Neuropsychological Task Performance Research Articles

Pure-tone audiometry and dichotic listening in primary progressive aphasia and Alzheimer's disease.

Hearing is multifaceted, and the relative contributions of peripheral and central hearing loss are rarely considered together in the context of dementia. Here, we assessed peripheral (as measured with pure-tone audiometry) and central (as measured with dichotic listening) hearing in 19 patients with typical amnestic Alzheimer's disease (tAD), 10 patients with logopenic variant primary progressive aphasia (lvPPA), 11 patients with nonfluent/agrammatic variant PPA (nfvPPA), 15 patients with semantic variant PPA (svPPA), and 28 healthy age-matched individuals. Participants also underwent neuropsychological assessment and magnetic resonance image scanning, allowing us to use voxel-based morphometry to assess associations between hearing scores and grey matter volume. Dichotic listening was impaired in all patient groups relative to healthy controls. In the combined patient (but not healthy control) cohort, dichotic listening scores were significantly correlated with measures of global cognitive functioning and speech-based neuropsychological tasks. Pure-tone audiometry scores were not significantly elevated in any patient group relative to the healthy control group, and no significant correlations were observed between peripheral hearing and neuropsychological task performance in either the combined patient or healthy control cohorts. Neuroanatomically, dichotic listening performance was associated with grey matter volume in a bilateral fronto-temporoparietal network over the combined patient cohort, but no correlates were identified for pure-tone audiometry. Our findings highlight the importance of speech parsing mechanisms beyond elementary sound detection in driving cognitive test performance, underline the importance of assessing central hearing alongside peripheral hearing in people with dementia, and further delineate the complex auditory profiles of neurodegenerative dementias.

Cognitive outcomes after fetal exposure to carbamazepine, lamotrigine, valproate or levetiracetam monotherapy: Data from the EURAP neurocognitive extension protocol

PurposePrenatal exposure to antiseizure medications (ASMs) has been associated with an increased risk of major malformations and neurodevelopmental disorders, with the latter being mainly associated with valproate (VPA). Our aim was to compare neurocognitive outcome at age 6–7 years in children exposed prenatally to lamotrigine (LTG), carbamazepine (CBZ), valproate (VPA) or levetiracetam (LEV) monotherapy. MethodsEligible mother–child pairs were identified from the observational prospective multinational EURAP cohort study. Assessor-blinded testing was conducted at age 6–7 years using WISC-III and NEPSY-II. Verbal IQ (VIQ), performance IQ (PIQ), full scale IQ (FSIQ) and performance in neuropsychological tasks were compared across ASM groups by ANOVA. Scores were adjusted for maternal IQ, paternal education, maternal epilepsy type and child sex. ResultsOf 169 children enrolled in the study, 162 (LTG n = 80, CBZ n = 37, VPA n = 27, LEV n = 18) had sufficient data from WISC-III, NEPSY-II or both, and were included in the analyses. Observed (unadjusted) PIQ and FSIQ did not differ across exposure groups, but a difference was identified for VIQ (P<0.05), with children exposed to VPA having lower scores than children exposed to LEV (P<0.05) and children from all groups combined (P<0.01). Adjusted VIQ, PIQ and FSIQ scores did not differ significantly across groups, but VPA-exposed children had borderline significantly lower adjusted VIQ scores than children from all groups combined (P=0.051). VPA-exposed children had lower scores in comprehension of instructions before and after adjustment for confounding variables than children exposed to LTG (P<0.001), LEV (P<0.01) or children from all groups combined (p < 0.001). The VPA-exposed group also had lower scores in immediate and delayed memory for faces compared to children exposed to CBZ (P<0.05 and P<0.001, respectively) and LTG (P<0.05 and P<0.02, respectively), and children from all groups combined (P<0.02 and P<0.001, respectively). LEV-exposed children had lower scores in delayed memory for names than children exposed to LTG (P<0.001), CBZ (P<0.001), VPA (P<0.05) and children from all groups combined (P<0.001). ConclusionsConsistent with previous reports, our results provide evidence for an adverse effect of prenatal exposure to valproate on verbal development. Our finding of relatively weaker performance of VPA-exposed children compared to other ASM exposures in both comprehension of instructions and face memory also suggest that children of mothers treated with VPA are at increased risk for compromised memory functions or altered processing of socially relevant information.

