Phonemic Fluency Tasks Research Articles

Language Impairment in Adolescents With Sydenham Chorea

BackgroundNeuropsychiatric comorbidities are frequent in Sydenham chorea. However, cognitive impairment in Sydenham chorea has not been sufficiently described. The objective of this study was to evaluate expressive and receptive language deficits in adolescents with Sydenham chorea. MethodsTwenty patients with Sydenham chorea were compared with 20 patients with rheumatic fever without chorea and 20 healthy controls. Participants were matched for age and gender. Participants were assessed with verbal fluency tasks (phonemic and semantic) and with verbal comprehension tasks (Token Test). Patients with Sydenham chorea were also assessed with the Universidade Federal de Minas Gerais Sydenham Chorea Rating Scale. ResultsPerformance in verbal fluency and in verbal comprehension tasks differed significantly (P < 0.01) among the three groups. Patients with Sydenham chorea performed significantly worse than healthy control group in phonemic and semantic verbal fluency tasks as well as in the Token Test. The group with rheumatic fever also performed worse than healthy controls in phonemic verbal fluency. Severity of motor signs in Sydenham chorea inversely correlated with performance in phonemic verbal fluency (words beginning with letter S, and total sum of words beginning with letters F, A, and S). ConclusionsAdolescents with Sydenham chorea show difficulties in verbal fluency and in verbal comprehension. Patients with rheumatic fever also have some degree of language impairment. Future studies must investigate language impairment in difference stages of Sydenham chorea (acute, persistent, and remission) and putative biological markers.

Executive functioning and verbal fluency in children with language difficulties

This study provided a detailed analysis of verbal fluency in children with language difficulties, and examined the relative contributions of executive functioning (executive-loaded working memory, switching, inhibition) and language ability to verbal fluency performance. Semantic and phonemic fluency, language, and executive functioning tasks were completed by 41 children with specific language impairment (SLI) and 88 children with typical development. Children with SLI showed difficulties with most aspects of verbal fluency (rates of output, errors, switching) relative to typical children. Language ability predicted nearly every aspect of phonemic fluency performance and some aspects of semantic fluency performance. The relationships between verbal fluency and executive functioning were modest: inhibition was related to error scores on the phonemic fluency task, but relationships with executive-loaded working memory and switching were absent. Educationally, these results emphasise the underlying importance of language abilities in generation tasks like verbal fluency, but point to the importance of inhibition skills for error monitoring. Interventions to improve search and generation abilities have the potential to offer broader benefits in the classroom for children with language difficulties.

Phonemic and semantic verbal fluency tasks: normative data for elderly Brazilians

This study aims to investigate the influence of sociodemographic characteristics on the performance of older people on two tasks of verbal fluency and provide normative data for a Brazilian population of healthy elderly individuals with different educational levels. The initial sample included 521 individuals aged from 60 years, participating in the Program Family Health Strategy. Participants who had scores suggestive of cognitive decline on the Mini-Mental State Examination, depressive symptoms in Geriatric Depression Scale and self-reported neurological or psychiatric disorders were excluded. The final sample consisted of 218 participants in phonemic verbal fluency task (letters F, A and S) and 265 participants for semantic verbal fluency task (animals). The performance in both tests was associated with age and education, but not with sex. Still, the education variable was shown to have a greater impact on scores in phonemic and semantic tests than age in both forms of evocation. The results of this study suggest the importance of providing normative data for elderly Brazilians appropriate to age and education on verbal fluency tasks.

Shared and distinct anatomical correlates of semantic and phonemic fluency revealed by lesion-symptom mapping in patients with ischemic stroke.

Semantic and phonemic fluency tasks are frequently used to test executive functioning, speed and attention, and access to the mental lexicon. In semantic fluency tasks, subjects are required to generate words belonging to a category (e.g., animals) within a limited time window, whereas in phonemic fluency tasks subjects have to generate words starting with a given letter. Anatomical correlates of semantic and phonemic fluency are currently assumed to overlap in left frontal structures, reflecting shared executive processes, and to be distinct in left temporal and right frontal structures, reflecting involvement of distinct memory processes and search strategies. Definite evidence for this assumption is lacking. To further establish the anatomical correlates of semantic and phonemic fluency, we applied assumption-free voxel-based and region-of-interest-based lesion-symptom mapping in 93 patients with ischemic stroke. Fluency was assessed by asking patients to name animals (semantic), and words starting with the letter N and A (phonemic). Our findings indicate that anatomical correlates of semantic and phonemic fluency overlap in the left inferior frontal gyrus and insula, reflecting shared underlying cognitive processes. Phonemic fluency additionally draws on the left rolandic operculum, which might reflect a search through phonological memory, and the middle frontal gyrus. Semantic fluency additionally draws on left medial temporal regions, probably reflecting a search through semantic memory, and the right inferior frontal gyrus, which might reflect the application of a visuospatial mental imagery strategy in semantic fluency. These findings establish shared and distinct anatomical correlates of semantic and phonemic fluency.Electronic supplementary materialThe online version of this article (doi:10.1007/s00429-015-1033-8) contains supplementary material, which is available to authorized users.

