card Sorting Test Research Articles

B - 59 Testing the Cognitive Model of Pathological Worry as an Explanation for Increased Worry among the Oldest Old.

Based on past research demonstrating increased worry among the oldest old compared to younger older adults, this study tested an existing cognitive model of worry to determine whether differences in executive functioning during aging contribute to increased worry among the oldest old. 97 community-dwelling older adults (M age = 74.49; range = 60-89years) completed self-report questionnaires including the Penn State Worry Questionnaire, Geriatric Anxiety Scale, and Cognitive Problems and Strategies Assessment, and were individually evaluated with neurocognitive measures including the RBANS, DKEFS Color-Word Interference Test, and Modified Wisconsin Card Sorting Test. Two-way ANOVAs revealed no significant differences in worry based on age group (i.e., 60s, 70s, and 80s; F[2, 85] = 1.31, p = 0.28) or gender (F[1, 85] = 3.22, p = 0.08). Further, response inhibition and problem-solving did not predict anxiety or worry severity in multiple regression analyses. Lower education was the only consistent predictor of both anxiety and worry when accounting for cognitive performance, age, and gender. However, subjective cognitive functioning also predicted worry among older adults, independent of objective performance. No age differences in worry or anxiety severity were found. Also, no evidence was found to support age-differences in executive functioning as a contributor to worry presentation in late life. The cognitive model of worry may only be applicable to pathological worry or executive decline among the sample was not pronounced enough to impact anxiety. Overall, this study demonstrates that the cognitive model of worry is not supported in healthy, community-dwelling older adults. However, limitations included limited demographic diversity, small sample size, and limited measurement of executive functioning.

Disentangling cognitive inflexibility in major depressive disorder: A transcranial direct current stimulation study.

Cognitive dysfunction is a persistent residual symptom in major depressive disorders (MDDs) that hinders social and occupational recovery. Cognitive inflexibility is a typical cognitive dysfunction in MDD and refers to difficulty in switching tasks, which requires two subcomponents: forgetting an old task and adapting to a new one. Here, we aimed to disentangle the subcomponents of cognitive inflexibility in MDD and investigate whether they can be improved by transcranial direct current stimulation (tDCS) on the prefrontal cortex. The current study included 20 patients with MDD (seven females) and 22 age-matched healthy controls (HCs) (seven females). The participants received anodal tDCS on either the dorsomedial prefrontal cortex (DMPFC) or dorsolateral prefrontal cortex (DLPFC) in a crossover design. Before and after the application of tDCS, the participants performed a modified Wisconsin Card Sorting Test, in which the task-switching rules were explicitly described and proactive interference from a previous task rule was occasionally released. We found that the behavioral cost of a task switch was increased in patients with MDD, but that of proactive interference was comparable between patients with MDD and HCs. The response time for anodal DMPFC tDCS was decreased compared with that for anodal tDCS on the DLPFC in MDD. These findings suggest that cognitive inflexibility in MDD is primarily explained by the difficulty to adapt to a new task and environment, and that tDCS on the DMPFC improves behavioral performance during cognitively demanding tasks that require conflict resolution.

Attention, memory, and executive functioning in hypoxemic chronic obstructive pulmonary disease patients