Verbal fluency patterns associated with the amnestic conversion from mild cognitive impairment to dementia

Patients with amnestic mild cognitive impairment (aMCI) are at a higher risk of converting to Alzheimer's disease. The aim of this study was to examine the potential use of Verbal Fluency (VF) measures as markers for predicting the conversion to dementia. At baseline, 61 aMCI, aged 65 to 80 years, underwent a comprehensive neuropsychological assessment, including phonemic (PVF) and semantic verbal fluency (SVF) tasks. After 18 months, 14 individuals with aMCI had progressed to a diagnosis of dementia. The findings revealed that aMCI-converter group had lower Mini Mental State Examination and Rey Auditory Verbal Learning Task scores than aMCI-no converter and produced fewer clusters in both VF tasks and a lower number of switches in PVF at baseline (p < 0.05). According to receiver operating characteristic curve analysis, the number of clusters in PVF had the highest predictive value (AUC = 0.80) with a threshold of 5.510 for identifying aMCI-converter at baseline. Additionally, participants with higher levels of education exhibited more clusters and switches in VF tasks (p < 0.05). These results suggest that qualitative measures of VF could serve as neuropsychological markers for predicting cognitive decline in individuals with aMCI. Furthermore, the study highlights the potential influence of the education level on cognitive performance in neuropsychological tasks.

Visuo-Cognitive Phenotypes in Early Multiple Sclerosis: A Multisystem Model of Visual Processing

Background: Cognitive impairment can emerge in the earliest stages of multiple sclerosis (MS), with heterogeneity in cognitive deficits often hindering symptom identification and management. Sensory–motor dysfunction, such as visual processing impairment, is also common in early disease and can impact neuropsychological task performance in MS. However, cognitive phenotype research in MS does not currently consider the relationship between early cognitive changes and visual processing impairment. Objectives: This study explored the relationship between cognition and visual processing in early MS by adopting a three-system model of afferent sensory, central cognitive and efferent ocular motor visual processing to identify distinct visuo-cognitive phenotypes. Methods: Patients with clinically isolated syndrome and relapsing–remitting MS underwent neuro-ophthalmic, ocular motor and neuropsychological evaluation to assess each visual processing system. The factor structure of ocular motor variables was examined using exploratory factor analysis, and phenotypes were identified using latent profile analysis. Results: Analyses revealed three ocular-motor constructs (cognitive control, cognitive processing speed and basic visual processing) and four visuo-cognitive phenotypes (early visual changes, efferent-cognitive, cognitive control and afferent-processing speed). While the efferent-cognitive phenotype was present in significantly older patients than was the early visual changes phenotype, there were no other demographic differences between phenotypes. The efferent-cognitive and cognitive control phenotypes had poorer performance on the Symbol Digit Modalities Test compared to that of other phenotypes; however, no other differences in performance were detected. Conclusion: Our findings suggest that distinct visual processing deficits in early MS may differentially impact cognition, which is not captured using standard neuropsychological evaluation. Further research may facilitate improved symptom identification and intervention in early disease.

Effects of chess-based cognitive remediation training as therapy add-on in alcohol and tobacco use disorders: protocol of a randomised, controlled clinical fMRI trial

BackgroundAlcohol and tobacco use disorders (AUD, TUD) are frequent, both worldwide and in the German population, and cognitive impairments are known to facilitate instances of relapse. Cognitive training has been...

Differentiating Individuals with and without Alcohol Use Disorder Using Resting-State fMRI Functional Connectivity of Reward Network, Neuropsychological Performance, and Impulsivity Measures.

