Neuropsychological Assessment Of Memory Research Articles

Association of Low Ejection Fraction With Impaired Verbal Memory in Older Patients With Heart Failure

Cognitive dysfunction has a major role in health outcomes for cardiac patients. The association of cognitive dysfunction with heart failure is well established, but the cardiac variables that contribute to cognition are not well understood. To investigate the relationships among age, memory, and left ventricular ejection fraction (EF) in patients with heart failure. Retrospective study. Academic medical center. A total of 207 patients with heart failure underwent neuropsychological assessment of memory on standardized tests. Patients were grouped by age quartiles, and memory function was compared in those with an EF below 30% vs those with an EF of 30% or higher. Demographic, cognitive, and medical variables having a significant association with a memory composite score were identified in a univariate linear regression analysis. In a multivariate linear model that adjusted for significant covariates, there was a significant interaction between age and EF for memory function. Patients younger than 63 years maintained stable memory function across EF levels, but patients 63 years or older showed a significant decline in memory performance when EF dropped below 30% (P < .02). Post hoc multivariate analysis showed that verbal delayed recall and recognition were the components of memory most affected by low EF. The effect of EF on memory differs by age such that older patients with lower EFs have significantly reduced verbal memory function.

Cognitive impairments in patients with low grade gliomas and high grade gliomas

The relationship between brain tumors and cognitive deficits is well established in the literature. However, studies investigating the cognitive status in low and high-grade gliomas patients are scarce, particularly in patients with average or lower educational level. This study aimed at investigating the cognitive functioning in a sample of patients with low and high-grade gliomas before surgical intervention. The low-grade (G1, n=19) and high-grade glioma (G2, n=8) patients underwent a detailed neuropsychological assessment of memory, executive functions, visuo-perceptive and visuo-spatial abilities, intellectual level and language. There was a significant impairment on verbal and visual episodic memory, executive functions including mental flexibility, nominal and categorical verbal fluency and speed of information processing in G2. G1 showed only specific deficits on verbal and visual memory recall, mental flexibility and processing speed. These findings demonstrated different levels of impairments in the executive and memory domains in patients with low and high grade gliomas.

Caudate nucleus-dependent response strategies in a virtual navigation task are associated with lower basal cortisol and impaired episodic memory

The present research examined the relationship between endogenous glucocorticoids, navigational strategies in a virtual navigation task, and performance on standard neuropsychological assessments of memory. Healthy young adult participants (N=66, mean age: 21.7) were tested on the 4 on 8 virtual maze (4/8 VM) and standard neuropsychological tests such as the Rey-Osterrieth Complex Figure (RO) and the Rey Auditory Verbal Learning Task (RAVLT), which measure episodic memory. The 4/8 VM differentiates between navigational strategies, where participants either use a hippocampal-dependent spatial strategy by building relationships between landmarks, or a caudate nucleus-dependent stimulus–response strategy by automatizing a pattern of open and closed arms to learn the location of objects within the maze. Degree of stress was assessed by administering the Perceived Stress Scale (PSS) questionnaire. Cortisol samples were taken on two consecutive days upon waking, 30min after waking, at 11am, 4pm, and 9pm. There was a significant difference in basal levels of cortisol between spatial and response learners. Interestingly, response learners had significantly lower cortisol levels throughout the day. The two groups did not differ in terms of perceived stress as measured with the PSS questionnaire. Moreover, there was no significant correlation between PSS scores and salivary cortisol levels, indicating that the higher cortisol levels in the spatial group were not associated with greater perceived stress. In addition, participants who spontaneously used a spatial strategy performed significantly better on the RAVLT and RO. These data indicate that the cortisol levels in the spatial group may be optimal in terms of episodic memory performance whereas the cortisol levels in the response group may be associated with poorer memory. These results are suggestive of an inverted U-shaped curve describing the effects of basal levels of circulating cortisol on memory in young adults.