Midlife plasma vitamin D concentrations and performance in different cognitive domains assessed 13 years later.

25-Hydroxyvitamin D (25(OH)D) insufficiency is very common in many countries. Yet, the extent to which 25(OH)D status affects cognitive performance remains unclear. The objective of the present study was to evaluate the cross-time association between midlife plasma 25(OH)D concentrations and subsequent cognitive performance, using a subsample from the French 'SUpplémentation en Vitamines et Minéraux AntioXydants' randomised trial (SU.VI.MAX, 1994-2002) and the SU.VI.MAX 2 observational follow-up study (2007-9). 25(OH)D concentrations were measured in plasma samples drawn in 1994-5, using an electrochemoluminescent immunoassay. Cognitive performance was evaluated in 2007-9 with a neuropsychological battery including phonemic and semantic fluency tasks, the RI-48 (rappel indicé-48 items) cued recall test, the Trail Making Test and the forward and backward digit span. Cognitive factors were extracted via principal component analysis (PCA). Data from 1009 individuals, aged 45-60 years at baseline, with available 25(OH)D and cognitive measurements were analysed by multivariable linear regression models and ANCOVA, stratified by educational level. PCA yielded two factors, designated as 'verbal memory' (strongly correlated with the RI-48 and phonemic/semantic fluency tasks) and 'short-term/working memory' (strongly correlated with the digit span tasks). In the fully adjusted regression model, among individuals with low education, there was a positive association between 25(OH)D concentrations and the 'short-term/working memory' factor (P=0.02), mainly driven by the backward digit span (P=0.004). No association with either cognitive factor was found among better educated participants. In conclusion, higher midlife 25(OH)D concentrations were linked to better outcomes concerning short-term and working memory. However, these results were specific to subjects with low education, suggesting a modifying effect of cognitive reserve.

Distinct functional connectivity of the hippocampus during semantic and phonemic fluency

Verbal fluency tasks are typically used in neuropsychological practice for assessment of language function in a variety of neurological disorders. Recently, it has been shown that the hippocampus, a region thought to be exclusive to the domain of memory, is also involved in tests of semantic fluency. The present study further explores hippocampal contribution to verbal fluency using functional Magnetic Resonance Imaging (fMRI) and examining mean activity and inter-regional functional connectivity with known task-related brain regions. Given the clear lateralization of brain areas involved in language, lateralization of hippocampal involvement in semantic and phonemic word fluency was also investigated. Different hippocampal recruitment during semantic and phonemic fluency was found: greater change in activity was seen during semantic fluency, as compared with phonemic fluency. This pattern was obtained in the right and the left hippocampus, with no lateralization effects. Functional connectivity analyses corroborate the notion of selective contribution of the hippocampus to semantic fluency. During the semantic fluency task, connectivity levels between the hippocampi and components of the semantic network did not differ from connectivity levels within the semantic network. In contrast, during the phonemic fluency task, the hippocampi were less correlated with components of the phonemic network, as compared to the within phonemic network connectivity. Importantly, hippocampal connectivity with the semantic network was task-dependent and restricted to periods of semantic fluency performance. Altogether, results suggest that the right and the left hippocampus are integral components of the brain network that selectively supports verbal semantic fluency, but not phonemic fluency.

