Nonverbal Deficits Research Articles

Post unilateral lesion response biases modulate memory: Crossed double dissociation of hemispheric specialisations

We propose that what appears to be hemispheric specialisation in the memory domain, as indexed by effects of unilateral brain lesions, is to a great extent explainable as response bias: left hemisphere lesions result in an omissive response bias or error pattern whereas right hemisphere lesions result in a commissive response bias or error pattern. To test this prediction a group of 40 non-confabulatory cases with a verbal and non-verbal retention deficit (hypomnesia), subsequent to a unilateral lesion, was assembled from the literature. A group of non-amnesic cases with confabulation, paramnesia, false memories or memory-laden hallucination (dysfunctional hypermnesia), due to a unilateral lesion, was also assembled from the literature (N=72). Most of the hypomnesic patients had left hemisphere lesions (73%, p<.005, two tailed) while most of the hypermnesic patients had right hemisphere lesions (78%, p<.0005, two tailed). This crossed double dissociation held good despite statistical control of the lesion's locus within the hemisphere, its size or its aetiology, presence of aphasic symptoms, psychiatric comorbidity, the patient's age, gender, or hand preference, and several other potentially confounding variables.

Nonverbal deficits in explicit and implicit memory of Parkinson's disease patients.

This study examined verbal and nonverbal aspects of explicit and implicit memory in a sample of 19 Parkinson's disease (PD) patients and 21 control subjects. For implicit memory evaluation, we used a Mirror Reading (MR) task employing verbal material as well as a nonverbal Serial Reaction Time (SRT) task. For explicit memory measurement we applied a word pairs task (verbal) and pairs of a Japanese ideograms task (nonverbal). The PD patients displayed impairments in the nonverbal tasks only, namely, in the SRT task and the pairs of Japanese ideograms task. No correlation between Wisconsin Card Sorting Test (WCST) scores and the results of tasks in which PD patients displayed deficits (SRT and pairs of Japanese ideograms) were discovered. Interestingly, such a correlation was found in the case of MR and words pairs tasks, which did not distinguish PD patients from control group.

Patterns of Cognitive Functioning in a Clinic-Referred Sample of Preschool Children

This study examined patterns of performance on the Wechsler Preschool and Primary Scale of Intelligence—Revised (WPPSI-R) and the relationship of these patterns to diagnoses of behavioural problems. The sample consisted of 108 children between age 3 and 7 years inclusive who had been referred to a day-treatment program for a wide variety of psychological difficulties. All children had Full Scale IQ scores between 50 and 130. Two-stage cluster analysis identified five reliable subtypes. Three of these were differentiated primarily by level of performance (low, average, and high). The other two were differentiated primarily by pattern of performance: one characterized by nonverbal deficits and the other by verbal deficits. Findings also revealed that the children's previous diagnoses were relatively consistent with their patterns of performance on the WPPSI-R. The significance of these findings in relation to previous research in this area is discussed, and suggestions for future investigations are formulated.

Memory and executive functions in adults with Gilles de la Tourette syndrome and chronic tic disorder

Introduction. The main aim of the current study was to assess whether adults with either Tourette syndrome (TS) or chronic tic disorder (CTD) show a similar neuropsychological profile. Neuropsychological investigations of tic disorders have been mostly focused on children, mainly because symptoms peak during that period. Little has been carried out on adults, even if a significant proportion of the tic population experience moderate or marked levels of tic frequency throughout adulthood. Still, it is not clear whether neuropsychological performances are affected to the same degree in adults with TS and CTD. Method. Patients diagnosed with TS were compared with a CTD group and a control group free of psychiatric or neurological diagnosis, comparable in terms of age, gender, and intelligence. All participants completed two tests of memory (Rey-Osterreich Complex Figure, California Verbal Learning Test), one test of motor dexterity (Purdue pegboard), and four tasks of executive function (Stroop, Color Trail Test, Tower of London, Wisconsin Card Sorting Test). Results. TS and CTD patients showed nonverbal memory impairments while verbal memory and executive functioning remained intact. Results also indicated that nonverbal memory performances decrease as a function of tic severity. Conclusion. Both TS and CTD patients present a specific nonverbal deficit whilst the executive and motor functions are relatively intact. The two tic disorder subgroups might be part of a spectrum implicating mainly nonverbal memory.