Individuals with alcohol use disorder (AUD) may manifest an array of neural and behavioral abnormalities, including altered brain networks, impaired neurocognitive functioning, and heightened impulsivity. Using multidomain measures, the current study aimed to identify specific features that can differentiate individuals with AUD from healthy controls (CTL), utilizing a random forests (RF) classification model. Features included fMRI-based resting-state functional connectivity (rsFC) across the reward network, neuropsychological task performance, and behavioral impulsivity scores, collected from thirty abstinent adult males with prior history of AUD and thirty CTL individuals without a history of AUD. It was found that the RF model achieved a classification accuracy of 86.67% (AUC = 93%) and identified key features of FC and impulsivity that significantly contributed to classifying AUD from CTL individuals. Impulsivity scores were the topmost predictors, followed by twelve rsFC features involving seventeen key reward regions in the brain, such as the ventral tegmental area, nucleus accumbens, anterior insula, anterior cingulate cortex, and other cortical and subcortical structures. Individuals with AUD manifested significant differences in impulsivity and alterations in functional connectivity relative to controls. Specifically, AUD showed heightened impulsivity and hypoconnectivity in nine connections across 13 regions and hyperconnectivity in three connections involving six regions. Relative to controls, visuo-spatial short-term working memory was also found to be impaired in AUD. In conclusion, specific multidomain features of brain connectivity, impulsivity, and neuropsychological performance can be used in a machine learning framework to effectively classify AUD individuals from healthy controls.

Direct and Indirect Effects of Blood Levels of Omega-3 and Omega-6 Fatty Acids on Reading and Writing (Dis)Abilities.

The purpose of the present study was to investigate whether there are associations between polyunsaturated fatty acid (PUFA) blood levels, reading/writing performance and performance in neuropsychological tasks. Moderate to strong correlations were found between PUFA levels (specific omega-6/omega-3 ratios) and reading/writing abilities, and the former and neuropsychological test scores. Mediation models analyzing the direct and indirect effects of PUFA on reading and writing scores showed that the effects of fatty acids on learning measures appear to be direct rather than mediated by the investigated visual and auditory neuropsychological mechanisms. The only significant indirect effect was found for the difference in accuracy between the left and right visual fields in visual-spatial cueing tasks, acting as a mediator for the effect of PUFA ratios on writing accuracy. Regression analyses, by contrast, confirmed the roles of phonological awareness and other visual attentional factors as predictors of reading and writing skills. Such results confirm the crucial role of visual-spatial attention mechanisms in reading and writing, and suggest that visual low-level mechanisms may be more sensitive to the effects of favorable conditions related to the presence of higher omega-3 blood levels.

Exploring individual differences in neuropsychological and visuospatial working memory task performance in aphantasia

Aphantasia describes the newly-identified experience of individuals who self-report a lack of voluntary visual imagery. Individuals with aphantasia are typically identified via subjective introspection on imagery experience, a process that has been shown to be modulated by personality traits. It is also not clear whether individuals with aphantasia show broader cognitive deficits or differences within other memory domains, which may explain their self-reported lack of visual imagery. This research examines group and individual differences within individuals with aphantasia on a battery of tests: a personality scale, a range of standardised neuropsychological tests of cognitive function and two visuospatial working memory tasks. Twenty individuals with congenital aphantasia (VVIQ 35). Within the personality tests, the groups differed only for agreeableness, possibly resulting from a sampling bias. Similarly, the only group differences in the neuropsychological and visuospatial cognitive tests were slower performance in a task during trials that had greater working memory load, and larger variability in response times for front/back orientations within an egocentric perspective-taking task. Nevertheless, exploratory individual differences examination of performance using multidimensional scaling (which groups participants’ performance across all measures in terms of the level of similarity or dissimilarity) identified four aphantasic subgroups, each of which exhibited differing performance. In summary, these results suggest that the personality and cognitive profile of people without imagery do not greatly differ from those with typical imagery when examined by group. However, observed group differences were apparent with increased working memory load. Subgroups of aphantasia were identified, suggesting that some aphantasic individuals may experience more specific cognitive deficits. Further research should investigate the processes adopted by these subgroups, or whether (or not) individuals with aphantasia have unconscious mental imagery.

Cognitive Dysfunction in Multiple Sclerosis: Educational Level as a Protective Factor.

