Phonetic Verbal Fluency Research Articles

Cognitive Control Performance as Measured by Clustering and Switching in Nepali – English Bilingual Verbal Fluency Task

Verbal fluency task is a simple yet powerful neuropsychological tool for measuring linguistic and cognitive processing. In this research article we report the clustering and switching, as identified by Troyer and colleagues (1997), as cognitive control measured through semantic and phonetic verbal fluency task. We tested 25 Nepali (L1) - English (L2) bilingual adults with mean age of 22 years on f, a, s for English phonemic fluency, s, k, d for Nepali phonetic fluency and animals, cloths, vegetables, fruits and flowers for semantic fluency in both Nepali and English. The participants performed better in L2 phonetic fluency compared to L1 phonetic fluency, whereas, there was mixed results in semantic output in both the languages. They exhibited more clusters in phonetic fluency compared to semantic fluency in both L1 and L2 which indicates participants needed to disengage from the previous strategy or subcategory and move on to the next strategy or subcategory, thus, reflecting more cognitive demand imposed by the phonetic fluency compared to semantic fluency. This is the first such study with Nepali – English bilinguals. This study may further be extended to include more diversified population in terms of age, language family, typicality and ethnicity as independent variables.

Neurocognitive Targets for Psychological Assistance in Patients with the Anhedonia Phenomenon within the Framework of Affective Pathology

IntroductionAnhedonia is a transdiagnostic psychopathological phenomenon that is considered a key feature for several disorders, primarily affective spectrum disorders. It exhibits a significant association with social and occupational maladjustment, reduced quality of life, and increased suicidal risk among psychiatric patients.ObjectivesThe aim of this study is to identify recommendations for psychotherapeutic assistance for patients with affective spectrum disorders.MethodsA total of 26 patients with affective spectrum disorders (ICD-10 code - F33, F31) and the phenomenon of anhedonia were examined. We utilized neuropsychological methods aimed at investigating a wide range of cognitive functions (Dynamic praxis; Color interference test; Arithmetic Tasks; Number of skips and impulsive errors; Reverse and straight rows; Verbal fluency; Design fluency; Rey-Osterritz figure) and psychometric methods designed to diagnose various types of anhedonia (consummatory (TEPS), anticipatory (TEPS), social (RSAS), and physical (PAS)).Results Among patients with depression, the consummatory type of anhedonia was the most pronounced. A relationship was found between anticipatory anhedonia and phonetic verbal fluency (r = 0.487; p < 0.01). Additionally, there were correlations between immediate (consummatory) pleasure experience and Rey figure errors (r = -0.349; p < 0.05). Social anhedonia was associated with phonetic verbal fluency productivity (r = -0.509; p < 0.01) and performance in visual fluency productivity (r = -0.473; p < 0.01).ConclusionsThe obtained results allow us to hypothesize that anhedonia is associated with difficulties both in evaluating and imagining possible positive stimuli, which leads to a lack of emotional response to the current stimulus. Thus, the availability of current pleasure may be linked to memory accessibility and regulatory function. When these domains are weakened, the respondent loses the ability to associate the current stimulus with positive past experiences, making it challenging to generate an emotional response in the current stimulus situation and disrupting the anticipation of pleasure. Based on the results, we propose the effective use of behavioral activation and work on the actualization of past experiences. Behavioral activation can be implemented by gradually introducing behaviors associated with past pleasures into the patient’s life, followed by cognitive restructuring aimed at focusing the emotional response on past and current stimuli. In addition to this, from a neurocognitive perspective, an additional element of therapy could involve training various types of cognitive functions, with an emphasis on the auditory modality.Disclosure of InterestNone Declared

Cognitive flexibility impairment in temporal lobe epilepsy: The impact of epileptic foci lateralization on executive functions