Background: Chronic obstructive pulmonary disease (COPD) is characterized by chronic airflow obstruction and is one of the leading causes of death globally. The changes in pulmonary functions in COPD are irreversible with devastating consequences. Cognitive functioning in COPD patients is often found impaired and postulated to happen due to hypoxemia, i.e., oxygen deprivation to the brain. An impaired cognitive functioning can have direct impact on functional abilities as well as quality of life of patients and could be a vital treatment goal. The study aimed to explore the attention, memory, and executive functioning in hypoxemic COPD patients in backdrop of dearth of studies from India. Materials and Methods: Using purposive sampling, 30 patients with COPD, having mild-to-moderate level of illness severity, and having minimum illness for duration of 5 years were compared with 30 healthy controls. Participants were assessed for cognitive functioning in the domains of sustained attention, processing and psychomotor speed, working memory, verbal learning, and memory and executive functions using neuropsychological tests, namely, Digit Symbol Substitution Test, Trial Making Test, Verbal N Back Test, Rey's Audio Visual Learning Test, Controlled Oral Word Association Test, Animal Naming Test, Stroop Neuropsychological Test, and Modified Wisconsin Card Sorting Test. Results: Findings suggest significant differences between COPD patients and healthy controls over processing and psychomotor speed, working memory, memory, learning, and executive functioning. Conclusion: In addition to pulmonary distress, COPD patients also have compromised cognitive functions affecting overall daily functioning and quality of life. Understanding the nature of decline in cognitive functions could be vital in improving daily psychosocial functioning of the patients with COPD, and the exploration could help professionals in intervention of specific cognitive functioning.

Functional Brain Network Analysis of Knowledge Transfer While Engineering Problem-Solving.

As a complex cognitive activity, knowledge transfer is mostly correlated to cognitive processes such as working memory, behavior control, and decision-making in the human brain while engineering problem-solving. It is crucial to explain how the alteration of the functional brain network occurs and how to express it, which causes the alteration of the cognitive structure of knowledge transfer. However, the neurophysiological mechanisms of knowledge transfer are rarely considered in existing studies. Thus, this study proposed functional connectivity (FC) to describe and evaluate the dynamic brain network of knowledge transfer while engineering problem-solving. In this study, we adopted the modified Wisconsin Card-Sorting Test (M-WCST) reported in the literature. The neural activation of the prefrontal cortex was continuously recorded for 31 participants using functional near-infrared spectroscopy (fNIRS). Concretely, we discussed the prior cognitive level, knowledge transfer distance, and transfer performance impacting the wavelet amplitude and wavelet phase coherence. The paired t-test results showed that the prior cognitive level and transfer distance significantly impact FC. The Pearson correlation coefficient showed that both wavelet amplitude and phase coherence are significantly correlated to the cognitive function of the prefrontal cortex. Therefore, brain FC is an available method to evaluate cognitive structure alteration in knowledge transfer. We also discussed why the dorsolateral prefrontal cortex (DLPFC) and occipital face area (OFA) distinguish themselves from the other brain areas in the M-WCST experiment. As an exploratory study in NeuroManagement, these findings may provide neurophysiological evidence about the functional brain network of knowledge transfer while engineering problem-solving.

The Impact of Sex on the Neurocognitive Functions of Patients with Parkinson's Disease.

This study aimed to understand the impact of sex on the neurocognitive function of patients with Parkinson’s disease (PD). Ninety-four participants with idiopathic PD and 167 age-matched healthy individuals as normal controls (NCs) were recruited and underwent comprehensive neuropsychological assessments. Sex differences were found in NCs, but not in patients with PD. Among male participants, patients with PD showed worse performance on the Digit Symbol Substitution (DSS) (p < 0.001) test and Symbol Search (SS) (p < 0.001) than NCs. Among female participants, patients with PD showed worse performance on the category score of the Modified Wisconsin Card Sorting Test (p < 0.001), SS (p < 0.001), and pentagon copying (p < 0.001) than NCs. After controlling for the effects of age and years of education, Hoehn and Yahr stage was found to predict the performance of the Color Trails Test part A (βA = 0.241, pA = 0.036), Stroop Color and Word Test (β = −0.245, p = 0.036), and DSS (β = −0.258, p = 0.035) in men with PD. These results indicate the differential effect of sex on the neurocognitive function among healthy aging and PD populations. The disappearance of sex differences, which is present in healthy aging, in patients with PD suggests a gradual loss of the neuroprotective effect of estrogen after the initiation of the neurodegenerative process. This study also found mental flexibility and visuospatial function to be the susceptible cognitive domains in women with PD, while the disease severity could predict the working memory and processing speed in men with PD.

