Perceptual Maze Test Research Articles

The Development and Validation of an Online Spatial Network Measure.

Planning is an essential cognitive process of executive functions and is considered as one of the most important brain functions. Planning has been extensively studied in the field of neuropsychology, but there is a lack of computerized assessment tools of planning ability that are easily accessible to researchers and clinicians. The present study aims to validate a newly developed online spatial network test that is designed for both clinical and nonclinical populations. Exploratory factor analysis revealed a unidimensional factorial structure with moderate to high internal consistency in the test. Two-parameter logistic item response theory analysis showed acceptable item and model fit and no violation of the local independence assumption. The overall success rate exhibited a positive correlation with the performance of planning before attempting to solve the items. After correcting for attenuation, moderate to high correlations were found between the spatial network test and the International Cognitive Ability Resource 16 short form cognitive ability test and the automated perceptual maze test, respectively, demonstrating convergent, discriminant, and criterion validity. Future directions and potential applications of the spatial network test as an assessment tool to measure planning for researchers and clinicians are discussed in the end.

The Perceptual Maze Test Revisited: Evaluating the Difficulty of Automatically Generated Mazes.

The Elithorn perceptual maze test is widely used in clinical research and practice. However, there is little evidence of its psychometric properties, and its application is limited by the technical difficulty of developing more mazes. The current research aims to adopt a rigorous approach to evaluate 18 mazes that were automatically generated by a novel R software package. Various item response theory models were employed to examine the difficulty parameters. The findings suggested that the data best fitted the Rasch model. The linear logistic test model revealed meaningful contribution to the sources of maze difficulty. Additionally, the linear logistic test model plus error was considered the most parsimonious model. The Automatic Perceptual Maze Test was moderately correlated with a nonverbal intelligence test. By introducing more mazes to provide adequate information on participants' ability at all levels, the Automatic Perceptual Maze Test promises future clinical and research utility for the study of cognitive performance.

Impairment of cognitive function in patients submitted to adjuvant chemotherapy for early breast cancer: A follow up study

8027 Background: There is increasing evidence that the degree and duration of cancer treatment may contribute to cognitive impairment. However, the precise role of standard adjuvant chemotherapy (ACT) in early breast cancer patients in the development of these impairments needs to be further investigated. Methods: The study design is longitudinal providing follow-up 12 months later. The treated group consisted of 53 breast cancer survivors (age, 60.3±4,3 yr) who were treated with ACT (5 yr since the end of cancer treatment). Patients (pts) were treated with CMF (n=24), ADM (n=4), CMF+ADM (n=25) plus (n=37) or minus (n=16) tamoxifene. The control group consisted of 71 breast cancer survivors (age, 63.4±4,1 yr) not treated with ACT (5 yr post-surgery). All pts were assessed using the following neuropsychological tests: two cognitive deterioration-screening tests (MODA and MMSE); 12 analytic tests (Prose memory test, Word list learning test, Digit cancellation test, Trail making test, Verbal span, Raven Coloured progressive matrices, Elithorn's perceptual maze test, Token test, Verbal phonemic fluency, Verbal semantic fluency, Street's completion test, Figure copying test). Results: Comparisons between the two groups did not reveal statistically significant differences on MMSE (treated group 29,6±0,9; control group 29.7±0.8) and MODA (treated group 94,4±3.3; control group 95.2±2.6) scores. Analysis of performance, in the 12 neuropsychological tests, showed statistically significant differences between the groups on Prose Memory Test (Wilcoxon Test, P=0,03) and Verbal Fluency Test (Wilcoxon Test, P=0,01).The treated group performances on the Prose Memory and on the Verbal Fluency scores were significantly worse than those of the control group. Conclusions: The preliminary results of this study show the presence of statistically significant difference on episodic memory and phonemic lexical access abilities between the groups. We propose that all pts over 55 yrs undergoing ACT should be submitted to a basal evaluation of cognitive function. This study was supported by grant from Healthy Ministry, PRF Conv. N.ICS 160/RA00.72 No significant financial relationships to disclose.