Most people with MS experience cognitive deficits especially in attention, memory, information processing, and executive functions, negatively impacting on their quality of life. Cognitive variables of short-term memory, logical memory, and verbal fluency in 65 patients with multiple sclerosis (MS) were analysed in conjunction with sociodemographic variables such as sex, age, and educational level that might influence disease progression. We found that psychoeducational variables exerted a significant effect on the cognitive status of patients with MS. Thus, when considering sex, age, educational level, and type of MS (SPMS or RRMS), tests for between-subject effects revealed statistically significant differences in all three cognitive variables. In addition, we found that the type of MS and time since onset also generated significant cognitive differences. Our study shows that educational achievement or level is a protective factor against the disease, acting as a source of intellectual enrichment that promotes cognitive reserve in patients with MS. Further longitudinal studies assessing disease progression and prognosis in patients with MS would be useful in order to determine the specific importance of these variables in such patients and in strategies that could enhance their performance in neuropsychological assessment tasks.

Exploring neuropsychological and socio-emotional task performance in anorexia nervosa: A cluster analytic approach.

The aim of this study was to characterise heterogeneity in neuropsychological and socio-emotional task performance in young women with anorexia nervosa (AN) using hierarchical cluster analysis. Further, we aimed to test whether cognitive profiles were associated with differences in clinical variables (body mass index, illness duration and age at diagnosis), psychopathology (eating disorder, autistic symptoms, anxiety and depression) and functional impairment. Set-shifting, central coherence and theory of mind abilities were measured in 118 women with acute or remitted AN. A hierarchical cluster analysis using Ward's method with a Euclidean distance measure was performed with the neuropsychological and socio-emotional variables. Differences between clusters were assessed using ANOVAs. Four clusters emerged, with significant differences in neuropsychological and socio-emotional task performance. There were no significant differences between clusters in clinical variables, psychopathology or functional impairment, however, these analyses lacked power due to small cluster sizes. Our results demonstrate significant heterogeneity in cognitive profiles in AN, supporting a more personalised approach to treatment. Studies in larger samples are required to establish whether these variables map onto clinically significant differences in aetiology, clinical presentation, comorbidity patterns and/or treatment responses.

Anosognosia in dementia with Lewy bodies: a systematic review.

Anosognosia, i.e. lack of awareness of one's own symptoms, is a very common finding in patients with dementia and is related to neuropsychiatric symptoms and worse prognosis. Although dementia with Lewy bodies (DLB) is the second most common form of degenerative dementia, literature on anosognosia in this disease is scarce. This paper aimed to review the current evidence on anosognosia in patients with DLB, including its prevalence in comparison with other neurological conditions, its severity and anatomical correlations. Database searches were performed in PubMed, Web of Knowledge and PsycINFO for articles assessing anosognosia in DLB. A total of 243 studies were retrieved, but only six were included in the review. Potential risk of selection, comparison or outcome biases were detected in relation to all the studies selected. Most of the studies used self-report memory questionnaires to assess cognitive complaints and compared their results to scores from informant-based instruments or to participants' cognitive performance in neuropsychological tasks. Subjects with DLB had worse awareness regarding memory than healthy older controls, but the results concerning differences in anosognosia between DLB and Alzheimer's disease (AD) patients were inconsistent across studies. Presence of AD pathology and neuroimaging biomarkers appeared to increase the prevalence of anosognosia in individuals with DLB. Anosognosia is a common manifestation of DLB, but it is not clear how its prevalence and severity compare with AD. Co-existence of AD pathology seems to play a role in memory deficit awareness in DLB.

Executive Function Assessment in Patients With Idiopathic Generalized Epilepsy: Applyingthe Frontal Assessment Battery

Background: Executive dysfunction is seen in idiopathic generalized epilepsy (IGE). The Frontal Assessment Battery (FAB) is a short neuropsychological instrument designed in clinical settings to evaluate frontal lobe activity. We aimed to assess the clinical use of FAB in patients with IGE for to detect executive impairment. Method: In this study, 30 patients with IGE and 30 age- and sex-matched healthy controls were included. The presence and severity of executive dysfunction was investigated with FAB. Cognitive flexibility, decision making, working memory, and general intelligence level were examined using Wisconsin Card Sorting Task (WCST), Iowa Gambling Task (IGT), N-back, and Wechsler Adult Intelligence Scale, respectively. In patients with IGE, FAB results were related to their neuropsychological task performance. Results: The FAB score in patients with IGE was significantly lower compared to healthy participants. In motor programming tasks, patients with IGE performed substantially worse. However, no correlation was found between FAB and neuropsychological task and clinical characteristics. Conclusion: Executive dysfunction was present in patients with IGE and FAB may be used in these patients as an effective tool for evaluating frontal lobe function.