Neuropsychological profile and correlation with outcomes in patients admitted to spdc

IntroductionLiterature showed that patients suffering from disorders belonging to the schizophrenic (SZ) and bipolar (DB) spectrum have a qualitatively similar but quantitatively different neurocognitive impairment that correlates with the outcomes. However, the majority of former studies are conducted on patients in remission phase.ObjectivesThis study aims to compare cognitive functions between SZ and DB in the acute phase and their possible correlations with treatment outcomes.MethodsIn a prospective longitudinal study conducted at the SPDC Ausl unit of Romagna - Cesena, 57 SZ and 82 DB took part in the study. The diagnosis was based on the SCID5 CV and SCID5 DP. Symptom severity was assessed with BPRS and HONOS both at the beginning and at the end of hospitalization. Executive functions were measured with Tower of London (ToL) and Modified Wisconsin Card Sorting Test (MCST), attention with Attentive Matrices (MA) and Stroop Test (ST), non-verbal logic skills with Colored Matrices by Raven (PM47). The statistical analyzes applied are ANOVA and logistic regression.ResultsThe cognitive tests did not reveal significant differences between SZ and DB. The logistic regression analysis showed that the scores obtained at the MCST and MA positively correlate with the efficacy of the treatment for both groups.ConclusionsCognition in DB and SZ patients was similarly impaired, supporting recent theories that placed diagnoses on a continuum of severity. Moreover, the results indicated that also in the acute phase the best predictors of the outcome were flexibility in problem solving strategies and visuospatial attention.DisclosureNo significant relationships.

Multivariate Base Rates of Low Scores on Tests of Executive Functions in a Multi-Country Latin American Sample

ABSTRACT The objective of the study was to determine the prevalence of low scores in a diverse Latin American population for two neuropsychological commonly used tests to evaluate executive functions and to compare the number of low scores obtained using normative data from a Spanish-speaking population from Latin America versus an English-speaking population from U.S.A. Healthy adults (N = 5402) were administered the Modified Wisconsin Card Sorting Test and Stroop Color-Word. Low scores on measures of executive functioning are common. Clinicians working with Spanish-speaking adults should take into account the higher probability of low scores on these measures to reduce false-positive diagnoses of cognitive deficits in an individual.

Cognitive factors of the transfer of empirical engineering knowledge: A behavioral and fNIRS study

Knowledge transfer is a progressive method to accelerate knowledge accumulation and technological innovation of enterprises. This hot research topic remains explorative on improving knowledge transfer efficiency in employees' training and engineering practice. However, due to ambiguous cognitive structure, how concepts and knowledge are stored and utilized in employees' minds during problem-solving was poorly answered. Therefore, this paper proposed a concept-sorting test, inspired by the modified Wisconsin Card-Sorting Test (M-WCST), to investigate the near/far transfer mechanism of empirical engineering knowledge (EEK) under the technological paradigm shift. Concept classification experiments were carried out for 31 participants by functional near-infrared spectroscopy (fNIRS) to explore the neuroscience basis of EEK transfer. Transfer performance and cognitive load measured in concept-sorting tests showed: (1) The cognitive level of the prior technological paradigm positively increases the transfer performance. However, it causes more perseverative errors due to set patterns of thinking. (2) The transfer distance negatively decreases the performance. Hence the display materials which are different from the prior cognitive structure are not beneficial for participants to learn. (3) The transfer distance significantly impacts the cognitive load. The activation level of brain areas becomes higher when people finish the near EEK transfer and apply it to solve new problems. As an explorative study, the evidence from fNIRS can provide insights into the theory and practice of empirical knowledge management.