Impairment of cognitive function in patients submitted to adjuvant chemotherapy for early breast cancer: A follow up study

8027 Background: There is increasing evidence that the degree and duration of cancer treatment may contribute to cognitive impairment. However, the precise role of standard adjuvant chemotherapy (ACT) in early breast cancer patients in the development of these impairments needs to be further investigated. Methods: The study design is longitudinal providing follow-up 12 months later. The treated group consisted of 53 breast cancer survivors (age, 60.3±4,3 yr) who were treated with ACT (5 yr since the end of cancer treatment). Patients (pts) were treated with CMF (n=24), ADM (n=4), CMF+ADM (n=25) plus (n=37) or minus (n=16) tamoxifene. The control group consisted of 71 breast cancer survivors (age, 63.4±4,1 yr) not treated with ACT (5 yr post-surgery). All pts were assessed using the following neuropsychological tests: two cognitive deterioration-screening tests (MODA and MMSE); 12 analytic tests (Prose memory test, Word list learning test, Digit cancellation test, Trail making test, Verbal span, Raven Coloured progressive matrices, Elithorn's perceptual maze test, Token test, Verbal phonemic fluency, Verbal semantic fluency, Street's completion test, Figure copying test). Results: Comparisons between the two groups did not reveal statistically significant differences on MMSE (treated group 29,6±0,9; control group 29.7±0.8) and MODA (treated group 94,4±3.3; control group 95.2±2.6) scores. Analysis of performance, in the 12 neuropsychological tests, showed statistically significant differences between the groups on Prose Memory Test (Wilcoxon Test, P=0,03) and Verbal Fluency Test (Wilcoxon Test, P=0,01).The treated group performances on the Prose Memory and on the Verbal Fluency scores were significantly worse than those of the control group. Conclusions: The preliminary results of this study show the presence of statistically significant difference on episodic memory and phonemic lexical access abilities between the groups. We propose that all pts over 55 yrs undergoing ACT should be submitted to a basal evaluation of cognitive function. This study was supported by grant from Healthy Ministry, PRF Conv. N.ICS 160/RA00.72 No significant financial relationships to disclose.

Executive function impairment in early-treated PKU subjects with normal mental development.

Executive functions were studied in 14 early and continuously treated PKU subjects (age 10.8 years, range 8-13) in comparison with controls matched for IQ, sex, age and socioeconomic status. Brain MRI examination was normal in all PKU patients. Neuropsychological evaluation included Wisconsin Card Sorting Test, Rey-Osterreith Complex Figure Test, Elithorn's Perceptual Maze Test, Weigl's Sorting Test, Tower of London, Visual Search and Motor Motor Learning Test. Whatever the IQ, PKU subjects performed worse than controls in tests exploring executive functions. Subgrouping the PKU subjects according to the quality of dietary control for the entire follow-up period (using 400 micromol/L as cut-off value for blood phenylalanine (Phe) concentration) showed that patients with worse dietary control performed more poorly than both the PKU group with the best dietary control and the control group. However, a mild impairment of executive functions was still found in PKU patients with a good dietary control (Phe <400 micromol/L) compared to controls. Concerning the PKU group as a whole, no linear correlation was found between neuropsychological performance and historical and concurrent biochemical parameters. We conclude that (a) PKU patients, even when treated early, rigorously and continuously, show an impairment of frontal lobe functions; (b) a protracted exposure to moderately high levels of Phe can affect frontal lobe functions independently of the possible effect of the same exposure on IQ; (c) in order to reduce the risk of frontal lobe dysfunction, the target of dietary therapy should be to maintain blood Phe concentration below 400 micromol/L.

Alteration of the counterregulatory responses to insulin-induced hypoglycemia and of cognitive function after massive weight reduction in severely obese subjects