Do Childhood Emotional Lability and ADHD Symptoms Have Shared Neuropsychological Roots?

Emotional Lability (EL) is a source of impairment in multiple mental disorders of children, including attention-deficit/hyperactivity disorder (ADHD). It has been proposed that the overlap between EL and ADHD symptoms is the result of common neuropsychological deficits. The aim of the present study was to test this hypothesis by using a multi-method approach. In a mixed sample of 61 children (49 community sample and 12 children with an ADHD diagnosis) aged between 8 and 12 years, we examined the relationship between parental reports of ADHD and EL, real-time children’s emotional expressions in an experimental context, children’s performance on neuropsychological tasks and parental ratings of neuropsychological functioning. Parental EL ratings were significantly predicted by task-based reaction time variability and by questionnaire measures of Self-Direction & Organization and Arousal Regulation. Parental EL ratings were also significantly related to both ADHD symptom dimensions. After controlling for shared neuropsychological factors, ADHD symptoms no longer predicted parental EL ratings. Neuropsychological task performance was not significantly related to real time emotional expressions. However, positive emotional expressions were significantly predicted by higher parental ratings of Cognition and negative emotional expressions by parental ratings of low Effort engagement – accounting for some of the correlation with ADHD symptoms. The current results highlight the plausible role of cognitive energetic processes in explaining the EL and ADHD symptom association.

Cognitive Functioning and Schizotypy: A Four-Years Study.

Although there is ample evidence from cross-sectional studies indicating cognitive deficits in high schizotypal individuals that resemble the cognitive profile of schizophrenia-spectrum patients, there is still lack of evidence by longitudinal/follow-up studies. The present study included assessments of schizotypal traits and a wide range of cognitive functions at two time points (baseline and 4-years assessments) in order to examine (a) their stability over time, (b) the predictive value of baseline schizotypy on cognition at follow-up and (c) differences in cognition between the two time points in high negative schizotypal and control individuals. Only high negative schizotypal individuals were compared with controls due to the limited number of participants falling in the other schizotypal groups at follow-up. Seventy participants (mean age: 36.17; 70% females) were assessed at baseline and follow-up. Schizotypal traits were evaluated with the Schizotypal Personality Questionnaire. We found that schizotypal traits decreased over time, except in a sub-group of participants (“schizotypy congruent”) that includes individuals who consistently meet normative criteria of inclusion in either a schizotypal or control group. In these individuals, negative schizotypy and aspects of cognitive-perceptual and disorganized schizotypy remained stable. The stability of cognitive functioning also varied over time: response inhibition, aspects of cued attention switching, set-shifting and phonemic/semantic verbal fluency improved at follow-up. High negative schizotypy at baseline predicted poorer response inhibition and semantic switching at follow-up while high disorganized schizotypy predicted poorer semantic processing and complex processing speed/set-shifting. The between-group analyses revealed that response inhibition, set-shifting and complex processing speed/set-shifting were poorer in negative schizotypals compared with controls at both time points, while maintaining set and semantic switching were poorer only at follow-up. Taken together, the findings show differential stability of the schizotypal traits over time and indicate that different aspects of schizotypy predict a different pattern of neuropsychological task performance during a 4-years time window. These results are of significant use in the formulation of targeted early-intervention strategies for high-risk populations.

Goal-Oriented Attention Self-Regulation Training Improves Executive Functioning in Veterans with Post-Traumatic Stress Disorder and Mild Traumatic Brain Injury.