Relationship between executive functions and impulsive behavior in adolescents: Comparative study

Introduction: Impulsivity can be directly related to maladaptive and disruptive behaviors; specifically, during adolescence, impulsivity is associated with behavioral and social problems, and it has been found that some behavioral difficulties are related to neuropsychological dysfunction of the prefrontal cortex, which is responsible for regulating impulse control and executive functions. Objective. To compare the relationships among executive functions, particularly inhibitory control, behavioral planning and behavioral flexibility, in adolescents between 13 and 15 years old with and without impulsivity. Method. This study was developed using an analytical, comparative design. The sample consisted of 62 participants whose impulsivity was measured using the BIS-11-A Impulsiveness Scale and whose data were compared with normative data from the same sample size. Executive functions were evaluated using the Tower of London test, Modified Wisconsin Card Sorting Test (M-WCST), Trail Making Test (TMT) and Stroop test. Results. Young people between 13 and 15 years old who exhibited impulsive behavior showed impairment in the executive functions studied, such as inhibitory control, cognitive flexibility, and behavioral planning. Discussion and conclusion. There is a direct correlation between impulsive behaviors and executive functions during adolescence. The results found here support the development of potential intervention protocols based on executive functioning.

Normative data for tests of attention and executive functions in a sample of European Portuguese adult population

ABSTRACT Objective: The main goal of this study was to produce normative data for the Portuguese population on five neuropsychological tests frequently used to assess executive functions and attention: the Modified Wisconsin Card Sorting Test (M-WCST), the Stroop Color and Word Test, the Trail Making Test (TMT), the Brief Test of Attention (BTA), and the Symbol Digit Modalities Test (SDMT). Method: The study included 300 individuals aged between 18 and 93 years, who had educational backgrounds ranging from 3 to 25 years. Results: The influence of age, education, and sex was explored for each measure, as well as their contribution to explain the performance variance. Conclusions: The normative data are presented as regression-based algorithms to adjust direct and derived test scores for sex, age, and education. This study provides a calculator of normative data, derived from the results of the regression models.

Comparative Study of Cognitive Function Between Treatment-Resistant Depressive Patients and First-Episode Depressive Patients.

ObjectiveDespite reports of cognitive dysfunction during the acute phase of depression, there is a lack of studies in patients with treatment-resistant depression (TRD). The aim of this study was to investigate the cognitive function profile of TRD and compare cognitive dysfunction between subjects with TRD and first-episode depression.Patients and methodsThe study included 31 patients with TRD and 53 with first-episode depression. Cognitive function was assessed by a series of neuropsychological tools such as the verbal fluency test, Modified Wisconsin Card Sorting Test (M-WCST), Tower of Hanoi test, Chinese-revision of the Wechsler Adult Intelligence Scale (WAIS-RC), and Trail Making Test A and B.ResultsThere were no significant demographic differences between the TRD, first-episode depression, and normal control groups (gender, age, years of education). The full-scale, verbal, and performance intelligence quotients measured with the WAIS-RC were also not significantly different (p>0.05). The normal group scores were all significantly better than TRD and first-episode depression, and the TRD group performed significantly worse than subjects with first-episode depression on Trail Making Test B, two WCST subscales, and the profile score of the Tower of Hanoi test (all p<0.05).ConclusionPatients with depression exhibited global impairments in cognitive function, and these were more common in TRD. Poor executive function may play an important role in TRD.

Children with autism spectrum disorder comorbid with attention-deficit/hyperactivity disorder examined by the Wisconsin card sorting test: Analysis by age-related differences

The DSM-5 confirmed that autism spectrum disorder (ASD) might be comorbid with attention-deficit/hyperactivity disorder (ADHD). This study investigated the executive function of ASD comorbid with ADHD (ASD + ADHD), ASD, and typically developed (TD) children using the Keio version of the modified Wisconsin card sorting test (KWCST). Children with ASD + ADHD (n = 43), ASD (n = 69), and TD (n = 69) were examined in two age groups: 5–9 years and 10–15 years. Both of the younger clinical groups showed significantly unfavorable scores for many indices in the second step compared to the TD group. As for the older groups, the ASD children showed significantly unfavorable scores in total errors in the second step, while the ASD + ADHD children did not show significant differences in either step. However, some index scores of the two older clinical groups were comparable to the older TD group in the second step. For the cognitive differences between clinical groups, the younger ASD + ADHD showed unfavorable scores in numbers of response cards until the first category achieved in the second step, while the older ASD showed unfavorable scores in categories achieved and perseverative errors of Nelson in the first step. For the degree of improvements in the second step, the older groups did not show significant group differences, while the younger ASD group showed significantly fewer improvements compared to the TD group. Based on these results, it is presumed that younger ASD + ADHD individuals are not sufficiently able to sustain attention and/or memory, and that the older ASD patients have difficulty in terms of flexibility.

