Paired Associate Learning Test Research Articles

未破裂脳動脈りゅうの治療―高次脳機能評価の重要性―

We evaluated the neuropsychological function in 46 patients with unruptured cerebral aneurysms who showed a good outcome postoperatively. Seventeen patients (37%) showed deterioration of test results 1 month after surgery compared with preoperative evaluation. Although no patients showed deterioration on mini-mental state examination, Kohs's block-design test results had deteriorated in 5% of patients, “Kana-hiroi” test in 17%, and paired associate learning test in 28%. Age, presence of systemic diseases and aneurysm location had detrimental effects on these psychological examinations. Three patients (7%) still showed deterioration of test results 6 months after surgery. These results suggest that the neuropsychological outcome after surgery for unruptured cerebral aneurysms was not satisfactory even in patients with good outcome, and that neuropsychological examination is necessary to evaluate surgical results considering the quality of the patient's life.

Hormone replacement therapy for cognitive function in postmenopausal women.

As estrogens have been found in animal models to be associated with the maintenance and protection of brain structures, it is biologically plausible that maintaining high levels of estrogens in postmenopausal women by medication could be protective against cognitive decline. To investigate the effect of ERT (estrogens only) or HRT (estrogens combined with a progestagen) in comparison with placebo in randomized controlled trials (RCTs) on cognitive function in postmenopausal women. The CDCIG Specialized Register was searched using the terms ORT, PORT, ERT, HRT, estrogen*, oestrogen*, progesteron* on 16 May 2002. In addition MEDLINE (1966-2002/01); EMBASE (1985-2000/11); PsycINFO (1967-2002/01) and CINAHL (1982-2001/12) were searched as the CDCIG Register does not contain all trials with healthy volunteers. All double-blind randomized controlled trials of the effect of ERT or HRT on cognitive function over a treatment period of at least two weeks in postmenopausal women. Abstracts of the references retrieved by the searches were read by two reviewers in order to discard those that were clearly not eligible for inclusion. The two reviewers studied the full text of the remaining references and independently selected studies for inclusion. Any disparity in the resulting lists was resolved by discussion with all reviewers in order to arrive at the final list of included studies. The selection criteria ensured that the blinding and randomization of the included studies was adequate. Two reviewers (EH and KY) assessed the quality of other aspects including design and assessment of outcomes. One reviewer (EH) extracted the data from the studies. In total, 15 trials involving 566 postmenopausal women were included, but 6 studies did not have adequate data for analysis. Meta-analyses showed a positive effect of 10 mg of estradiol (E2) bolus injections intramuscularly monthly in relatively young surgically menopausal women on the Paired Associate learning test immediate recall (z=2.40, p<0.05, chi-square test=1.12, p=0.29, SMD=1.02, 95% C.I.=0.19-1.85), on a test of abstract reasoning (z=10.45, p<0.0001, WMD=6.80, 95% C.I.=5.52-8.08) and a test of speed and accuracy (z=9.16, p<0.0001 WMD=6.00, 95% C.I.=4.72-7.28). However, most studies showed no evidence of an effect on verbal or visuospatial memory, mental rotations, speed or accuracy measures. There was little evidence that Premarin, the most widely prescribed estrogen for postmenopausal use, had positive effects on cognitive function. The one effect of 9 months of treatment with Premarin (and a progestagen) on a measure of complex speed of information processing (the TMT-B) was probably explained by baseline differences, as it was not reported by the authors. There was little evidence regarding the effect HRT or ERT on overall cognitive function in healthy postmenopausal women. There was an effect on some verbal memory functions (immediate recall), on a test of abstract reasoning and a test of speed and accuracy in relatively young (47 years of age) surgically menopausal women who had been given a bolus intramuscular injection of 10 mg E2 every month for 3 months. These effects were from small studies from a single research group. It remains to be determined whether factors such as an older age (> 69 years of age), type of menopause (surgical or natural) and type of treatment (E2 with or without a progestagen), mode of delivery (transdermal, oral or intramuscular), dosage and duration (> 3 months) could alter the effect on memory functions to a clinically relevant level. In addition, whether the absence or presence of menopausal symptoms can modify treatment effects should be investigated in more detail. Longitudinal RCTs currently underway in the U.S.A., U.K. and Canada will be able to test these hypotheses by the year 2010.