Dual task-related gait changes in patients with mild cognitive impairment

Mild cognitive impairment (MCI) entails a high risk of developing Alzheimer's dementia. In MCI patients gait impairment, which increases the risk of falls and institutionalization, is an early motor sign. A dualtask (DT) paradigm might improve the observation of this phenomenon. The aim of this study was to investigate motor-cognitive interference in a sample of MCI patients and a group of matched healthy controls submitted to DT conditions. To this end, three different cognitive tasks were used: counting backwards, short story recall and a phonemic fluency task. Overall, the patients, compared with the healthy participants, performed worse on the cognitive tasks and showed some degree of gait impairment. In the DT conditions, both groups showed significant gait disruption independently of the concomitant cognitive task. As regards cognitive performance, counting backwards worsened during dual tasking, while short story recall improved in both groups. Overall, our results suggest that the use of a DT paradigm does not improve the early detection of MCI. Our findings of enhanced story recall during walking might have interesting implications for rehabilitation of memory function.

Hyperglykaemiás hemiballismus: implikációk a hálózatanalízisből a kognitív károsodásra

[Hyperglycaemia induced movement disorders, such as hemiballism are rare disorders. The syndrome is characterised by the triad of hemiballism, contralateral T1-hyperintense striatal lesion and non-ketotic hyperglycaemia. Here we report a patient with untreated diabetes presenting with acute onset of hemiballism. MRI revealed T1 hyperintensity of the head of the caudate nucleus and the anterior putamen. The patient also had acantocytosis. Based on the detailed examination of the neuroradiological results and earlier findings we will imply on the pathomechanism. Based on previous findings microhemorrhages, extensive mineralisation, gemistocytic astrocytosis might play role in the development of the imaging signs. The connectivity pattern of the striatal lesion showed extensive connections to the frontal cortex. In coexistence with that the most severe impairment was found on the phonemic verbal fluency task measuring frontal executive functions. ]

Hyperglykaemiás hemiballismus: implikációk a hálózatanalízisből a kognitív károsodásra

Hyperglycaemia induced movement disorders, such as hemiballism are rare disorders. The syndrome is characterised by the triad of hemiballism, contralateral T1-hyperintense striatal lesion and non-ketotic hyperglycaemia. Here we report a patient with untreated diabetes presenting with acute onset of hemiballism. MRI revealed T1 hyperintensity of the head of the caudate nucleus and the anterior putamen. The patient also had acantocytosis. Based on the detailed examination of the neuroradiological results and earlier findings we will discuss the pathomechanism. Based on previous findings microhemorrhages, extensive mineralisation, gemistocytic astrocytosis might play a role in the development of the imaging signs. The connectivity pattern of the striatal lesion showed extensive connections to the frontal cortex. In coexistence with that the most severe impairment was found on the phonemic verbal fluency task measuring frontal executive functions.

Alexithymia in patients with Parkinson's disease treated with DBS of the subthalamic nucleus: a case-control study.

Objectives: To evaluate the effect of deep brain stimulation of the subthalamic nucleus (STN-DBS) on alexithymia, a deficit in affective regulation, comparing patients with Parkinson’s disease (PD) submitted to STN-DBS (DBS group) to PD patients not yet treated with STN-DBS (pre-DBS group) and to healthy participants (C group).Methods: We recruited 27 consecutive STN-DBS PD patients, 38 consecutive pre-DBS patients and 27 healthy participants. Patients were assessed for alexithymia (Toronto Alexithymia Scale), depression, [beck depression inventory (BDI)], and cognitive functions (reasoning, memory, attentional, and executive tests).Results: The DBS patients performed worse than the pre-DBS patients in the corsi’s block-tapping test, in the phonemic fluency task and in the Frontal Assessment Battery. Around 30% of DBS (29.6%) and pre-DBS (31.6%) patients resulted alexithymic, compared with 14.8% in the C group. The results pointed out significantly higher alexithymia scores in both the DBS and pre-DBS groups compared with the C group, while no difference emerged between the DBS and pre-DBS groups. Pre-DBS group showed a significantly higher BDI score than the C group, while DBS group did not.Conclusion: Although the results suggest that STN-DBS does not affect alexithymia, both the DBS and pre-DBS patients reported higher prevalence (about 30%) of alexithymia than did healthy subjects (14.8%).

SS3.03: Cognitive screening for dementia: crossing four essential borders

SS3.03: Cognitive screening for dementia: crossing four essential borders

How formal education and literacy impact on the content and structure of semantic categories

Abstract We examined the hypothesis that formal education and literacy impact the richness and precision of semantic knowledge but not the organization of semantic categories and basic mechanisms of access to them. In Experiment 1, adults of varying levels of formal education were presented with semantic fluency tests and a superordinate naming task. Experiment 2 examined the impact of reading proficiency on adults of varying degrees of literacy. They were presented with simple semantic, alternating semantic and phonemic fluency tasks, as well as with literacy-related, reasoning and memory tests. Fluency was analyzed in terms of overall performance, sequential order and speed of responses. Despite lower performance, illiterates and adults with null or limited formal education displayed taxonomic clustering and retrieval by semantic subcategory, as did participants with higher formal education levels. Yet, formal education and literacy slightly speed up access to categories, probably providing useful cues for generating category exemplars.