Diagnostic Accuracy of Percent Retention Scores on RBANS Verbal Memory Subtests for the Diagnosis of Alzheimer's Disease and Mild Cognitive Impairment

Previous research has supported the use of percent retention scores in the neuropsychological assessment of memory, and many widely used memory measures provide for the calculation and normative comparison of these scores. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), an increasingly utilized assessment tool for cognitive impairment, provides normative data on delayed memory total raw scores only. The current study was aimed at determining the diagnostic accuracy of a novel percent retention score calculated from RBANS verbal memory subtests (delayed recall minus last learning trial) when distinguishing between normal controls, individuals diagnosed with Mild Cognitive Impairment, and individuals diagnosed with Alzheimer's disease. Results revealed excellent diagnostic accuracy of the RBANS percent retention scores when discriminating between the three groups. Findings suggest that RBANS percent retention scores provide excellent diagnostic accuracy offering supplementary information to clinicians and researchers alike.

Measuring Impairments in Memory and Executive Function in Older People Using the Revised Cambridge Cognitive Examination

The Revised Cambridge Cognitive Examination (CAMCOG-R) is a cognitive screen that has been used to discriminate individuals with dementia from cognitively intact older people. It consists of items assessing various cognitive domains, but the construct validity of the cognitive subscores has not been established yet. The authors examine the subscores Memory and Executive Function in relation to extensive neuropsychological testing in a group of older adults with or without cognitive decline. Observational study. Memory clinic at the department of geriatrics of a university medical center. A convenience sample of 36 outpatients diagnosed with cognitive decline and 24 older healthy participants. Sensitivity and specificity of the CAMCOG-R Memory subscore and Executive Function subscore were established using extensive neuropsychological assessment of memory (using the Rey-Auditory Verbal Learning Test, Location Learning Test, Visual Association Test, and Story Recall) and executive function (using the Brixton Spatial Anticipation Test, Trail Making Test, and Key Search test) as the gold standard. For the CAMCOG-R Executive Function subscore, a cutoff point of 16.5 had a good sensitivity (0.82) and adequate specificity (0.73) for discriminating people with and without executive dysfunction. However, the Total Score and Language subscore also differentiated between people with and without executive dysfunction. The CAMCOG-R Memory subscore could not validly distinguish between people with and without memory impairment. The CAMCOG-R subscores Memory and Executive Function have limited validity, and clinicians should be cautious in interpreting these in the absence of other neuropsychological measures or clinical information.

A Cognitive Training Program Based on Principles of Brain Plasticity: Results from the Improvement in Memory with Plasticity‐based Adaptive Cognitive Training (IMPACT) Study

To investigate the efficacy of a novel brain plasticity-based computerized cognitive training program in older adults and to evaluate the effect on untrained measures of memory and attention and participant-reported outcomes. Multisite randomized controlled double-blind trial with two treatment groups. Communities in northern and southern California and Minnesota. Community-dwelling adults aged 65 and older (N=487) without a diagnosis of clinically significant cognitive impairment. Participants were randomized to receive a broadly-available brain plasticity-based computerized cognitive training program (intervention) or a novelty- and intensity-matched general cognitive stimulation program modeling treatment as usual (active control). Duration of training was 1 hour per day, 5 days per week, for 8 weeks, for a total of 40 hours. The primary outcome was a composite score calculated from six subtests of the Repeatable Battery for the Assessment of Neuropsychological Status that use the auditory modality (RBANS Auditory Memory/Attention). Secondary measures were derived from performance on the experimental program, standardized neuropsychological assessments of memory and attention, and participant-reported outcomes. RBANS Auditory Memory/Attention improvement was significantly greater (P=.02) in the experimental group (3.9 points, 95% confidence interval (CI)=2.7-5.1) than in the control group (1.8 points, 95% CI=0.6-3.0). Multiple secondary measures of memory and attention showed significantly greater improvements in the experimental group (word list total score, word list delayed recall, digits backwards, letter-number sequencing; P<.05), as did the participant-reported outcome measure (P=.001). No advantage for the experimental group was seen in narrative memory. The experimental program improved generalized measures of memory and attention more than an active control program.