The autonomic nervous system (ANS) and hypothalamic-pituitary-adrenal (HPA) axis are reported as activated in excess in the morbidly obese state and, therefore, changes after weight loss can be anticipated. The aim of this study was to investigate the impact of a massive (∼30%) weight reduction on the activation of the HPA axis and the ANS following bariatric surgery. Eight (7 women, 1 man) severely obese (125 ± 12 kg; body mass index [BMI], 45 ± 4 kg/m 2) nondiabetic subjects, underwent a 3-hour hyperinsulinemic (1,034 pmol/kg/h) glucose clamp study at hypoglycemia of arterial B-glucose concentration of 3.4 mmol/L. Cognitive function was evaluated by a visuospatial computerized problem-solving test, the Perceptual Maze Test (PMT). The mean weight loss was 40 ± 9 kg approximately 12 months postsurgery when their weight was stabilized (85 ± 6 kg; BMI, 31 ± 3 kg/m 2), and insulin sensitivity improved to an average increase of 376% ± 250% ( P < .01) of initial value. Before weight reduction, all patients demonstrated brisk peak responses in glucagon, epinephrine, pancreatic polypeptide (PP), norepinephrine, and cortisol, indicative of preserved or exaggerated activation of ANS and HPA axis. In the reduced-obese state, all these responses were attenuated and most markedly so for glucagon, which was totally abolished. In contrast, the growth hormone (GH) response was increased after weight reduction. The cognitive function was clearly modified by weight reduction both during normoglycemia and hypoglycemia and was changed preferentially to a speed-preferring strategy in the reduced-obese state compared with a more accuracy preferred problem-solving process of PMT test presurgery. These results demonstrate a reduction of the glucose counterregulatory hormonal responses, increased insulin sensitivity, and perturbed cognitive function after massive weight reduction. It may be speculated on if the increased insulin sensitivity and reduced counterregulation to hypoglycemia could predispose to low plasma glucose concentrations.

Pattern of neuropsychological deficits in patients with treated Wilson's disease

The study aimed to describe the neuropsychological profiles in patients with treated Wilson's disease (WD). The series included 19 symptomatic and 2 asymptomatic patients with a mean age of 35.3 +/- 9.2 years. They were tested with the Automated Psychological Test system (APT), a comprehensive computerised neuropsychological test battery. APT comprised eleven separate tests and assessed five essential types of neuropsychological functions: motor functions, basic neuropsychological functions, specific cognitive functions, memory, and executive functions. The results were compared to current norms of the test battery. The symptomatic WD patients had significantly lower performance than the norms on all finger tapping tasks, the simple reaction time, the simultaneous capacity background task, the short-term memory test, the index of word decoding speed, the grammatical reasoning test, and the perceptual maze test. They were significantly higher on the index of impulsive errors, and used a significantly more global processing mode in the test of selective attention. The female symptomatic patients displayed more pronounced neuropsychological deficits than the males in the complex tasks. WD patients displayed a specific profile of moderate neuropsychological impairment. The results are theoretically interesting and have practical implications for the management of WD patients, e.g. some patients confronted with the results have had increased compliance.

Pain-related cerebral activation is altered by a distracting cognitive task

It has previously been suggested that the activity in sensory regions of the brain can be modulated by attentional mechanisms during parallel cognitive processing. To investigate whether such attention-related modulations are present in the processing of pain, the regional cerebral blood flow was measured using [ 15O]butanol and positron emission tomography in conditions involving both pain and parallel cognitive demands. The painful stimulus consisted of the standard cold pressor test and the cognitive task was a computerised perceptual maze test. The activations during the maze test reproduced findings in previous studies of the same cognitive task. The cold pressor test evoked significant activity in the contralateral S1, and bilaterally in the somatosensory association areas (including S2), the ACC and the mid-insula. The activity in the somatosensory association areas and periaqueductal gray/midbrain were significantly modified, i.e. relatively decreased, when the subjects also were performing the maze task. The altered activity was accompanied with significantly lower ratings of pain during the cognitive task. In contrast, lateral orbitofrontal regions showed a relative increase of activity during pain combined with the maze task as compared to only pain, which suggests the possibility of the involvement of frontal cortex in modulation of regions processing pain.

Alcohol activates the cerebral reward system in man.