A test of foreign language acquisition: paired‐association learning

AbstractThis experiment investigated college student difficulties with foreign language acquisition. We developed a word‐sound, paired‐associates learning test that discriminated 92% of the control participants and 95% of the experimental participants. The results are interpreted in terms of an associative model of foreign language learning disability. We discuss how to integrate the test into a larger diagnostic battery for predicting the facility with which a person will be able to learn a foreign language. Copyright © 2002 John Wiley &amp; Sons, Ltd.

Paired-associate learning and memory interference in schizophrenia

Patients with frontal lobe damage have been shown to exhibit disproportionate impairments of second list learning as a result of interference effects. Based upon the assumption that schizophrenia is associated with frontal dysfunction, we attempted to explore how various manipulations of paired-associate learning tasks would interfere with schizophrenic patients’ memory performance. Patients with schizophrenia were administered four tests of paired-associate learning, in which cue and response words were manipulated to increase interference across two study lists. In two tests of paired-associate learning (AB-AC test), cue words used in one list were repeated in a second list but were associated with different response words (e.g. lion–hunter, lion–circus). One version of this test employed moderately related word pairs and the other version employed unrelated word pairs. In the other two tests (AB-ABr test), all words used in one list were repeated in a second list but were rearranged to form new pairs. Again, one version of this test used moderately related word pairs and the other version used unrelated word pairs. We hypothesized that patients with schizophrenia would exhibit disproportionate impairment of second-list learning as a result of interference effects and that they would do especially poorly in the AB-ABr task, where the word pairs were unrelated. However, these predictions were not supported. Furthermore, it was difficult to tease apart a specific problem in list discrimination from the generally poor memory of the schizophrenic patients. We suggest that the susceptibility to these interference effects in patients with schizophrenia is not a specific problem in cognition, but rather one that is confounded by general memory problems.

Guanfacine and Clonidine, Alpha2-Agonists, Improve Paired Associates Learning, but not Delayed Matching to Sample, in Humans

The present study compares the effects of two alpha2-agonists, clonidine (0.5, 2, and 5 μg/kg, PO) and guanfacine (7 and 29 μg/kg, PO) in young healthy volunteers on their performance in visual paired associates learning (PAL) and delayed matching to sample (DMTS) visual short-term recognition memory tests. In the PAL test, clonidine 2 and guanfacine 29 μg/kg improved the subjects’ performance. In the DMTS test, clonidine at 5 μg/kg delay-dependently impaired performance accuracy, and at 2 and 5 μg/kg it also slowed responses. Guanfacine had no effect on DMTS test performance. Clonidine 5 and guanfacine 29 μg/kg equally increased subjective feelings of sedation and reduced blood pressure. The results suggest that both clonidine and guanfacine facilitated PAL learning by improving “frontal strategies,” but only clonidine disrupted “mnemonic processing” decreasing DMTS accuracy. The greater selectivity of guanfacine for alpha2A-adrenoceptor subtype may explain the different profile of action of the drugs.

Paired-associate learning in attention-deficit/hyperactivity disorder as a function of hyperactivity-impulsivity and oppositional defiant disorder.

A paired-associate learning (PAL) test was administered to 22 community volunteers without disruptive disorders and 197 children (7.5-13.5 years-old) presenting with the inattentive and combined subtypes of attention-deficit/hyperactivity disorder (ADHD) either in combination with or without oppositional defiant disorder (ODD). Participants were screened for learning disorders. In comparison to non-ADHD participants, children with ADHD achieved worse PAL and made errors rated as more acoustically and less semantically similar to the correct paired associates. These deficits were not related to hyperactivity-impulsivity or comorbid ODD. These results suggest that ADHD children are less competent at PAL and use less efficient learning strategies than their non-ADHD peers.