A Comparison of Implicit Memory Tests in Schizophrenic Patients and Normal Controls

The objective of the current study was to compare the performance of schizophrenic patients and normal controls on implicit memory tests. Two neuropsychological tasks were administered to 29 patients and normal participant samples. The implicit tests were: Word fragment completion and Word production from semantic categories. The priming score was the variable of interest. Priming effects are obtained in normal subjects and schizophrenia patients, regardless of the implicit test used. However, a dissociation in priming between normal and patient groups was observed, depending on the test used. For word fragment test, priming was identical between the two groups. However, for word production, priming obtained in schizophrenics was lower than priming in normal controls. Results confirm a dissociation effect in implicit memory tests. These results could be explained in the context of the Roediger and Blaxton (1987) distinction between data-driven and conceptually-driven processing. This evidence suggests that a complete neuropsychological assessment of memory in schizophrenia should include different kinds of implicit memory tests (procedural, perceptual, and conceptual tasks).

Evaluation of a Structured Group Format Memory Rehabilitation Program For Adults Following Brain Injury

To evaluate the impact of an 8-session structured group format memory rehabilitation program on impaired memory functioning. Adults with traumatic brain injury (N = 10) or cerebral vascular accidents (N = 2). A waitlist control study with pregroup, postgroup, and 1-month follow-up assessments. WECHSLER MEMORY SCALE-REVISED: Neuropsychological assessments of memory (California Verbal Learning Test, Wechsler Memory Scale-Revised logical memory, visual-paired associates, and Rey Complex Figure) and both self-report and significant other report of behaviors indicative of memory difficulties and the use of memory strategies. Participation in the memory group increased participants' knowledge of memory and memory strategies as well as use of memory aids and strategies; reduced behaviors indicative of memory impairment; and had a positive effect on neuropsychological assessments of memory (eg, delayed recall for words and figures). All significant improvements exceeded change experienced by waiting-list controls and were maintained at 1-month follow-up assessment. While extension of the findings is needed, the memory group has a positive impact on both neuropsychological measures of memory and everyday memory functioning.

Clinical application of functional MRI for memory using emotional enhancement: Deficit and recovery with limbic encephalitis

Although some functional MRI memory studies show reliable neural activity in the hippocampus and mesial temporal lobe (MTL), most typically report results from group studies. However, fMRI memory probes need to be robust enough to show MTL activity in individual patients to be helpful in diagnosis and treatment planning. We present the case of a patient with non-paraneoplastic limbic encephalitis who had severe anterograde amnesia with subsequent recovery to illustrate a fMRI probe of MTL activity that is easily administered to neurological patients. The task uses emotionally positive and affiliative stimuli to elicit responsivity in the amygdala–hippocampus region. In this patient, weak bilateral hippocampal activation was observed in the acute stage that increased after recovery, paralleling findings on structural MRI and neuropsychological memory assessment. This case study demonstrates that using emotional stimuli to enhance memory responsivity may be an effective way to visualize clinical changes in individual patients.

Evaluación de la memoria mediante resonancia magnética funcional: aplicaciones en pacientes prequirúrgicos y en la enfermedad de Alzheimer

The assessment of memory functions related to medial temporal lobe has become one of the most important issues on current neuropsychology. On this communication, we review the results which our research group has achieved using two functional magnetic resonance Image procedures to assess memory function: Hometown walking task and an encoding/retrieval task using complex images. Nine patients with tumoural temporal lesions performed the hometown walking task. The results of these patients showed either a bilateral or contralesional representation of memory function. These results confirm those obtained by Jokeit, Okujava y Woermann (2001), and they seem to prove that this protocol is useful to determine the preservation of memory function in the non damaged hemisphere. On the other hand, the images encoding/retrieval task has been run by two groups of four patients diagnosed as Alzheimer disease and mild cognitive impairment, and another group of five patients who participated as a control group. According to our hypothesis, the results have shown a lower activation at the left parahippocampal gyrus in mild cognitive impairment and Alzheimer disease patients than controls, just as a lower bilateral activation in the same structure for the Alzheimer group than the control group. As a whole, our results show how important may become functional magnetic resonance image for neuropsychological assessment of memory, and as a diagnostic tool for CNS diseases.