We investigated the effect of 0.07% alcohol on regional brain activity at rest and during cognitive performance in order to elucidate the anatomical substrate for the effects of alcohol in man as well as to clarify the interaction between changes in cerebral activity induced by cognitive performance and alcohol inebriation. Regional cerebral blood flow (3D-PET, 15O Butanol) was measured in 13 male, nonalcoholic volunteers. Each subject was scanned 12 times, three scans in each of the following four situations: sober/rest, sober/test and inebriated/rest, inebriated/test. We used statistical parametric mapping and a computerized brain atlas for localization. Alcohol induced a sense of inebriation and elation as well as a relative increase of the cerebral blood flow in medial parts of the temporal lobes, in the anterobasal parts of the anterior cingulate cortex including the septal region. In addition, there was an increase of blood flow in midline parts of the lower brain stem. Relative decreases of flow were observed in the cerebellum and in the occipital cortex bilaterally. In the sober state, a computerized perceptual maze test and a (silent) serial seven test induced two distinct neocortical activation patterns that were specific to the tasks. Alcohol did not change these patterns and the test performance was also uninfluenced. A moderate dose of alcohol selectively activates target structures that pertain to the so-called cerebral reward system and the ascending reticular activating system. Alcohol (approximately 0.07%) appears to have only minor effects in the neocortical systems that are involved in on-line cognitive activity. This apparent independence between the subcortical alcohol target and the neocortical cognitive mechanisms is a new finding that appears to be of importance for an understanding of the effect of moderate doses of alcohol on the brain.

Brain Activation Induced by the Perceptual Maze Test: A PET Study of Cognitive Performance

We investigated with PET the cerebral activation pattern elicited by the perceptual maze test (PMT), a neuropsychological test used to evaluate organic brain injury. The PMT examines visuospatial skill, general intelligence, visually guided motor planning, and the ability to obey rules. Eight right-handed volunteers were examined with PET using the tracer [15O]butanol. Three paradigms containing the PMT, a motor control (SHAM), and a rest condition were examined twice in a randomized order. Solving the PMT caused extensive bilateral activations in the occipital lobe extending rostrally into the parietal lobe and caudally to the posterior part of the temporal lobe. Bilateral activations were also seen in the prefrontal, medial premotor, and the anterior cingulate cortex (ACC). The premotor and primary sensory motor cortices contralateral to the performing hand were also activated. Marked activations were noted in the visual system, including areas pertaining to visuospatial decoding. The previously defined functional network (ACC, prefrontal and posterior parietal cortex) for the maintenance of visuospatial attention was activated during the PMT. Extensive bilateral deactivations were seen in frontomedial, temporal, parietal, and posterior cingulate regions. This pattern may represent relatively decreased blood flow in cortical areas pertaining to sensory modalities that were not activated in the PMT. The decreased activity in these regions could also express diminished cognitive processing in neuronal systems that might interfere with the task-related performance.

Exploring the connections between platelet monoamine oxidase activity and behavior. II. Impulsive personality without neuropsychological signs of disinhibition in air force pilot recruits.

Platelet monoamine oxidase (MAO) activity and serum levels of the adrenal androgen metabolite dehydroepiandrosterone sulfate (DHAS) were measured in 18 male air force pilot recruits and 19 randomly selected male conscripts. Personality scales from three inventories were given, and computerized neuropsychological tests were performed: finger tapping and alternation, reaction time, perceptual maze, perspective fluctuation and lexical decision. The pilot recruits had higher scores in sensation-seeking-related scales suggesting disinhibited behavior in the social sphere, interest in sports and activities involving some danger, and a need for change. They also had higher scores on an impulsivity scale which comprises sensation-seeking content. In the neuropsychological tasks, the pilot recruits were faster in finger-tapping alternation and performed more efficiently in the perceptual-maze test than the conscripts. In a linear discriminant analysis, neuropsychological-task performance discriminated significantly between the pilot and conscript groups. In the biochemical measures, the pilot recruits had higher DHAS levels but similar MAO activity levels compared to the conscripts, which is in contrast to what has been found in other sensation-seeking groups in comparison to controls. This result is in accordance with the normal scores in one of the impulsivity scales in the pilot recruits, and with the absence of signs of disinhibition in neuropsychological tasks. It is proposed that only some aspects of the impulsivity concept might be critical for the association with low MAO activity.