Neurocognitive Function in Persons with HIV and Healthy Controls from Tijuana, a Border Region in Mexico

Abstract Objective To examine neurocognitive impairment (NCI) in vulnerable HIV infected (HIV+) adults in Mexico. Participants and Method Twenty-eight adults (15 HIV+ and 13 HIV-) living in Tijuana (Mexico) participated in the study (Age: M = 40.5, SD = 11.1; 54% female; Education: M = 8.6, SD = 4.7). Participants with HIV were recruited from the board-and-care home “Las Memorias” (100% AIDS; 93% on ART; Years since HIV diagnosis: Median = 11, IQR = 5,16). Healthy controls, matched in age and education to HIV+ participants, were recruited from the same city. Participants completed a neuropsychological test battery which was comprised of the Modified Wisconsin Card Sorting Test, letter and animal fluency, Trail Making Test Parts A and B, Stroop Color-Word Test, and Symbol-Digit Test. Raw scores garnered from these tests were transformed to percentiles using norms for a Mexican population, and averaged to calculate scores on global cognition and on three cognitive domains (verbal fluency, processing speed and executive function). Wilcoxon rank sum tests were conducted to investigate group differences. NCI was defined as global percentile scores &amp;lt; 16. Results HIV+ participants showed significantly lower scores in global cognition (p = .04, Cohen’s d = 0.86), as well as the domains of processing speed (p = .03, Cohen’s d = 0.87) and executive function (p = .04, Cohen’s d = 0.84), with no significant differences (but medium effect sizes) on verbal fluency (p = .10, Cohen’s d = 0.60). NCI was evident in 53% of HIV+ persons and 15% of healthy controls. Conclusions Approximately half of the persons living with HIV showed notable NCI, which is consistent with findings of prior studies of Latinos in the US with HIV. This pattern of neurocognitive function was also similar to those of prior studies in HIV. Future studies might examine key predictors of HIV-associated NCI in this vulnerable Mexican population, including biological and culturally relevant factors: such as deportation, and discrimination for sexual preference or HIV status.

The Reliability of the Wisconsin Card Sorting Test in Clinical Practice.

The Wisconsin Card Sorting Test (WCST) represents the gold standard for the neuropsychological assessment of executive function. However, very little is known about its reliability. In the current study, 146 neurological inpatients received the Modified WCST (M-WCST). Four basic measures (number of correct sorts, categories, perseverative errors, set-loss errors) and their composites were evaluated for split-half reliability. The reliability estimates of the number of correct sorts, categories, and perseverative errors fell into the desirable range (rel ≥ .90). The study therefore disclosed sufficiently reliable M-WCST measures, fostering the application of this eminent psychological test to neuropsychological assessment. Our data also revealed that the M-WCST possesses substantially better psychometric properties than would be expected from previous studies of WCST test-retest reliabilities obtained from non-patient samples. Our study of split-half reliabilities from discretionary construed and from randomly built M-WCST splits exemplifies a novel approach to the psychometric foundation of neuropsychology.

Modified Wisconsin Card Sorting Test (M-WCST): Normative Data for the Lebanese Adult Population

ABSTRACTThe aim of this study was to generate normative data on the M-WCST in a Lebanese adult population and to examine the relationship between performance on this task and demographic variables. The sample consisted of 220 healthy adults aged between 18 and 64 years. Regression-based strategy was applied to generate normative data. The results showed a statistically significant effect of age and level of education on the M-WCST measures, whereas gender was not significant. Demographically calibrated percentiles and scaled scores were created. Finally, this study was the first to provide normative-adjusted tables for the M-WCST scores in Lebanon.