IntroductionTemporal Lobe Epilepsy (TLE) has been associated with memory impairments, which are typically linked to hippocampal and mesial temporal cortex lesions. Considering the presence of extensive bidirectional frontotemporal connections, it can be hypothesized that executive dysfunction in TLE is modulated by the lateralization of the epileptic foci. Material and MethodsA comprehensive neuropsychological executive functions protocol was administered to 63 participants, including 42 individuals with temporal lobe epilepsy (20 with right-TLE and 22 with left-TLE) and 21 healthy controls aged 20–49. ResultsThe results indicate that TLE patients exhibit poorer executive performance compared to healthy controls in working memory (F(2,60) = 4.18, p <.01), planning (F(2,60) = 4.71, p <.05), set shifting (F(2,60) = 10.1, p <.001), phonetic verbal fluency (F(2,60) = 11.71, p <.01) and semantic verbal fluency (F(2,60) = 9.61, p <.001. No significant differences were found in cognitive inhibition. Furthermore, right-TLE patients showed lower performance than left-TLE in set shifting (F(1,61) = 6.45, p <.05), while no significant differences were observed in working memory, planning, inhibition, and verbal fluency. ConclusionsThis research emphasize the importance of considering the lateralization of the temporal lobe focus to achieve a more accurate neuropsychological characterization. The cognitive differences between left and right TLE patients highlight the need for individualized approaches in their treatment and care.

Сognitive Functioning in Patients with the Phenomenon of Anhedonia in the Framework of Affective Pathology and Schizophrenia Spectrum Disorders

Background: anhedonia is a transdiagnostic psychopathological phenomenon, which is assessed as “core” for several diseases at once — first of all schizophrenic and affective spectrum disorders. The problem of clinical features differentiation and identification of anhedonia’s neurobiological mechanisms in the structure of the affective and schizophrenic spectrum disorders is still topical and far from being resolved.The aim of the study: to compare the relationship between the features of neurocognitive functioning and the manifestations of anhedonia among patients with disorders of the schizophrenic and affective spectra.Patients: the sample consisted of 40 patients including 17 patients with schizophrenic spectrum disorders (ICD-10 diagnosis codes F20.01, F20.02, F21.3, F21.4, F25.0, F25.1) and 23 patients with affective disorders (ICD-10 diagnosis code F33, F31).Methods: clinical, psychometric, experimental psychological and statistical.Results: patients with schizophrenia spectrum disorders show lower scores on pleasure anticipation ability and ability to experience pleasure in the social sphere. The affective spectrum group showed a correlation between anticipatory anhedonia and phonetic verbal fluency (r = –0.487; p &lt; 0.01). There was also a correlation between immediate pleasure experience and errors in the Rey figure test (r = –0.349; p &lt; 0.05). Social anhedonia in these patients was associated with phonetic verbal fluency productivity (r = –0.509; p &lt; 0.01) and performance in visual fluency productivity (r = –0.473; p &lt; 0.01). Patients with schizophrenia spectrum disorders had a correlation between anticipatory anhedonia and the Color-Word Interference Test (r = –0.329; p &lt; 0.05) and the Rey Complex Figure Test (r = –0.307; p &lt; 0.05). Consummatory anhedonia was correlated with verbal fluency test (r = –0.511; p &lt; 0.01) and the Rey Complex Figure Test (r = –0.417; p &lt; 0.01). Social anhedonia was correlated with Color-Word Interference Test (r = –0.656; p &lt; 0.01), verbal fluency (r = –0.523; p &lt; 0.01), and story description (r = –0.421; p &lt; 0.01).Conclusion: manifestations of different parameters of anhedonia demonstrate the differences in schizophrenia and affective spectrum disorders. Patients with schizophrenia spectrum disorders have greater difficulties in anticipating pleasure and experiencing pleasure in the social sphere. The ability to anticipate pleasure may be associated with executive function, while the ability to experience pleasure immediately may be associated with memory function. Social anhedonia affects a wide range of cognitive functions.

Montreal Cognitive Assessment Predicts the Short-Term Risk of Lewy Body Disease in Isolated REM Sleep Behavior Disorder with Reduced MIBG Scintigraphy.