Difficulties in executive-control functions are common sequelae of both traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD). The goal of this study was to assess whether a cognitive rehabilitation training that was applied successfully in civilian and military TBI would be effective for military Veterans with comorbid PTSD and mild TBI (mTBI). In the previous study, Veterans with a history of mild to severe TBI improved significantly after goal-oriented attentional self-regulation (GOALS) training on measures of attention/executive function, functional task performance, and emotional regulation. The objective of this study was to assess effects of GOALS training in Veterans with comorbid PTSD and mTBI. Forty Veterans with a current PTSD diagnosis and history of mTBI (6+ months post) were randomized to either five weeks of GOALS or Brain-Health Education (BHE) training matched in time and intensity. Evaluator-blinded assessments at baseline and post-training included neuropsychological and complex functional task performance, and self-report measures of emotional functioning/regulation. After GOALS but not BHE training, participants significantly improved from baseline on primary outcome measures of: overall complex attention/executive function neuropsychological performance composite (F = 12.35, p = 0.001; Cohen d = 0.48), and overall mood disturbance -POMS emotional regulation self-report (F = 4.29, p = 0.05, Cohen d = 0.41). In addition, GOALS but not BHE participants indicated a significant decrease in PTSD symptoms (PCL-M Total Score) (F = 4.80, p = 0.05, Cohen d = 0.60), and demonstrated improvement on complex functional task performance-GPS Learning and Memory (F = 5.06, p = 0.05, Cohen d = 0.56]. Training in attentional self-regulation applied to participant-defined goals may improve cognitive functioning in Veterans with comorbid PTSD and mTBI. Improving cognitive control functioning may also improve functioning in other domains such as emotional regulation and functional performance, potentially making it particularly relevant for Veterans with a history of mTBI and comorbid psychiatric symptoms.

Functional connectivity changes in patients with brain tumours—A systematic review on resting state-fMRI

AimResting-state functional magnetic resonance imaging (rs-fMRI) has been utilised to explore the brain's functional changes in patients with brain tumours. However, it remains unclear how such alterations affect functional connectivity (FC) and thus lead to changes in behaviour. To better understand the present state of knowledge, we conducted a systematic review. Material and methodsA systematic literature search of patients with brain tumours with rs-fMRI methods was conducted using the PubMed/MEDLINE and Cochrane Library electronic databases following PRISMA guidelines. References and citations were checked in Scopus database. ResultsTen independent studies were identified, comprising of 361 adult participants (218 had brain tumours; and the remainder were healthy controls). In comparison to healthy controls, patients with brain tumours demonstrated network distortions, alterations, and associated changes in the resting state networks (RSNs). Location and types of tumour affected RSNs integrity, particularly in the Default Mode Network (DMN). The left hemisphere was reported to have the largest effect on RSNs regardless of size or type of tumour. Result also demonstrate significant alterations to the local networks (decreases in the intra-hemispheric and inter-hemispheric FC). Studies also demonstrated that alterations in rs-fMRI were related to poorer neuropsychological task performance. ConclusionHowever, more studies utilising rs-fMRI to investigate effects of brain tumours on different types of RSNs are needed to draw clear conclusions about effects of tumour growth on properties of brain functional networks. Notably, not all studies have used the same nodes or regions for the networks, even though tumour locations often overlap.

Similar impairments shown on a neuropsychological test battery in adolescents with high-functioning autism and early onset schizophrenia: a two-year follow-up study

ABSTRACTIntroduction: Cognitive impairments are common in both Autism Spectrum Disorders (ASD) and schizophrenia, but it is unclear whether the pattern of difficulties is similar or different in the two disorders. This cross-sectional and longitudinal study compared the neuropsychological functioning in adolescents with ASD with adolescents with Early Onset Schizophrenia (EOS).Methods: At baseline and at two-year follow-up, participants were assessed with a brief neuropsychological test battery measuring executive functions, visual and verbal learning, delayed recall and recognition and psychomotor speed.Results: We found similar levels of neuropsychological impairment across groups and over time in the adolescents with ASD or EOS. Adolescents in both groups did not improve significantly on verbal learning, verbal delayed recall, visual learning, visual delayed recall or visual delayed recognition, and both groups performed poorer on verbal recognition. Both groups improved on measures of psychomotor processing and executive functions.Conclusion: The findings suggest that it may be difficult to differentiate adolescents with EOS and ASD based on neuropsychological task performance. An implication of the results is that adolescents with either disorder may benefit from a similar approach to the treatment of cognitive impairment in the disorders.