A Prospective Open-Label Pilot Study of Transcranial Direct Current Stimulation in High-Functioning Autistic Patients with a Dysexecutive Syndrome

Background: Executive functions (EF) are often impaired in autism spectrum disorder (ASD). Such dysfunctions are associated with anxiety, depression, and a lack of autonomy. Transcranial direct current stimulation (tDCS) has been shown to enhance EF in healthy adults and clinical populations and to improve working memory − a component of the EF − in adults with high-functioning ASD (HF-ASD). We hypothesized that tDCS could improve the EF of HF-ASD patients. Such enhancement could improve their adaptive behaviors. Method: Eight patients with HF-ASD received 10 consecutive cathodal tDCS sessions (2 mA) over the left dorsolateral prefrontal cortex (F3) for 15 min each in an open trial. EF (with the Stroop test, Trail Making Test [TMT] A and B, Modified Wisconsin Card Sorting Test [mWCST], and Verbal Fluency Test) and behavioral dysexecutive syndrome (with the Behavioral Dysexecutive Syndrome Inventory and the Repetitive and Restricted Behaviour scale) were assessed before and 10 days after treatment. Results: This study showed significant improvement in initiation (TMT-A time: p = 0.018) and cognitive flexibility (TMT-B time: p = 0.009; letter Verbal Fluency Test: p = 0.017; mWCST total errors: p = 0.028) after tDCS. Regarding behavior, the hypoactivity of the patients improved, as well as their repetitive and restrictive behaviors. In addition, this noninvasive neurostimulation technique was well tolerated. Conclusions: Flexibility and initiation are the most impaired EF in autism. These are promising results which justify a randomized and placebo-controlled study in a wider population. If these results were confirmed by a randomized controlled trial, tDCS could be an easy and well-tolerated adjunctive treatment aiming to improve the quality of life and the autonomy of ASD patients.

Developing set-shifting improvement tasks (SSIT) for children with high-functioning autism.

Children with autism spectrum disorder (ASD) experience set-shifting deficit as a part of executive function, which can lead to cognitive and behavioural flexibility deficits and/or restricted behaviours. Despite the increasing body of research on this cognitive deficit, set-shifting training has not been exclusively studied in ASD. In this study, a training condition [set-shifting improvement tasks (SSIT)] was developed to improve set-shifting ability; afterwards, the possible effects of these tasks were investigated. With the aim of improving set-shifting ability in children with autism, a training program (SSIT), involving a computer game (Tatka, a puzzle game produced by our research team) with some home-based tasks (for generalisation purposes), was developed. Then, in a quasi-experimental design, the effects of SSIT tasks were studied on children (n=13, 5-7years old) with high-functioning autism. Outcome measures (pre-training, post-training and a 6-week follow-up) were assessed using Modified Wisconsin Card Sorting Test, Bender-Gestalt Test and Behavioural Flexibility Rating Scale. A significant change was observed in both cognitive (Bender Gestalt, ; WCST; ) and behavioural flexibilities ( ) and also in repetitive behaviours ( ). Furthermore, the result remained stable to some extent for about 1month after the training condition. Developing the SSIT is just an initial step in the major target of creating cognitive rehabilitation tools to be used by clinicians and parents for children diagnosed with ASD and should be understood as a supplement, rather than an alternative, to the main treatments such as applied behaviour analysis. Future research with larger samples are needed to confirm whether this intervention is effective for children with ASD.

Multiple Levels of Control Processes for Wisconsin Card Sorts: An Observational Study.