Extraversion and performance in the perceptual maze test

This study examined the relationship between Extraversion and Perceptual Maze Test (PMT) performance in groups of extreme extraverts and introverts defined by the Eysenck Personality Inventory (EPI). Subjects completed the PMT both with and without information about optimal solution being provided. Strategies used in solving the mazes were also investigated. Extraversion was associated with faster, less accurate and less reflective performance, particularly in the ‘without information’ condition. Extraverts used a ‘high dot density’ strategy to solve the mazes, whereas introverts used an ‘item-by-item’ strategy. The results are discussed in relation to arousal theory (classical and revised). It is tentatively suggested that performance and strategy differences between introverts and extraverts might reflect differences in their cognitive appraisal of ambiguous task situations.

Exploring the Connections between Platelet Monoamine Oxidase Activity and Behavior: Relationships with Performance in Neuropsychological Tasks

Platelet MAO activity has been found to have behavioral (psychiatric and personality) correlates. The purpose of the present study was to explore the nature of the connections between platelet MAO activity and behavior by analyzing performance in neuropsychological tasks in relation to platelet MAO activity, measured in 37 male subjects. The following neuropsychological tests were given: a finger tapping and alternation test, a reaction time test, a perceptual maze test, a perspective fluctuation task (the Necker cube), and a lexical decision task. The reaction time tasks comprised a motor disinhibition task, in which auditory stimuli given simultaneously with light stimuli were signals for response inhibition. Significant relationships were obtained between low MAO activity and short response times and small variations in response times to left-sided visual stimuli, suggesting a readiness for higher right hemisphere activation in low MAO subjects, and between low platelet MAO activity and many perspective reversals, in line with expectations. Furthermore, high MAO subjects had equal tapping speed for both hands, which has been found in schizophrenic patients. Of special interest in the present results is the strong negative relationship obtained between platelet MAO activity and number of failed inhibitions in the motor disinhibition task, which in a multiple regression analysis highly significantly contributed to the prediction of platelet MAO activity. This finding is in line with the poor passive avoidance performance associated with serotonergic deficiency and syndromes of disinhibition, and thus supports the assumption that platelet MAO activity may be considered as a genetic marker for some properties of the central serotonergic system.

Smooth pursuit eye tracking and neuro-psychological performance in healthy volunteers. Exploring a possible genetic marker for vulnerability to schizophrenia.

Eye movement dysfunction (EMD) has been repeatedly found in schizophrenics and their first-degree relatives. In the present study, smooth pursuit eye tracking was measured in healthy subjects and related to performance on computerized neuropsychological tasks assumed to involve frontal or frontoparietal functions: monitoring perspective fluctuations (Necker cube), finger tapping, trail making, reaction time (RT) and a perceptual maze test. Poor trackers performed worse on tasks requiring parallel processing (trail making with letters and digits and RT with random auditory signals for response inhibition) and made more errors and cancellations on the mazes. Results are in line with our earlier EMD results on schizophrenics, showing poor performance on frontal tasks. However, their deficiency was more pervasive, whereas the present healthy EMD subjects only had difficulties with more complex tasks. The results are of interest in view of the recent evidence that EMD may be a genetic marker for vulnerability to schizophrenia.

Hand preference and sex as determinants of neuropsychological skill, solving strategy and side preference

The purpose of this study was to analyze cognitive neuropsychological differences in terms of skill, strategy, and side preference between right- and left-handers. Three computerized tests (Reaction Time, Perceptual Maze Test, and Trail Making) and a paper-and-pencil test battery comprising verbal and perceptuomotor tests were given to 48 left-handed males, 54 left-handed females, 49 right-handed males and 53 right-handed females. Only small and scattered differences emerged between right- and left-handers. Left-handers were superior in spelling and in reading comprehension speed as compared to right-handers. Females excelled over males in reading speed (Stroop A) and in spelling, as well as in writing fluency. Males were faster than females in most of the tests, but with lower accuracy. Females showed some side preferences as evidenced from, for example, the relatively shorter reaction time when stimuli were presented on the right side.