Long-term follow-up of isolated rapid eye movement (REM) sleep behavior disorder (IRBD) patients reveals a high risk of α-synucleinopathies. We explored the early clinical predictive factors of phenoconversion from IRBD to Parkinson's disease (PD) or dementia with Lewy bodies (DLB). We assessed baseline office-based cognitive test scores (Montreal Cognitive Assessment [MoCA-J], Mini-Mental State Examination [MMSE], and Frontal Assessment Battery [FAB]), motor function, and olfactory function in 36 consecutive polysomnography (PSG)-confirmed IRBD patients with reduced metaiodobenzylguanidine (MIBG) accumulation. PD or DLB was confirmed by medical chart review retrospectively. Of 36 IRBD patients, 19 (n=19, 52.8%) with abnormal MoCA-J score (< 26) had significantly lower scores in trail making B, phonetic verbal fluency sub-items in the executive domain, and in delayed recall in the memory domain. In total, 12 (33.3%) patients developed PD or DLB; seven of 12 patients (58.3%) developed DLB at a mean follow-up period of 6.8 years. In the normal MoCA-J group (n=17, 47.2%), two patients developed PD, but none developed dementia. Furthermore, in the abnormal MoCA-J group, seven patients developed DLB and three developed PD without dementia. The phenoconverter group had significantly lower scores in delayed recall in the memory domain compared to the disease-free group. Cox hazard analysis showed that MoCA-J was superior to MMSE. Among IRBD patients with reduced cardiac MIBG accumulation, MoCA-J score of <26 (Mild Cognitive Impairment-Lewy body) and a low sub-item score for delayed recall predicted short-term progression to probable DLB.

Neuropsychological impairment in post-COVID condition individuals with and without cognitive complaints.

www.ClinicalTrials.gov, identifiers NCT05307549 and NCT05307575.

Verbal Fluency in Metabolic Syndrome.

Metabolic syndrome (MetS) or otherwise insulin resistance (IR) is described as a cluster of several commonly occurring disorders, including abdominal obesity; lipids disorders, such as hypertriglyceridemia; and low levels of high-density-lipoprotein cholesterol (HDL-C), hypertension (≥130/85 mmHg), and carbohydrates disorders, such as impaired fasting glucose or diabetes mellitus type 2. Type 2 diabetes (T2DM) constitutes insulin resistance, which is a strong risk factor for strokes. Patients with MetS are often prone to cognitive decline. Metabolic risk factors, hypertension, and diabetes, amongst them, have been hypothesized to play a great role in the pathogenesis of Alzheimer’s disease (AD) and the development of vascular dementia. For neuropsychological diagnostic and theoretical purposes verbal fluency is defined as a cognitive function that facilitates information retrieval from memory. It engages executive control and other cognitive processes, such as selective attention, selective inhibition, mental set shifting, internal response generation, and self-monitoring, as well as imagination and psychomotor skills. A total of 90 subjects, divided into 2 groups, patients with MetS (45) and healthy controls (45), were assessed. A significant difference in performance was found between the patients and controls, both in the phonetic (p < 0.01) and semantic fluency trials (p < 0.001). The MetS patients produced less words in the letter K and animal categories. The analysis of descriptive statistics shows that the group of patients with metabolic syndrome generated fewer words in both the phonetic and semantic categories. Our study shows that there is an association between metabolic factors and the verbal fluency performance of MetS patients. This is true, especially for phonetic verbal fluency, which is traditionally connected with the frontal cortex. Lower switching signifies possible executive dysfunctions amongst people with MetS. Subjects with this condition generated more diverse words and created less standard associations. This further implies the existence of dysexecutive syndrome and the need for diagnosing patients in this direction and involving this group of people in therapy. The proper correction of MetS components may improve cognitive function.