We explored short-term behavioral plasticity on the Modified Wisconsin Card Sorting Test (M-WCST) by deriving novel error metrics by stratifying traditional set loss and perseverative errors. Separating the rule set and the response set allowed for the measurement of performance across four trial types, crossing rule set (i.e., maintain vs. switch) and response demand (i.e., repeat vs. alternate). Critically, these four trial types can be grouped based on trial-wise feedback on t − 1 trials. Rewarded (correct) maintain t − 1 trials should lead to error enhancement when the response demands shift from repeat to alternate. In contrast, punished (incorrect) t − 1 trials should lead to error suppression when the response demands shift from repeat to alternate. The results supported the error suppression prediction: An error suppression effect (ESE) was observed across numerous patient samples. Exploratory analyses show that the ESE did not share substantial portions of variance with traditional neuropsychological measures of executive functioning. They further point into the direction that striatal or limbic circuit neuropathology may be associated with enhanced ESE. These data suggest that punishment of the recently executed response induces behavioral avoidance, which is detectable as the ESE on the WCST. The assessment of the ESE might provide an index of response-related avoidance learning on the WCST.

Similar profiles of cognitive domain deficits between medication-naïve patients with bipolar II depression and those with major depressive disorder

BackgroundBipolar disorder (BD) II is more likely to be misdiagnosed as major depressive disorder (MDD) than other types of BD, leading to incorrect treatment and poor outcomes. Previous studies have shown inconsistent results regarding the differences in cognitive deficits between the two disorders. To eliminate the compounding effects of medication and aging, we sought to investigate changes in cognitive function in medication-naïve, non-late-life patients with BDII and MDD. MethodsThree subject groups were enrolled: 30 depressed BDII patients, 30 depressed MDD patients and 30 healthy controls. All subjects underwent a battery of cognitive tests to assess 8 cognitive domains. The cognitive domains were compared between the three subject groups. In BDII and MDD, the effect sizes were computed as evaluation parameters, weighing the degree of the cognitive deficits and the correlations between cognitive test deficits and clinical variables were also computed. ResultsCompared with the controls, the BDII and MDD patients were characterized by similar deficits in psychomotor speed, working memory, visual memory, attention switching and verbal fluency. Moderate to severe deficits in the majority of cognitive tests were observed in the BDII and MDD patients. Furthermore, correlations between the modified Wisconsin Card Sorting Test total errors and age of onset in the BDII patients and between correct digit span responses (backward and total) and depressive severity were found in the MDD patients. ConclusionsOur findings suggest that BDII and MDD patients may suffer from similar profiles of cognitive domain deficits that may not assist in distinguishing between the two disorders. In addition, cognitive deficits may be correlated with the age of onset and depressive severity in mood disorders.

Modified Wisconsin Card Sorting Test (M-WCST): Normative data for Spanish-speaking pediatric population.

To generate normative data for the Modified Wisconsin Card Sorting Test (M-WCST) in Spanish-speaking pediatric populations. The sample consisted of 4,373 healthy children from nine countries in Latin America (Chile, Cuba, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Peru, and Puerto Rico) and Spain. Each participant was administered the M-WCST as part of a larger neuropsychological battery. Number of categories, perseverative errors, and total error scores were normed using multiple linear regressions and standard deviations of residual values. Age, age2, sex, and mean level of parental education (MLPE) were included as predictors in the analyses. The final multiple linear regression models indicated main effects for age on all scores, such that the number of categories correct increased and total number of perseverative errors and total number of errors decrease linearly as a function of age. Age2 had a significant effect in Chile, Cuba, Ecuador, and Spain for numbers of categories; a significant effect for number of perseverative errors in Chile, Cuba, Mexico, and Spain; and a significant effect for number of total errors in Chile, Cuba, Peru, and Spain. Models showed an effect for MLPE in Cuba (total errors), Ecuador (categories and total errors), Mexico (all scores), Paraguay (perseverative errors and total error), and Spain (categories and total errors). Sex affected number of total errors for Ecuador. This is the largest Spanish-speaking pediatric normative study in the world, and it will allow neuropsychologists from these countries to have a more accurate way to interpret the M-WCST with pediatric populations.