Changes in brain activation related to visuo-spatial memory after real-time fMRI neurofeedback training in healthy elderly and Alzheimer’s disease

Cognitive decline is a symptom of healthy ageing and Alzheimer’s disease. We examined the effect of real-time fMRI based neurofeedback training on visuo-spatial memory and its associated neuronal response.Twelve healthy subjects and nine patients of prodromal Alzheimer’s disease were included. The examination spanned five days (T1–T5): T1 contained a neuropsychological pre-test, the encoding of an itinerary and a fMRI-based task related that itinerary. T2–T4 hosted the real-time fMRI neurofeedback training of the parahippocampal gyrus and on T5 a post-test session including encoding of another itinerary and a subsequent fMRI-based task were done. Scores from neuropsychological tests, brain activation and task performance during the fMRI-paradigm were compared between pre and post-test as well as between healthy controls and patients.Behavioural performance in the fMRI-task remained unchanged, while cognitive testing showed improvements in visuo-spatial memory performance. Both groups displayed task-relevant brain activation, which decreased in the right precentral gyrus and left occipital lobe from pre to post-test in controls, but increased in the right occipital lobe, middle frontal gyrus and left frontal lobe in the patient group.While results suggest that the training has affected brain activation differently between controls and patients, there are no pointers towards a behavioural manifestation of these changes. Future research is required on the effects that can be induced using real-time fMRI based neurofeedback training and the required training duration to elicit broad and lasting effects.

Obsessive compulsive personality traits: Understanding the chain of pathogenesis from health to disease

BackgroundObsessive-Compulsive Personality Disorder (OCPD) is the most common personality disorder across the globe, and has been associated with heightened impulsivity and compulsivity. Examination of whether these findings extend to people with subsyndromal OCPD may shed light on pathogenic mechanisms contributing to the ultimate expression of full personality disorder. MethodsNon-treatment seeking participants were recruited in the general community of two US cities, and completed a detailed clinical assessment, along with questionnaires and cognitive tests relating to impulsivity and compulsivity. Participants were classified into two groups: those with subsyndromal OCPD (N = 104) and healthy controls free from mental disorders (N = 52). Demographic, clinical, and cognitive characteristics between the study groups were compared. ResultsGroups did not differ on age, gender, or educational levels. Subsyndromal OCPD had significantly elevated impulsivity (Barratt Impulsivity Scale) and compulsivity (Padua Inventory) scores, but did not differ on neuropsychological task performance (response inhibition, set-shifting, or decision-making). Across the whole sample in ordinary least squares modelling, self-rated OCPD scores were unrelated to Barratt Impulsivity Scale scores, but were highly related to Padua Inventory scores. ConclusionsSubsyndromal OCD was associated with impulsivity and compulsivity on self-report questionnaires, but not cognitive tasks. Interestingly, only compulsivity scores reflected the extent of OCPD traits by self-report, suggesting impulsivity may constitute a vulnerability rather than severity marker. The extremely high rates of morbid disorders in those with subsyndromal OCPD may suggest such traits induce a propensity for other disorders.

Differences in neuropsychological performance between incompleteness- and harm avoidance-related core dimensions in obsessive-compulsive disorder

BackgroundThe division of symptom themes into those related to incompleteness (INC) and those related to harm avoidance (HA) has been identified as an alternative to conventional subtyping. The aim of this study was to elucidate any potential differences between these two symptom themes based on neuropsychological task performance. Method: Participants (N = 123) with a primary DSM-5 diagnosis of OCD were recruited and classified into INC or HA groups based on detailed direct report of their current most troubling symptoms. All participants completed a set of neuropsychological tasks covering verbal memory and various executive function subdomains. Results: Those in the INC group performed better on a task assessing verbal memory (p < .05) while those in the HA group showed better performance on the Tower of London task (p < .05). The INC group also rated themselves as significantly more impaired across domains of subjective cognition. Discussion: The differences observed in neuropsychological task performance are in line with the hypothesis that HA-related symptoms of OCD may be more closely related to generalized anxiety—with poorer performance observed on verbal memory—while INC-related symptoms appear to be associated with executive function and problem-solving deficits.