Screening for cognitive impairment in systemic lupus erythematosus: Application of the Montreal Cognitive Assessment (MoCA) in a Greek patient sample

Cognitive impairment (CI) is one of the most frequent neuropsychiatric manifestations of systemic lupus erythematosus (SLE). Given that extensive neuropsychological testing is not always feasible in routine clinical practice, brief cognitive screening tools are desirable. The aim of this study was to evaluate the Montreal Cognitive Assessment (MoCA) as a screening tool for CI in SLE. Consecutive SLE patients followed at a single centre were evaluated using MoCA and an extensive neuropsychological test battery (NPT), including the Digits Forward and Digits Backwards, Rey Auditory Verbal Learning Memory Test, Trail Making Test, Stroop Colour-Word Test, Semantic and Phonetic Verbal Fluency tests and a 25-problem version of the General Adult Mental Ability test. The criterion validity of MoCA was assessed through receiver operating characteristic (ROC) analyses using three different case definitions: i) against normative population data, ii) and iii) against average performance of a comparison group of rheumatoid arthritis (RA) patients, to adjust for possible confounding effects of chronic illness and inflammatory processes on cognitive performance. The effect of patient-related (age, years of education, anxiety, depression, fatigue and pain) and disease-related (activity, damage, age at diagnosis, disease duration, use of glucocorticoid, psychotropic and pain medication) parameters on the MoCA was examined. A total of 71 SLE patients were evaluated. MoCA significantly correlated with all NPT scores and was affected by education level (p < 0.001), but not by other demographic or clinical variables. The optimal cutoff for detecting CI, as defined on the basis of normative population data, was 23/30 points, demonstrating 73% sensitivity and 75% specificity. A cutoff of 22/30 points, using neuropsychological profiles of the RA group as inflammatory disease controls, exhibited higher sensitivity (100%, based on both definitions) and specificity (87% and 90%, depending on the definition). The standard cutoff of 26/30 points displayed excellent sensitivity (91-100%) with significant expenses in specificity (43-45%). The MoCA is an easily applied tool, which appears to be reliable for identifying CI in SLE patients. The standard cutoff score (26/30) ensures excellent sensitivity while lower cutoff scores (22-23/30) may, also, provide higher specificity.

A-250 Evidence for Language and Memory Improvements Following Right Anterior Temporal Lobectomy in a Patient with Mixed Language Dominance

Abstract Objective Anterior temporal lobectomy (ATL) surgery for epilepsy is commonly associated with post-surgical impairments in memory and language abilities, specifically episodic memory and confrontational naming. Less is known regarding outcomes of patients with atypical language dominance. Method Casey is a 19 year-old, ambidextrous, male with a history of remote symptomatic medically intractable focal epilepsy secondary to right inferior temporal encephalomalacia. Casey underwent right anterior temporal lobectomy and resection of mesial structures including part of the hippocampus. Results Casey’s pre-surgical neuropsychological evaluation revealed overall intellectual functioning in the average range with relative strengths in perceptual reasoning skills and weaknesses in attention, executive control, confrontational naming, and verbal fluency. Casey’s pre-surgical cognitive profile and functional MRI were suggestive of bilateral language organization. At post-surgical evaluation, Casey demonstrated strong overall cognitive abilities, basic reading, visual–spatial skills, and visual memory, as well as notable improvements in his processing speed and visual-motor integration. He demonstrated significant improvement in verbal working memory, verbal fluency, and contextual verbal memory. Casey continued to show significant weaknesses in word finding, phonetic verbal fluency, and rote verbal learning and memory, and milder weaknesses in aspects of executive functioning. Casey continued to demonstrate mood difficulties. Conclusions The current case provides evidence of continued mild deficits in traditional dominant hemisphere skills including rote verbal memory and focal language abilities, in a patient with a history of mixed language dominance, following right hemisphere ATL surgery. This case further highlights the importance of pre-surgical neuropsychological evaluation and fMRI in patients undergoing right ATL surgery.