C-23 * Longitudinal Analysis of Verbal Fluency in Chronic Schizophrenia

Objective: It has been argued that semantic verbal fluency may be a promising cognitive endophenotype in schizophrenia and possibly a trait-like cognitive measure of the illness. The present study examined the stability of verbal fluency performance in schizophrenia over-time. It was hypothesized that verbal fluency performance would be stable over 1 year. Method: Data was extracted from a larger study that followed 53 out-patients (16 female; mean age = 39.2 years) diagnosed with schizophrenia or schizoaffective disorder at baseline, 6, and 12 months. At each testing interval, phonemic (i.e., F, A, S) and semantic (i.e., animals) fluency tasks were administered as per Benton (1968) and Butters et al. (1987), respectively. Traditional scoring (i.e., total correct words in one minute/trial) along with phonemic clustering, semantic clustering, phonemic switching, and semantic switching component scores were derived and compared across time points. Results: Linear regression analyses were performed to examine clustering and switching patterns for semantic and phonemic fluency longitudinally. No significant differences (p > 0.05) were found over time. Furthermore, no significant changes in performance were observed over time for both semantic and phonemic mean cluster size or number of switches. Moreover, partial correlation analysis revealed no statistical relationship between phonemic fluency and years of illness. Conclusion(s): The results support the hypothesis in that the component verbal fluency performance across the three time points was stable. Accordingly, the results provide further substantiation to the assertion of verbal fluency as a possible cognitive endophenotype in schizophrenia.

Component analysis of verbal fluency performance in younger participants with moderate-to-severe traumatic brain injury

Primary objective: To investigate phonemic and semantic verbal fluency performance in a group of young adult participants with and without traumatic brain injury.Research design: Group comparison.Methods and procedures: Twenty-five participants with moderate-to-severe TBI and 25 participants with no brain damage (NBD) were given phonemic and semantic verbal fluency tasks. Responses were analysed quantitatively and qualitatively.Main outcomes and results: Young participants with moderate-to-severe TBI generated significantly fewer total correct words and sub-categories for both fluency conditions when compared to controls. The total number of correct words generated on the phonemic condition and for the semantic category of animals was positively correlated with the number of category switches produced during the task.Conclusions: While young participants with moderate-to-severe TBI produced fewer total correct words on both verbal fluency conditions in comparison to controls, these differences were greater on the phonemic condition. Participants with moderate-to-severe TBI switched less frequently on both fluency tasks and produced smaller cluster sizes only on the phonemic task in comparison to controls. These results are in contrast with previous investigations that have observed greater age-related declines on semantic tasks when compared to phonemic tasks.

A coordinate-based ALE functional MRI meta-analysis of brain activation during verbal fluency tasks in healthy control subjects

BackgroundThe processing of verbal fluency tasks relies on the coordinated activity of a number of brain areas, particularly in the frontal and temporal lobes of the left hemisphere. Recent studies using functional magnetic resonance imaging (fMRI) to study the neural networks subserving verbal fluency functions have yielded divergent results especially with respect to a parcellation of the inferior frontal gyrus for phonemic and semantic verbal fluency. We conducted a coordinate-based activation likelihood estimation (ALE) meta-analysis on brain activation during the processing of phonemic and semantic verbal fluency tasks involving 28 individual studies with 490 healthy volunteers.ResultsFor phonemic as well as for semantic verbal fluency, the most prominent clusters of brain activation were found in the left inferior/middle frontal gyrus (LIFG/MIFG) and the anterior cingulate gyrus. BA 44 was only involved in the processing of phonemic verbal fluency tasks, BA 45 and 47 in the processing of phonemic and semantic fluency tasks.ConclusionsOur comparison of brain activation during the execution of either phonemic or semantic verbal fluency tasks revealed evidence for spatially different activation in BA 44, but not other regions of the LIFG/LMFG (BA 9, 45, 47) during phonemic and semantic verbal fluency processing.