Síndrome amnésico postraumático

Mnesic deficits are frequent in subjects which have suffered from head injury and may persist during may years. We will analyze posttraumatic amnesia characteristics (PTA) as well as learning and memory deficits which are normally observed once the PTA phase is over. The PTA is defined as the period that follows a brain injury in which the affected person is incapable of consistently remembering at least the last 24 hours. That is, the period after the head injury in which the incorporation of new information in long term memory is not possible. The study of PTA has generally been focussed on the analysis of the alterations of temporo-spatial orientation and mnesic deficits, however other cognitive and behavioral alterations do exist (linguistic, attentional, critical judgement, information processing, perception, etc.), and they are associated with the particular memory disorder that we are studying, given their influence on it. We will take on board the different theories that have been proposed to explain mnesic deficits which occur during the PTA phase: lack of consolidation of new information within longterm memory; recall deficit as a result of inefficient coding of information; failures of the mechanisms to carry out the process of consolidation-recall, and poor organization in the coding of new material. We will put forward a guide for the neuropsychological assessment of memory based on the analytic and concrete study of each mnesic cognitive component, sustained generally by specific neurophysiological functional systems which allow us to establish a diagnosis, prognosis, and adequate therapeutic focus for each concrete case.

Memory bias in obsessive–compulsive disorder (OCD)

There is a memory bias associated with depression, and good reason to expect a memory bias associated with anxiety. However, the results of studies reported to date have been ambiguous. Accordingly, an experiment was conducted to assess memory for contamination in people with different types of anxiety. Memory for contaminated stimuli among participants who met DSM-IV criteria for obsessive–compulsive disorder (OCD) and indicated a fear of contamination ( n=10) was compared to memory in a group of anxious controls ( n=10), and in undergraduate students ( n=20). Participants were shown 50 objects, 25 of which were contaminated by the experimenter and 25 which were touched but not contaminated. They then completed a neuropsychological memory assessment, after which the participants were asked to recall all of the objects touched by the experimenter. They were then asked to approach each object and to rate their anxiety about touching it. Finally, participants were asked about their perceptions of the cleanliness of each object. The OCD group had better memory for contaminated objects than for clean ones. Neither control group showed such a bias. Neuropsychological test scores indicated that this bias is not the result of differences in general memory ability. The results are discussed in terms of the memory-deficit theory of OCD and of behavioural and cognitive approaches to understanding the role of information processing in fear and anxiety.

Age-related changes in performance on a visual-closure task.

A sample of 645 volunteer subjects, 50-79 years of age, took part for two consecutive years in a neuropsychological study of perception and memory. The sample was divided into three age groups (50-59, 60-69, and 70-79) in order to examine any age-related changes in performance. On a visual-closure task, similar to that of Gollin (1960), all age groups showed significant improvements in performance (savings) with repeated exposure to the drawings, both after a 15-min, and again after a 1-year, time interval. There were significant differences, however, between the different age groups on all aspects of the task, including number of errors made during initial perceptual performance, percentage of savings over both short- and long-time intervals, and number of items recalled. These findings are contrasted with those from studies of implicit and explicit aspects of verbal memory in normal young and old people, which have found no age-related differences in implicit memory abilities. Implications of these findings, as they relate to the neuropsychological assessment of memory in older people, are discussed briefly.

Neuropsychological assessment of memory in the elderly.

Neuropsychological assessment of memory in the elderly.