Propriedades psicométricas da Frontal Assessment Battery na esclerose múltipla

Contexto: A Esclerose Múltipla (EM) é uma doença desmielinizante crónica que pode envolver alterações cognitivas e executivas. As alterações executivas, relacionadas essencialmente com o lobo frontal, podem ser subdiagnosticadas, uma vez que os instrumentos utilizados na EM são extensos e complexos, podendo os seus resultados ser comprometidos pelos níveis de fadiga que poderão daí decorrer. A Bateria de Avaliação Frontal (FAB) é de aplicação rápida e simples e avalia as funções do lobo frontal. Objetivo: Explorar as propriedades psicométricas da FAB numa amostra de doentes com EM. Métodos: No estudo avaliaram-se 68 doentes com EM e 81 indivíduos sem diagnóstico de doença neurológica (amostra de controlo) com a FAB, a Subescala executiva do Montreal Cognitive Assessment/MoCA-E e o Teste de Fluências Verbais Fonéticas/TFVF. Vinte e nove doentes foram reavaliados com a FAB (intervalo 4-8 semanas). Resultados: Na amostra com EM, a consistência interna revelou-se adequada e a estabilidade temporal situou-se entre moderada a alta nas subescalas Semelhanças, FluênciasLexicais, Séries Motoras de Luria e Go-no-Go. A FAB correlacionou-se de forma elevada com o MoCA-E e TFVF, atestando a sua validade convergente, e a sua estabilidade temporal teste-reteste revelou-se adequada. A amostra com EM teve pontuações significativamente inferiores nas subescalas Fluências Lexicaise Séries Motoras de Luria comparativamente com a amostra de controlo(p &lt; 0,05). Na EM, a FAB discriminou os níveis de escolaridade (p &lt; 0,001) e a subescala Séries Motoras de Luria diferenciou os padrões de EM (p &lt; 0,05). Conclusões: A FAB apresenta propriedades psicométricas adequadas para avaliar as funções do lobo frontal em doentes com EM, devendo integrar a sua avaliação neuropsicológica para auxiliar no correto encaminhamento terapêutico. Adicionalmente, a subescala das Fluências Lexicais parece ser importante para avaliar estes doentes, tendo potencial para o nível I do rastreio da disfunção frontal na EM.

Elevated perseveration errors on a verbal fluency task in frequent nightmare recallers: a replication.

A recent study reported that individuals recalling frequent idiopathic nightmares (NM) produced more perseveration errors on a verbal fluency task than did control participants (CTL), while not differing in overall verbal fluency. Elevated scores on perseveration errors, an index of executive dysfunction, suggest a cognitive inhibitory control deficit in NM participants. The present study sought to replicate these results using a French-speaking cohort and French language verbal fluency tasks. A phonetic verbal fluency task using three stimulus letters (P, R, V) and a semantic verbal fluency task using two stimulus categories (female and male French first names) were administered to 23 participants with frequent recall of NM (≥2 NM per week, meanage=24.4±4.0years), and to 16 CTL participants with few recalled NM (≤1 NM per month, meanage=24.5±3.8years). All participants were French-speaking since birth and self-declared to be in good mental and physical health apart from their NM. As expected, groups did not differ in overall verbal fluency, i.e. total number of correct words produced in response to stimulus letters or categories (P=0.97). Furthermore, groups exhibited a difference in fluency perseveration errors, with the NM group having higher perseveration than the CTL group (P=0.03, Cohen's d=0.745). This replication suggests that frequent NM recallers have executive inhibitory dysfunction during a cognitive association task and supports a neurocognitive model which posits fronto-limbic impairment as a neural correlate of disturbed dreaming.

Role of anxiety and brooding in specificity of autobiographical recall.

Overgeneral schemas and lack of autobiographical memory (AM) specificity about our past experiences can predict mood disturbance. Rumination, functional avoidance and executive processes are the main explanatory variables of such overgenerality. However, in non-clinical samples, rumination predicts overgenerality most consistently after the induction of dysphoric mood. Anxiety also activates rumination. Furthermore, anxiety predicts memory performance and has effects on mood which are independent of the effects of rumination. So, what might be the role of anxiety in autobiographical memory performance? A sample of 210 voluntary participants reported measures of autobiographical memory, anxiety, rumination (brooding and reflection), functional avoidance and executive functions (semantic and phonetic verbal fluency task). Autobiographical performance (specificity) was negatively associated with brooding and age and positively with phonetic verbal fluency but not with functional avoidance and anxiety. However, anxiety and brooding were positively correlated even after controlling for depression scores. Moreover, using structural equationmodeling, anxiety showed a significant indirect effect on autobiographical specificity through brooding rumination. These results suggest a possible association of anxiety with autobiographical recall through brooding rumination.