Do anti‐arthritic drugs decrease the risk for cognitive decline?

We ascertained nonsteroidal anti-inflammatory drug (NSAID) use in 2,651 participants in the UK MRC treatment trial of hypertension in older adults and measured change in cognitive function over the subsequent 54 months. There was a significant, although modest, association between change in the Paired Associate Learning Test score over time and NSAID use, which was modified by age. NSAID users showed less decline, with younger subjects seeming to benefit more than older. We found no relationship between NSAID use and time taken to complete the Trail Making Test and also no relationship between anti-indigestion drug use and either cognitive outcome. These analyses highlight the need for larger studies with prospective classification of NSAID use and adequate control of confounding, including exposure to other medications. A randomized controlled trial of NSAIDs, in those known to be at risk of cognitive decline or dementia, may be indicated in the future.

A Longitudinal Study of Phonological Awareness, Visual Skills, and Chinese Reading Acquisition among First-graders in Taiwan

The main purpose of this study was to investigate whether a child’s phonological awareness and visual skills before instruction in school had any predictive power for later Chinese reading ability among 1st-graders in Taiwan. The study also examined the extent to which phonological awareness and visual skills varied in three separate testing sessions during the 1st grade. These testing sessions took place just before the children had learned the alphabetic system Zhu-Yin-Fu-Hao, immediately after the children had learnt Zhu-Yin-Fu-Hao, and, finally, at the end of the first year of schooling. Forty 6-year-old Chinese children from Taiwan took part in the study. The test materials included a Chinese Characters Reading Test, a set of Phonological Awareness tests, a Visual Paired Associates learning test, and a vocabulary and IQ test. Phonological awareness at the first testing session was found to be significantly related to the ability to read Chinese characters at the end of the first year. However, the predictive power of early phonological awareness decreased markedly when the effects of preschool reading scores were partialled out. Therefore, the study provided evidence that phonological processes are significantly related to success in the first year of Chinese reading, but was unable to establish whether or not differences in phonological skills are a cause of differences in the reading ability of Chinese children. In addition 10 weeks of instruction in Zhu-Yin-Fu-Hao led to an increase in performance on all tests of phonological awareness. This is consistent with the view that learning an alphabetic script improves phonological awareness ability.

TREATMENT OF MAJOR DEPRESSION IN GENERAL PRACTICE: A DOUBLE‐BLIND COMPARISON OF PAROXETINE AND LOFEPRAMINE

SUMMARY A six‐week, double‐blind, randomised study was used to compare the efficacy, tolerability, safety and effect on cognitive function of paroxetine with that of lofepramine in the treatment of 138 patients with major depression in general practice. Efficacy was assessed using the Montgomery and Asberg Depression Rating Scale (MADRS) and Clinical Global Impression (CGI) scale. Effect on cognitive function was assessed using the paired associate learning test and the serial ‘E’ cancellation test. The results showed that the antidepressant efficacy of paroxetine was comparable to that of lofepramine in the treatment of depressed patients. Similar improvements in mean total MADRS scores were observed in both treatment groups, but a significantly greater improvement was seen in the CGI with paroxetine at weeks 2 and 4. The effect of treatment on cognitive function did not differ significantly across the two treatment groups, nor did the number of adverse events reported nor the overall tolerability.

Susceptibility to Memory Interference Effects following Frontal Lobe Damage: Findings from Tests of Paired-Associate Learning

Abstract Patients with frontal lobe lesions were adminstered tests of paired-associate learning in which cue and response words are manipulated to increase interference across two study lists. In one test of paired-associate learning (AB-AC test), cue words used in one list are repeated in a second list but are associated with different response words (e.g., LION-HUNTER, LION-CIRCUS). In another test (AB-ABr test), words used in one list are repeated in a second list but are rearranged to form new pairs. Compared to control subjects, patients with frontal lobe lesions exhibited disproportionate impairment of second-list learning as a result of interference effects. In particular, patients exhibited the poorest performance during the initial trial of the second list, a trial in which interference effects from the first list would be most apparent. These findings suggest that the on-line control of irrelevant or competing memory associations is disrupted following frontal lobe lesions. This disruption may be indicative of an impaired gating or filtering mechanism that affects not only memory function but other cognitive function as well.