Cognitive Sex Differences: Speed and Problem-Solving Strategies on Computerized Neuropsychological Tasks

Skill, strategy, and laterality measures obtained through computerized neuropsychological tasks, a reaction time (RT) test, and a visuospatial problem-solving test, the Perceptual Maze Test, were analyzed in relation to sex and handedness of 56 high-school students. Boys were significantly faster than girls on most RT subtasks (including a response-inhibition task) and made more two-choice RT response errors for right-sided stimuli, which may be interpreted as resulting from a less cautious strategy. In maze performance, boys were superior to girls. An analysis of separate phases of the maze-solution process suggested that boys preferentially used an impulsive-global strategy. Girls, using a more reflective-sequential task-solving strategy, were significantly slower, without hitting more targets. Compared to all other groups, left-handed girls (strongly left-handed) had lower performance on maze tasks with no target information, particularly in left-sided solution pathways. Results were interpreted as reflecting differences in hemispheric competence and activation patterns between the sexes. Signs of a less differentiated lateralization and slight dysfunction of visuospatial skills in the left-handed girls were discussed.

THE USE OF TWO AUTOMATED NEUROPSYCHOLOGICAL TESTS, COGFUN AND THE PERCEPTUAL MAZE TEST, WITH ALCOHOLICS

Forty-eight male detoxified alcoholics completed the automated neuropsychological tests, Cogfun II and the Perceptual Maze Test. On both tests, the younger group of patients performed better than the older group. No differences were found between short- and long-term drinkers, although there was some indication that older long-term drinkers performed less well than younger long-term drinkers. Control subjects performed significantly better than alcoholic subjects. Thus characteristics found by others using conventional psychometric tests were also apparent when using new, automated tests, and baselines were established from which to measure change over the passage of time.

Neuropsychological correlates of platelet monoamine oxidase (MAO) activity in female and male subjects

Platelet monoamine oxidase (MAO) activity has been found to have behavioral (psychiatric and personality) correlates and is assumed to be linked to central transmitter systems and thus presumably to neuropsychological processes. In the present study, computerized neuropsychological tests, a reaction time (RT) test and a visuo-spatial problem solving test, the Perceptual Maze Test (PMT), were given to 32 female and 29 male students, each sex group divided into three subgroups on the basis of platelet MAO activity. The tests yield measures of laterality (reaction time for left- versus right-sided stimuli) and different aspects of cognitive strategy and skill, e.g. time used for inspection of the maze, for processing the stimulus pattern, and for checking the correctness of solutions. Low MAO female subjects had shorter RTs, pronounced for left-sided stimuli, and shorter inspection times in the PMT compared to other female subjects. Low and high MAO males had difficulties in inhibiting responses, when required, and low MAO males were more rapidly prepared to respond to new stimuli after short intervals than other males. In the PMT, high MAO male subjects spent a smaller part of the total time on inspection in relation to other male groups and had more rubouts than low MAO males, whose maze solving behavior indicated higher visuo-spatial ability. The results are discussed in terms of possible neurochemical bases of impulsivity and psychopathy, and of spatial skill.

Non-cognitive determinants of perceptual problem-solving strategies

The study examined whether extraversion and rigidity were associated with particular types of errors or response tendencies on the perceptual maze test. In addition to examining overall levels of performance, the study included a detailed analysis of specific components of Ss' response pathways. Extraverted Ss solved more mazes incorrectly but this was not reflected in a significantly larger number of errors made in the binary choice configurations, examined by the response analysis program. Extraverted Ss did show one characteristic response, namely an impulsive exit strategy towards the completion of their solution pathway. Rigidity was not associated with overall level of performance but there was a non-significant trend towards more straight-line response in the more rigid subjects. In contrast with previously studied cognitive factors, the non-cognitive factors do not appear to strongly influence Ss' decisions made in localised binary choice configurations.

Ageing and perceptual problem-solving: A response analysis approach

This study investigates the nature of age-related changes in performance on a perceptual maze test. A clear linear decline in overall level of performance was found in a cross-sectional study of 20- to 70-yr-old Ss. While some of this decline is due to slowing with age, a detailed analysis of specific components of Ss' response pathways also revealed certain qualitative changes. Although there was no significant evidence of reduced look-ahead or planning in the elderly, there was a clear increase in the proportion of straight-line responses and errors. In contrast to the performance of low-scoring younger Ss, the lower scores of older Ss are not due to their making more errors of all types since they show very selective changes in their response strategies on this task.