Is semantic verbal fluency impairment explained by executive function deficits in schizophrenia?

Objective:To investigate if verbal fluency impairment in schizophrenia reflects executive function deficits or results from degraded semantic store or inefficient search and retrieval strategies.Method:Two groups were compared: 141 individuals with schizophrenia and 119 healthy age and education-matched controls. Both groups performed semantic and phonetic verbal fluency tasks. Performance was evaluated using three scores, based on 1) number of words generated; 2) number of clustered/related words; and 3) switching score. A fourth performance score based on the number of clusters was also measured.Results:Individuals with schizophrenia produced fewer words than controls. After controlling for the total number of words produced, a difference was observed between the groups in the number of cluster-related words generated in the semantic task. In both groups, the number of words generated in the semantic task was higher than that generated in the phonemic task, although a significant group vs. fluency type interaction showed that subjects with schizophrenia had disproportionate semantic fluency impairment. Working memory was positively associated with increased production of words within clusters and inversely correlated with switching.Conclusion:Semantic fluency impairment may be attributed to an inability (resulting from reduced cognitive control) to distinguish target signal from competing noise and to maintain cues for production of memory probes.

Cognitive profile in patients with a first-ever lacunar infarct with and without silent lacunes: a comparative study

BackgroundThe detection of early neuropsychological abnormalities as precursors of cognitive decline of vascular origin in patients with lacunar stroke is a subject of increasing interest. The objective of this study was to assess whether there were differences in the performance of a battery of neuropsychological tests in first-ever lacunar stroke patients with and without associated silent multiple lacunar infarctions found incidentally on the brain magnetic resonance imaging (MRI) scan.MethodsA total of 72 consecutive patients with first-ever lacunar infarction were studied 1 month after stroke. All patients underwent a comprehensive neuropsychological evaluation, which included the California Verbal Learning Test (CVLT), Phonetic Verbal Fluency Test (PMR), Semantic Verbal Fluency Test (category “animals”), Digit Span Forward and Backward from the Wechsler Adult Intelligence Scale (WAIS-III), and Mini-Mental State Examination (MMSE).ResultsA total of 38 patients (52.7%) had silent multiple lacunar infarcts, with corona radiata as the most frequent topography (P < 0.023). White matter hyperintensities (leukoaraiosis) were observed in 81.1% of patients with silent multiple lacunar infarcts and in 50% with a single lacunar infarction (P < 0.007). Patients in both groups showed similar scores in the MMSE, but those with associated silent lacunar infarctions showed a poorer performance in the semantic fluency test (P < 0.008) and in short delayed verbal memory (P < 0.001). In both cases, however, leukoaraiosis was not statistically significant in multivariate linear regression models adjusted by confounding covariates. In these models, multiple silent lacunar infarctions and education were independent predictors of poor performance in the semantic fluency test and in short delayed verbal memory.ConclusionsThe presence of silent multiple lacunar infarctions documented on brain MRI scans in patients with first-ever lacunar stroke was associated with mild neuropsychological abnormalities, particularly in the performance of executive functions (semantic fluency) and short delayed verbal memory. According to these findings, in the initial stages of small vessel disease, mild neuropsychological abnormalities appear to be related to lacunes rather than to leukoaraiosis or perivascular hyperintensities of vascular cause.