Verbal Short-term Memory and Vocabulary Learning in Polyglots

Polyglot and non-polyglot Italian subjects were given tests assessing verbal (phonological) and visuo-spatial short-term and long-term memory, general intelligence, and vocabulary knowledge in their native language. Polyglots had a superior level of performance in verbal short-term memory tasks (auditory digit span and nonword repetition) and in a paired-associate learning test, which assessed the subjects' ability to acquire new (Russian) words. By contrast, the two groups had comparable performance levels in tasks assessing general intelligence, visuo-spatial short-term memory and learning, and paired-associate learning of Italian words. These findings, which are in line with neuropsychological and developmental evidence, as well as with data from normal subjects, suggest a close relationship between the capacity of phonological memory and the acquisition of foreign languages.

Remembering norman schwarzkopf: evidence for two distinct long-term fact learning mechanisms

Abstract We report two patients who showed distinctive and contrasting patterns of performance relating to their ability to remember new facts. A patient who sustained a missile injury to the mammillary bodies four years previously was left with a marked memory disorder. He nevertheless showed evidence of having acquired long-term factual knowledge…e.g. he accurately recalled information about Norman Schwarzkopf…in spite of severe deficits on a matched test of name-occupation learning that was administered as a standard paired-associate learning test. By contrast, a patient who suffered bilateral non-medial temporal lobe pathology 10 years previously showed the reverse pattern of performance…he could not identify names such as Norman Schwarzkopf, but he performed well on the matched name-occupation learning test. These data point to two anatomically distinct and functionally dissociable long-term fact learning mechanisms, one that is primarily subserved by limbic-diencephalic structures and one that is primarily based in the neocortex.

Assessment of long-term verbal memory in children.

This study was designed to evaluate the use of a Paired Associate Learning Test (PALT) and a Story Recall test with children aged from 8 to 12 years. 46 normal control children and 19 children of low ability were given the PALT from the Wechsler Memory Scale, and a story recall task, based on Wechsler's Logical Memory subtest, but using stories designed to be suitable for children. Performance on PALT approached ceiling levels for the control children. Both PALT and story recall were more strongly correlated with measures of verbal ability than with digit span. Reliable measures of immediate story recall can be obtained using two or three stories. Many children who are unable to recall a story after a 45 minute delay show dramatic improvement when given a single cue, and it is argued that cued delayed recall gives a better index of long-term memory than uncued recall. Correlations between immediate recall and cued delayed recall are high, and the data presented here may be used to compute a forgetting score which takes into account the level of immediate recall. In the sample seen here, rate of forgetting was remarkably constant across individuals, in both normal and low ability individuals. It is concluded that memory deficits affecting rate of forgetting are rare, but that the test materials described here could be useful for identifying such disorders in children with neurological impairments.

Four Easy Memory Tests for Older Adults

This report describes four short memory tests which have been developed for use with older adults. Three of these tests are recognition memory tests; one is verbal, one is visual, and one is predominantly visual, but likely to involve some verbal mediation. The fourth task is a verbal paired-associate learning test which uses two sets of six high frequency words. Normative data obtained from 107 subjects aged 64-81 on all four tests are provided. A ceiling effect was obtained, indicating that these tests are relatively easy. A validation study was carried out, in which a group of patients with a cortical degenerative condition was assessed on the easy tests, and performance on published recognition memory tests could be compared with performance on the easy tests. Several patients who had scored at chance on the published version not only obtained measurable scores on the easy version, but also obtained discrepancy scores. Possible uses for the four short memory tests are suggested.