Enhancing Verbal Creativity via Brief Interventions During an Incubation Interval

Previous studies revealed inconsistent findings about the effects of cognitively low or high demanding interpolated tasks during incubation period on post-incubation creative performance. To explain this contradiction, two intervention tasks were administered (Reflecting on the generated ideas [RF] and the Word puzzle task [WP]), which are supposed to elicit remote associative processes but with varying levels of cognitive demands, along with two verbal control tasks (phonemic fluency task and object characteristics task). A delayed-incubation paradigm was used to assess whether performance on verbal creative problem solving (Alternative Uses Task, AUT) could be stimulated by the applied intervention tasks. The results showed that only RF and WP tasks, but not the control tasks, were associated with significant incubation effects. The findings suggest that the interpolated tasks that were assumed to elicit remote associative processes can unfold beneficial effects on verbal creative problem solving, regardless of whether the task is cognitively low or high demanding.

Pulmonary Function Affects Language Performance in Aging

Pulmonary Function Affects Language Performance in Aging

Executive Functioning in Children With Developmental Dyslexia

The term “executive function” has been used to describe several higher-order cognitive processes. This study examined the processing speed, shifting, planning, and verbal fluency of a sample of 50 Portuguese children with developmental dyslexia (DD) and 50 typically developing children (TDC; chronological-age-matched controls) between 8 and 12 years of age to evaluate the children’s executive functioning. Compared to TDC, children with DD revealed significant processing speed, shifting, and verbal fluency deficits. After controlling for differences in the general intellectual ability, significant group differences remained for shifting, verbal fluency and marginally for processing speed. No significant differences in planning ability were observed between the groups. No significant interaction of group, gender, and age was found for any of the executive functions measures studied. Word productivity in both semantic and phonemic verbal fluency tasks decreased significantly over the 60 seconds for both groups. Shifting was the only significant predictor of DD in the binary logistic regression analysis and yielded the highest area under the curve value (receiver operating characteristics curve analysis). Therefore, although these findings highlight the presence of specific executive functions deficits in children with DD, they should not be interpreted as indicative of the presence or absence of this learning disorder.

10.5937/specedreh13-6829 = Verbal fluency in children with intellectual disability: Influence of basic executive components

Phonemic and semantic fluency tasks are frequently used to differentiate executive control roles and the integrity of lexical-semantic representation. The main goal of this study is to determine the influence of basic executive components on phonemic and semantic productivity in children with mild intellectual disability. The sample consisted of 95 children with unspecified mild intellectual disability (MID), ages 10-13.11. Phonemic fluency was assessed by the Controlled Oral Word Association Test (COWAT), while semantic fluency was assessed by the Category Naming Test (CNT). Cognitive flexibility was assessed by Wisconsin Card Sorting Test (WCST) and Trail Making Test (TMT). Number Manipulation Task (NMT) was used for the verbal working memory assessment, while Day/Night Stroop Task was used for the assessment of inhibitory control. The results analysis showed that all of the assessed EF components significantly affect phonemic productivity. Semantic productivity significantly depends on WCST and TMT performance. Verbal working memory and inhibitory control do not significantly contribute to semantic productivity. The results of our study indicate that the discrepancy between phonemic and semantic productivity in children with MID could be directly associated with the basic executive functions components.

Effect of aneurysmal subarachnoid hemorrhage on word generation.

Background. Aneurysmal subarachnoid hemorrhage (aSAH) survivors commonly exhibit impairment on phonemic and semantic fluency tests; however, it is unclear which of the contributing cognitive processes are compromised in aSAH patients. One method of disentangling these processes is to compare initial word production, which is a rapid, semiautomatic, frontal-executive process, and late phase word production, which is dependent on more effortful retrieval and lexical size and requires a more distributed neural network. Methods. Seventy-two individuals with aSAH and twenty-five control subjects were tested on a cognitive battery including the phonemic and semantic fluency task. Demographic and clinical information was also collected. Results. Compared to control subjects, patients with aSAH were treated by clipping and those with multiple aneurysms were impaired across the duration of the phonemic test. Among patients treated by coiling, those with anterior communicating artery aneurysms or a neurological complication (intraventricular hemorrhage, vasospasm, and edema) showed worse output only in the last 45 seconds of the phonemic test. Patients performed comparably to control subjects on the semantic test. Conclusions. These results support a “diffuse damage” hypothesis of aSAH, indicated by late phase phonemic fluency impairment. Overall, the phonemic and semantic tests represent a viable, rapid clinical screening tool in the postoperative assessment of patients with aSAH.