A Turner syndrome neurocognitive phenotype maps to Xp22.3.

BackgroundTurner syndrome (TS) is associated with a neurocognitive phenotype that includes selective nonverbal deficits, e.g., impaired visual-spatial abilities. We previously reported evidence that this phenotype results from haploinsufficiency of one or more genes on distal Xp. This inference was based on genotype/phenotype comparisons of individual girls and women with partial Xp deletions, with the neurocognitive phenotype considered a dichotomous trait. We sought to confirm our findings in a large cohort (n = 47) of adult women with partial deletions of Xp or Xq, enriched for subjects with distal Xp deletions.MethodsSubjects were recruited from North American genetics and endocrinology clinics. Phenotype assessment included measures of stature, ovarian function, and detailed neurocognitive testing. The neurocognitive phenotype was measured as a quantitative trait, the Turner Syndrome Cognitive Summary (TSCS) score, derived from discriminant function analysis. Genetic analysis included karyotyping, X inactivation studies, fluorescent in situ hybridization, microsatellite marker genotyping, and array comparative genomic hybridization.ResultsWe report statistical evidence that deletion of Xp22.3, an interval containing 31 annotated genes, is sufficient to cause the neurocognitive phenotype described by the TSCS score. Two other cardinal TS features, ovarian failure and short stature, as well as X chromosome inactivation pattern and subject's age, were unrelated to the TSCS score.ConclusionDetailed mapping suggests that haploinsufficiency of one or more genes in Xp22.3, the distal 8.3 megabases (Mb) of the X chromosome, is responsible for a TS neurocognitive phenotype. This interval includes the 2.6 Mb Xp-Yp pseudoautosomal region (PAR1). Haploinsufficiency of the short stature gene SHOX in PAR1 probably does not cause this TS neurocognitive phenotype. Two genes proximal to PAR1 within the 8.3 Mb critical region, STS and NLGN4X, are attractive candidates for this neurocognitive phenotype.

Semantic memory in partial epilepsy: verbal and non-verbal deficits and neuroanatomical relationships

Semantic memory was evaluated in 124 epilepsy patients, including 84 with left ( n = 44) or right temporal lobe epilepsy (TLE) ( n = 40) and 40 with left ( n = 25) or right frontal lobe epilepsy (FLE) ( n = 15), in order to determine their verbal and visual deficits, and the neuroanatomical relationships between them. The controls were 35 healthy subjects. Semantic memory was assessed by means of Picture Naming, Picture Pointing, the verbal Pyramid and Palm Trees Test (PPTT), the visual PPTT, Object Decision Hard, and Drawing From Memory. Episodic memory was assessed by means of the Short Story, Rey's Complex Figure, the Verbal and Visual Selective Reminding Procedure and Brown–Peterson Procedure. Factor analysis of the epilepsy patients distinguished their semantic memory scores from other neuropsychological domains. The semantic memory factor was significantly related to the side of the epileptic region, with lower scores in the left hemisphere and left TLE patients. In comparison with the controls, the left TLE patients were significantly impaired on Picture Naming, Picture Pointing, and Object Decision Hard. Subsequent analyses showed that, in comparison with the controls and the right TLE patients, the left TLE patients with lateral temporal lobe lesions were impaired in Picture Naming whereas, in comparison with the controls, the left TLE patients with mesial temporal lobe lesions were impaired in Object Decision Hard. On the contrary, the episodic memory factor was not related to the side of the epileptic region, and a few material-specific tests revealed opposite impairments in the left and right hemisphere patients. These results show that left TLE may cause semantic memory deficits involving verbal and visual information. Unlike the material-specific pattern of episodic memory, this pattern of impairment is in line with the view of an amodal semantic store in which all of the information about a thing overlaps. The semantic memory impairment may reflect damage in the lateral and mesial temporal lobe regions that impair neocortical functions in storing and retrieving information or hippocampal functions in processing meaningful stimuli.