Neural organization for the long-term memory of paired associates

Most of our long-term memories of episodes or objects are organized so that we can retrieve them by association. Clinical neuropsychologists assess human memory by the paired-associate learning test, in which a series of paired words or figures is presented and the subject is then asked to retrieve the other pair member associated with each cue. Patients with lesions of the temporal lobe show marked impairment in this test. In our study, we trained monkeys in a pair-association task using a set of computer-generated paired patterns. We found two types of task-related neurons in the anterior temporal cortex. One type selectively responded to both pictures of the paired associates. The other type, which had the strongest response to one picture during the cue presentation, exhibited increasing activity during the delay period when the associate of that picture was used as a cue. These results provide new evidence that single neurons acquire selectivity for visual patterns through associative learning. They also indicate neural mechanisms for storage and retrieval in the long-term memory of paired associates.

Effect of naltrexone upon self-injurious behavior, learning and activity: a case study

Naltrexone significantly attenuated self-injurious behavior in a 20-year-old mildly retarded autistic male patient. The patient was videotaped daily and behavior was evaluated with a time-sampling procedure. Behavioral ratings of SIB frequency, SIB severity, and activity were collected automatically with a computerized system. Learning and memory were tested on a weekly basis with a modification of a paired associate learning test (PALT). Treatment with naltrexone resulted in (a) attenuation of SIB in the unstructured setting and (b) improvements in learning and memory without influencing activity levels.

Prosopagnosia: A Reclassification

We report a quantitative investigation of three patients who presented with a profound prosopagnosia. They were tested on a series of tests of face perception, face recognition, and paired associate learning using faces. A patient with marked perceptual difficulties but no difficulty whatever in recognizing faces was tested as a control. The control patient's performance was as bad or worse on the tests of perception of faces, and it is concluded that impaired performance on tests of face perception does not contribute to difficulties in recognizing familiar faces. The major difference between the three prosopagnosic patients was the evidence of covert recognition in two of these cases but not in the third. We use this evidence to argue that the perceptual/mnestic distinction is an inappropriate classification and would suggest instead that the two types may be described in terms either of a disconnection of the face recognition units or of damage to the units themselves.

Prediction of survival in dementia by cognitive tests: A six‐year follow‐up

One hundred and sixteen elderly female in-patients with confirmed diagnoses of senile or arteriosclerotic dementia were tested on the Paired-Associate Learning Test (PALT) and Cognitive Assessment Scale (CAS) of CAPE and were followed up annually for six years. Comparison of those patients who had died by each follow-up date with those who had survived showed that in general the latter had had better PALT and CAS scores.

Comparison of the Sensitivity of Three Instruments for the Detection of Cognitive Decline in Elderly Living at Home

We followed up 181 elderly living at home over 2 years. The changes shown on a brief dementia rating scale (the Abbreviated Mental Test Score (AMTS] were monitored. At follow-up, subjects were classified as organic or non-organic by three potential screening tools-a screening questionnaire (the Psychogeriatric Assessment Schedule), a psychometric test (the Inglis' Paired Associate Learning Test) and a dementia scale (the AMTS). The value of these as screening tools for community samples was considered as a function of their sensitivity to cognitive decline. The classifications made by each were significantly related to previous cognitive change, but all were conservative, missing many subjects who had declined. Of the three, the AMTS appeared the most useful as a predictor of previous change on the AMTS. It remains to be seen whether it is equally useful with different samples and with different measures of outcome.

The effect of magnetic resonance imaging on human cognition

Potential effects of MRI exposure on aspects of human cognition were investigated out of concern that possible safety hazards associated with the procedure may exist. One hundred and fifty-seven volunteer subjects were randomly assigned to either an imaged, sham-imaged or nonimaged control condition. The following psychological tests were administered in a double blind procedure at pretreatment, post-treatment and follow-up time periods: the Wechsler Adult Intelligence Scale-Revised (Digit Span, Block Design and Digit Symbol), the Wechsler Memory Scale Paired Associate Learning test, the Benton Revised Visual Retention test, the Vandenberg Mental Rotation test, the Sternberg memory scanning paradigm and the State Anxiety Inventory. The overall analysis of results indicated that MRI at 0.15 T has no significant effect upon the cognitive functions assessed.