Memory, fluency, and orientation (MEFO): A five-minute screening test for cognitive decline

BackgroundThe prevalence of cognitive impairment (CI) will double in the next 20 years, making early detection a key priority. ObjectivesValidation of a 5-minute CI screening test. MethodsAdults aged 60 years and older were recruited from memory clinics and the community at large in the Santiago, Chile metropolitan area. Based on clinical examination they were categorised as No CI (NCI), Mild CI (MCI) and dementia sufferers (DS). We measured the validity of a new test, MEFO, evaluating memory (5 points), phonetic verbal fluency (2 points) and orientation (6 points) by comparing its results with those from the MMSE. ResultsWe evaluated 214 subjects, comprising 49 with dementia, 47 with MCI, and 118 with no CI. The MEFO differentiated between all 3 groups whereas the MMSE did not discriminate between the MCI and NCI groups. The area under the ROC curve (AUC) for the MEFO distinguishing NCI subjects from dementia sufferers was 0.97; for NCI vs CI (dementia+MCI), 0.89; and for NCI vs MCI, 0.80. On the MMSE these values were 0.95, 0.84, and 0.73, respectively. A cut-off score of 6/7 on the MEFO identified dementia sufferers with a sensitivity of 86% and a specificity of 96%. A cut-off score of 8/9 distinguished CI from NCI subjects with a sensitivity of 83% and a specificity of 75%. ConclusionsThe MEFO is a valid and reliable test for discriminating between dementia and CI sufferers and subjects with no CI. Its validity is similar to that of the MMSE under these conditions, but it is more effective for identifying subjects with MCI and its administration time is shorter.

Zinc, vitamin A, and glutamine supplementation in Brazilian shantytown children at risk for diarrhea results in sex-specific improvements in verbal learning

OBJECTIVE:To identify the impact of supplemental zinc, vitamin A, and glutamine, alone or in combination, on long-term cognitive outcomes among Brazilian shantytown children with low median height-for-age z-scores.METHODS:A randomized, double-blind, placebo-controlled trial was conducted in children aged three months to nine years old from the urban shanty compound community of Fortaleza, Brazil. Demographic and anthropometric information was assessed. The random treatment groups available for cognitive testing (total of 167 children) were: (1) placebo, n = 25; (2) glutamine, n = 23; (3) zinc, n = 18; (4) vitamin A, n = 19; (5) glutamine+zinc, n = 20; (6) glutamine+vitamin A, n = 21; (7) zinc+vitamin A, n = 23; and (8) glutamine+zinc+vitamin A, n = 18. Neuropsychological tests were administered for the cognitive domains of non-verbal intelligence and abstraction, psychomotor speed, verbal memory and recall ability, and semantic and phonetic verbal fluency. Statistical analyses were performed using SPSS, version 16.0. ClinicalTrials.gov: NCT00133406.RESULTS:Girls receiving a combination of glutamine, zinc, and vitamin A had higher mean age-adjusted verbal learning scores than girls receiving only placebo (9.5 versus 6.4, p = 0.007) and girls receiving zinc+vitamin A (9.5 versus 6.5, p = 0.006). Similar group differences were not found between male study children.CONCLUSIONS:The findings suggest that combination therapy offers a sex-specific advantage on tests of verbal learning, similar to that seen among female patients following traumatic brain injury.

1123 – Cognitive impairment in euthimic bipolar patients

Cognitive dysfunction is a core feature in the course of bipolar disorder (BD) and persists during the remission periods. Only few studies valueted separately patients with BDI and BDII. To analyze the pattern of neurocognitive dysfunction between healthy controls and euthimic patients with BDI and BDII. 27 patients with BD (17 BDI patients and 10 BDII patients, according to DSM IV TR) and 20 controls underwent a neuropsychological battery. The inclusion criteria for the bipolar groups was an Hamilton Rating Scale For Depression's score ≤ 7. The neuropsychological battery consisted of: the Mini Mental State Examination The Corsi and the verbal span, to assess the short term memory; the Rey Auditory Verbal Learning Test (RAVLT) and the logical memory test, to assess the long term memory; the progressive Raven Matrices, to assess the logical - abstractive capacity The frontal assessment battery and the phonetic verbal fluency, to assess the executive functions The continuos performance test to assess the selective attention. Patients affected by BDI performed significantly worse to controls when the short term spatial memory, the long term verbal memory, logical abstractive capacity, the executive functions and the selective attention were measured (p< 0,05). Patients affected by BDII performed significantly worse (p< 0,05) to controls when the long term verbal memory was measured. Euthimic Patients with BDI disorder seem to have a more severe cognitive profile respect of BDII patients.