Le syndrome vélo-cardio-facial (délétion 22q11.2): une revue de littérature et présentation d'un cas clinique

Velocardiofacial syndrome (VCFS) is estimated to occur in at least one per 2000-4500 births. The characteristic features of the disorder are hypernasal speech, cardiac defects, a distinctive facial appearance, learning disabilities and behavioural disturbances. More than 100 congenital medical conditions or physical abnormalities are associated with velocardiofacial syndrome, however, there is great variability in the frequency and severity of the associated problems. The objective of this study is to describe velocardiofacial syndrome and provide an illustrative case study as a way of understanding how a neurogenetic syndrome specifically affects physical, cognitive and behavioural development. In 1992, Scambler et al. identified a common microdeletion at chromosome 22q11.2 in patients affected by velocardiofacial syndrome and other similar syndromes known at that time by different names. Individuals with the 22q11.2 deletion are hemizygous for all genes contained by the deletion site. In most affected individuals, a de novo 3 mb deletion at chromosome 22q11.2 is responsible for the syndrome; however, in 10-25% of cases, velocardiofacial syndrome is inherited from a parent with velocardiofacial syndrome. At least 30 genes are encoded in the commonly deleted segment, a few of which are highly expressed in brain tissue and likely to be essential for normal brain development. Certain specific genes within the 22q11.2 deletion site have attracted intense interest because of their known relationship to central nervous system structure or functioning (GSCL, Es2, UFD1L, COMT, TBX1). Over the past decade, MRI methodologies have been utilised to investigate the effect of the 22q11.2 deletion on brain structure. The majority of the available neuroimaging literature suggests early alterations of the parietal lobe and cerebellum. Furthermore, recent studies report significant structural changes in cerebral morphology. As much as an 11% reduction in total brain volume, including grey and white matter, has been reported. Notably, the areas most significantly decreased in size were parietal lobe grey matter in the left hemisphere, the cerebellum and the vermis. Moreover, an accelerated decrease, increasing in rate as a function of age, of grey matter in the temporal lobes and hippocampus has been found in affected individuals during childhood and adolescence. Most of the brain alterations described in velocardiofacial syndrome are common to those reported in the neuroimaging literature on schizophrenia. In patients with adult-onset schizophrenia, substantial grey-matter volume reduction is evident at the first clinical presentation of the disorder. The majority of toddler and preschool children with velocardiofacial syndrome have mild gross motor delays and severe expressive and receptive language delays. By school age children and adolescents with velocardiofacial syndrome demonstrate mild to moderate decrements in overall cognitive and language abilities. Some learning disabilities are almost invariably present. The cognitive profile of velocardiofacial syndrome is generally characterised by non-verbal deficits. It has been suggested that they might have lower non-verbal IQ than verbal IQ scores. Children with this disease also have a high rate of maladaptive behaviours and social problems including: impulsive, emotionally labile and disorganised behaviours, and social problems such as shyness or disinhibition. Psychiatric disorders have frequently been reported in individuals with this syndrome. Multiple studies have suggested that approximately 20-30% of people with velocardiofacial syndrome develop schizophrenia, establishing velocardiofacial syndrome as the first identified genetic subtype of schizophrenia. In summary, in the current report we describe the genetic, medical, cognitive and psychiatric aspects of velocardiofacial syndrome from infancy to adulthood.

Evidence for distinct cognitive deficits after focal cerebellar lesions

Objectives: Anatomical evidence and lesion studies, as well as functional magnetic resonance imaging (fMRI) studies, indicate that the cerebellum contributes to higher cognitive functions. Cerebellar posterior lateral regions seem to...

Impact of comorbid depressive symptoms on nonverbal memory and visuospatial performance in obsessive-compulsive disorder

Introduction. Recent research has suggested that some executive dysfunctions in obsessive-compulsive disorder (OCD) represent an epiphenomenon of comorbid depressive symptoms. The present study investigated whether the impact of comorbid depressive symptoms on cognitive dysfunction in OCD extends to nonverbal memory impairment. Methods. A total of 32 OCD patients and 20 healthy controls took part in the study. Participants were administered a neurocognitive battery with a focus on nonverbal memory and visuospatial functions. Results. While evidence was provided that neurocognitive processes necessitating visuospatial transformation and visuoconstruction are deficient in OCD patients regardless of comorbid depressive symptoms, nonverbal memory dysfunctions were only apparent for patients with elevated scores in the Hamilton Depression (HDRS) Rating Scale (total score S 8). Correlations with subscores of the HDRS revealed that core depressive symptoms are related to nonverbal memory deficits in OCD. Mental rotation, middle discrimination, and position discrimination were found to be unaffected in OCD. Y-BOCS scores, length of illness, onset of illness, number of hospital admissions, and checking compulsions were not associated with neurocognitive disturbances. Conclusions. Nonverbal memory is disturbed in only a subgroup of OCD patients displaying elevated HDRS scores (HDRS S 8). It is claimed but awaits further empirical testing that differences in depression profile across OCD studies have contributed to inconsistencies in prior investigations on neurocognitive functioning in OCD. Our results are questioning the hypothesis that nonverbal deficits are a causal factor for the development of checking compulsions.

A clinical and neurobehavioural review of high-functioning autism and Asperger's disorder.

To compare, contrast and review clinical and neuropsychological studies of high-functioning autism and Asperger's disorder. This paper reviews past and contemporary conceptualizations of autism and Asperger's disorder, together with epidemiological information, genetic and neurobehavioural findings. This paper focuses on neurobehavioural studies, in particular, executive functioning, lateralization, visual-perceptual and motor processing, which have provided an important source of information about the potential neurobiological dissociation that may exist between autism and Asperger's disorder. The clinical profiles of autism and Asperger's disorder contain a mixture of psychiatric and neurological symptoms: for example, movement abnormalities (i.e. stereotyped behaviours, hand flapping, toe walking, whole-body movements), atypical processing of parts and wholes, verbal and non-verbal deficits, ritualistic/compulsive behaviour, disturbances in reciprocal social interaction and associated depression and anxiety. The considerable clinical overlap between autism and Asperger's disorder has led many to question whether Asperger's disorder is merely a mild form of autism, or whether it should be considered as a separate clinical entity. In light of the growing body of epidemiological information, genetic, and neurobehavioural evidence that distinguishes autism from Asperger's disorder, it is premature to rule out the possibility that these disorders may be clinically, and possibly neurobiologically separate.

Quantitative and qualitative evaluation of neuromotor behaviour in children with a specific speech and language disorder

AbstractSeveral studies have described problems in a wide area of motor functions in language impaired children. The purpose of this study was to identify the nature of the motor deficits in two subgroups of language impaired children. A standard neurological examination was performed on 18 children with an expressive language disorder and 21 children with a receptive language disorder. The motor performance of the language disordered children was compared with the motor performance of 23 normal children. The standard neurological examination allowed for a qualitative and quantitative assessment of five specific neurological subsystems. Handedness was determined for all children. The language impaired children had more motor problems than the control children on most neurological subsystems. There were few statistically significant differences between the two groups of language impaired children. An excess in left‐handedness was established in the group of children with a receptive language disorder. There was a co‐occurrence of verbal and non‐verbal deficits in language impaired children. As these motor problems put an additional burden on the development of language impaired children, they should be diagnosed as early as possible. Copyright © 2002 John Wiley &amp; Sons, Ltd.

Effect of age of onset of temporal lobe epilepsy on the severity and the nature of preoperative memory deficits

The nature and severity of pre-operative memory deficits observed in unilateral temporal lobe epilepsy depend upon a number of variables. Among these variables, age of seizure onset seems to be important. The age at which the lesion is sustained could modify the normal functional organization of the brain. Many studies have examined the effect of age of onset on the severity of memory deficits but have seldom focused on the nature of such deficits (verbal/nonverbal) as a function of epileptic focus laterality. This study investigates the effect of age of onset on the nature and severity of memory impairments. Fifty-six epileptics with unilateral temporal lobe epilepsy and 20 normal subjects were administered a neuropsychological evaluation. Four groups of patients were constituted: left or right temporal lobe epilepsy with early (0–5 years) or late (10 years and over) age of seizure onset. The early group showed major verbal and nonverbal memory deficits. The late group presented minor specific deficits: essentially verbal deficits with left temporal lobe seizures and nonverbal deficits with right temporal lobe seizures. These results may be interpreted in the framework of ontogenesis theories of hemispheric specialization.