Memoria, fluidez y orientación: prueba de cribado de deterioro cognitivo en 5 minutos

BackgroundThe prevalence of cognitive impairment (CI) will double in the next 20 years, making early detection a key priority. ObjectivesValidation of a 5-minute CI screening test. MethodsAdults aged 60 and older were recruited from memory clinics and the community at large in the Santiago, Chile metropolitan area. Based on clinical examination they were categorised as No CI (NCI), Mild CI (MCI) and dementia sufferers (DS). We measured the validity of a new test, MEFO, evaluating memory (5 points), phonetic verbal fluency (2 points) and orientation (6 points) by comparing its results with those from the MMSE. ResultsWe evaluated 214 subjects, comprising 49 with dementia, 47 with MCI, and 118 with no CI. The MEFO differentiated between all 3 groups whereas the MMSE did not discriminate between the MCI and NCI groups. The area under the ROC curve (AUC) for the MEFO distinguishing NCI subjects from dementia sufferers was 0.97; for NCI vs CI (dementia+MCI), 0.89; and for NCI vs MCI, 0.80. On the MMSE these values were 0.95, 0.84, and 0.73, respectively. A cut-off score of 6/7 on the MEFO identified dementia sufferers with a sensitivity of 86% and a specificity of 96%. A cut-off score of 8/9 distinguished CI from NCI subjects with a sensitivity of 83% and a specificity of 75%. ConclusionsThe MEFO is a valid and reliable test for discriminating between dementia and CI sufferers and subjects with no CI. Its validity is similar to that the MMSE under these conditions, but it is more effective for identifying subjects with MCI and its administration time is shorter.

Perfil neuropsicológico de niños adoptados internacionalmente en Cataluña

Introduction During the last years, International adoption has increased significantly in our country over the last few years. China, Russia, Colombia and Ethiopia represent 77% of international adoptions in Spain. Cognitive and behavioural aspects are very important for an adequate social, family and school integration of these children. Objective To describe the neuropsychological profiles of a group of internationally adopted children in Catalonia from China, Russia, Colombia and Ethiopia. Patients and methods Neuropsychological examination of 49 children from international adoption (6 of Chinese origin, 24 from Russia, 13 from Colombia and 6 of Ethiopian origin). Results The group of Chinese origin obtained average scores of all functions evaluated. The Russian origin group was below the average for, selective attention, phonetic verbal fluency, control of impulsivity, mechanics and reading comprehension, and spelling. Scores on the impulse control in the Colombian origin group were below average. The group of Ethiopian origin obtained average scores in all functions evaluated except for spelling difficulties. Conclusion Children adopted from Russia have greater neuropsychological difficulties than the others. Most pre-adoption history is unknown; therefore we are unable to determine the origin of these difficulties. Maternal alcohol consumption during pregnancy and the institutional environment could be influencing factors in neuropsychological delay. Inclusion of neuropsychological assessment in health protocols for these children is recommended if they develop suggestive signs of cognitive and/or behavioral impairment.

Changes in cognition and health-related quality of life with unilateral thalamotomy for Parkinsonian tremor

Cognitive functioning and health-related quality of life were assessed pre- and post-operatively in a consecutive series of 31 Parkinson’s disease patients who underwent stereotactic unilateral thalamotomy (22 left-sided, 9 right-sided) for tremor alleviation. Neuropsychological functions assessed included verbal and visual memory, language and speech production, verbal and non-verbal reasoning, and attention and working memory. Health-related quality of life measures included both general and disease-specific questionnaires. We found a statistically significant post-operative decline in phonetic verbal fluency scores for left-operated patients, as well as improvements in self-ratings of stigma and bodily discomfort on the disease-specific quality of life questionnaire. These findings suggest that thalamotomy, when indicated, has limited cognitive sequelae and may result in improved quality of life in areas specific to Parkinson’s disease.