Right hemisphere contribution to developmental language disorder: Neuroanatomical and behavioral evidence

Developmental language disorder (DLD) is identified by virtue of the verbal deficits that define it. However, numerous studies have also documented nonverbal deficits in this population. This study attempts to explain the co-occurrence of both verbal and nonverbal deficits in this population from a brain-based perspective. Two samples of adults selected for DLD were compared with subjects without such a history on verbal and nonverbal skills in exploratory and confirmatory studies. Subjects also received MRI scans, which were used to determine the relation between left- and right-hemisphere regions hypothesized to relate to the behavioral skills tested. Results revealed replicable differences between groups on both verbal and nonverbal tasks. In addition, a significant association between performance on tests sensitive to facial affect and spatial rotation with the gray matter volume within the right supramarginal gyrus was found in both samples. These results support the hypothesis of a right hemisphere contribution to the profile of DLD. Learning outcomes: As a result of this activity, the participant will be able to describe evidence in support of a role for the right hemisphere in DLD.

Stimulus Gender and Emotional Difficulty Level

The ability to recognize emotions that were easily identifiable and those that were more difficult to identify, as expressed by male and female faces, was studied in 48 nondisabled children and 76 children with learning disabilities (LD) ages 9 through 12. On the basis of their performance on the Rey Auditory Verbal Learning Test and the Benton Visual Retention Test, the LD group was divided into three subgroups: those with verbal (VD), nonverbal (NVD), and both verbal and nonverbal (BD) deficits. A shortened version of Ekman and Friesen's Pictures of Facial Affect, including pictures of both men and women, was the measure of ability to identify facial expressions of affect. Children of both genders in all three groups of children with LD, as well as their normally achieving peers, were more accurate in identifying expressions of affect from female faces, notwithstanding differences in sensitivity to such emotional communication in favor of the nondisabled and VD groups. However, a significant interaction was found between gender and emotional recognition difficulty level, with female faces being more expressive for emotions that were difficult to recognize.

Strategic processing and episodic memory impairment in obsessive compulsive disorder.

There is evidence that nonverbal memory problems in obsessive compulsive disorder (OCD) are mediated by impaired strategic processing. Although many studies have found verbal memory to be normal in OCD, these studies did not use tests designed to stress organizational strategies. This study examined verbal and nonverbal memory performance in 33 OCD patients and 30 normal control participants with the Rey-Osterrieth Complex Figure Test and the California Verbal Learning Test. OCD patients were impaired on verbal and nonverbal measures of organizational strategy and free recall. Multiple regression modeling indicated that free recall problems in OCD were mediated by impaired organizational strategies used during learning trials. Therefore, verbal and nonverbal episodic memory deficits in OCD are affected by impaired strategic processing. Results are consistent with neurobiological models proposing frontal-striatal system dysfunction in OCD.

The Effects of Childhood Cancer and Its Treatment on Two Objective Measures of Psychological..

The incidence, severity, and potential causative and contributory factors of significant psychological distress in pediatric cancer patients and survivors were investigated. The parents of 88 childhood cancer patients (n = 24) and survivors (n = 64) completed 2 independent measures of psychological functioning on their child. Patients were all between the ages of 6 and 16 years old and were accrued from a large variety of diagnostic and treatment conditions. In analyzing the determinants of psychological functioning, the following variables were investigated: dosage of cranial irradiation (CRT), intrathecal methotrexate, and systemic methotrexate; age; sex; socioeconomic status; age at diagnosis; months since both first and last treatment; being on or off treatment; intelligence; and if a central nervous system cancer had occurred. The overall incidence of psychological adjustment disturbances was relatively low (approximately 10% to 20%) and similar to that reported in the general population. The most common parent-reported problems were related to somatic concerns, anxiety symptoms, and cognitive disabilities. Being female, age at diagnosis, CRT, and nonverbal intelligence deficits were predictive of parent-reported cognitive impairment and socialization difficulties. No other consistent relation between the cancer and demographic variables and psychological dysfunction was noted.

Cognitive impairments in patients with congenital nonprogressive cerebellar ataxia.

To report neuropsychologic functions and developmental problems of patients with congenital nonprogressive cerebellar ataxia. Growing interest in cerebellar function has prompted closer attention to cognitive impairments in patients with cerebellar damage. The authors studied 11 patients with nonprogressive congenital ataxia (NPCA) with Wechsler's intelligence testing, with additional tests of attention, memory, language, visual perception, and frontal functions. Seven of the 11 patients had an IQ of 60 to 92, with marked nonverbal deficits and subnormal to normal verbal performance (group A). Four patients had an IQ of 30 to 49 without pronounced profile asymmetry (group B). Four of the 7 group A patients had decreased alertness and sustained attention, but all had normal selective attention. Tests of frontal functions and memory yielded higher verbal scores than nonverbal scores. There was no deficit on the Aachener Naming Test (similar to the Boston Naming Test), because there were marked difficulties in the majority with visuoconstructive tasks and visual perception. Group B was significantly abnormal in almost all subtests, having a less prominent but similar profile. Patients with NPCA have significant cognitive deficits with an asymmetric profile and better verbal than nonverbal performance. Effects on nonverbal performance of longstanding deficits in visuospatial input during learning, the influence of impaired procedural learning, and asymmetric plasticity of the cerebral hemispheres may contribute to this uneven neuropsychological profile.

Psychoeducational profile of the 22q11.2 microdeletion: A complex pattern

Objectives: To examine the psychoeducational profile associated with the chromosome 22q11.2 microdeletion (DiGeorge/velocardiofacial syndrome). Study design: Thirty-three patients (aged 6 to 27 years) with a 22q11.2 microdeletion underwent psychoeducational testing as part of a comprehensive evaluation. Nonparametric statistics were used to compare verbal and performance IQ, academic achievement scores, and receptive versus expressive language scores. Post hoc comparisons were made of IQ subtest scores and of language versus verbal IQ. Results: Full-scale IQ ranged from the normal to the moderately retarded range. Mean verbal IQ was significantly higher than mean performance IQ. In a similar manner, mean reading and spelling scores were superior to the mean mathematics score, although achievement scores typically were in the range of verbal IQ. In addition, many children showed clinically significant language impairments, with mean language scores lower than mean verbal IQ. Conclusions: The IQ and academic profiles are reminiscent of a “nonverbal learning disability,” although achievement was not discrepant from IQ. The coincidence of language impairment with a relative strength in reading belies a unique neuropsychologic profile. Educational programming for these children must address both verbal and nonverbal deficits. (J Pediatr 1999;134:193-8)

Fluency Performance Patterns in Alzheimer's Disease and Parkinson's Disease

This study compared 38 patients with Alzheimer's disease, 20 patients with Parkinson's disease, and 51 normal controls on nonverbal, semantic, and phonological fluency tasks. Semantic and nonverbal fluencies declined significantly with age. The AD group was impaired on all fluency measures, with the greatest impairments on nonverbal and semantic fluency. The PD group was impaired on nonverbal and semantic fluencies. Differences observed in semantic fluency between the AD and PD groups could not be accounted for by dementia severity. Motor disability did not account for the PD nonverbal fluency deficit. This study provides evidence for a semantic-based impairment in AD and suggests that PD fluency deficits are primarily cognitive rather than motor in nature.

Linguistic dissociations in Williams syndrome: evaluating receptive syntax in on-line and off-line tasks

Williams syndrome (WS) is a neurodevelopmental disorder of genetic origin which results in relatively spared language in the face of serious non-verbal deficits. There is controversy, however, about how intact WS language abilities are. The discussion has focused on impairments of lexico-semantics and of morphological feature analysis, with the presumption that WS syntax is intact. We challenged this view and assessed WS receptive syntax by using two tasks testing various syntactic structures; an on-line word monitoring task and an off-line picture-pointing task. WS performance on the off-line task was generally poor. By contrast, their performance on the on-line task was far better and allowed us to ascertain precisely which aspects of WS receptive syntax are preserved and which are impaired. WS participants were sensitive to the violation of auxiliary markers and phrase structure rules but, unlike both the normal young and elderly controls, they did not show sensitivity to violations of subcategory constraints. The present study suggests that there exist dissociations within WS language which are not restricted to lexico-semantics or to morphological feature analysis, but which also invade their processing of certain syntactic structures. We conclude by arguing that WS syntax is not intact and that their language might turn out to be more like second language learning than normal acquisition.