Phonological Verbal Fluency Task Research Articles

Neuropsychological aspects of reversible cerebral vasoconstriction syndrome.

To describe the frequency and expand the understanding of cognitive dysfunction in RCVS. The neuropsychological evaluation was performed using a battery consisting of specific neuropsychological instruments that were administered to patients diagnosed with RCVS. A triage was conducted to exclude other potential causes of cognitive impairment. Performance on the tests was treated as a categorical variable, and a cutoff of -1.5 Z-score was adopted to indicate impaired performance. Seven patients diagnosed with RCVS were evaluated, all of whom had a bachelor's degree and normal score in the Mini-Mental State Examination. The average time between diagnosis and neuropsychological evaluation was 1.8 years. Among the patients, 85.6% (n=6) exhibited performance below that of the normal population in at least two of the administered tests. Specifically, 71.4% (n=5) showed alterations in tests from the Psychological Battery for Attention Assessment, with impairment observed in concentrated (n=1), divided (n=3), or alternating (n=4) attention. Furthermore, 28.6% (n=2) demonstrated impairments in the Phonological Verbal Fluency Task, another 28.6% (n=2) exhibited difficulties copying elements of the Rey Complex Figure, and 14.3% (n=1) displayed lower performance in the Five-Digit test, all indicating executive dysfunction. This study provides evidence that cognitive impairment associated with RCVS is more prevalent than previously believed and has not received sufficient attention. Specifically, attention and executive functions are the cognitive domains most significantly impacted by RCVS.

Semantic Memory as an Early Cognitive Marker of Alzheimer’s Disease: Role of Category and Phonological Verbal Fluency Tasks

Background: The assessment of semantic memory may be a useful marker to identify individuals with mild cognitive impairment (MCI) who will progress to Alzheimer’s disease (AD) in the early stages of the disease. Objective: The aim of this five-year follow-up longitudinal study is to assess whether semantic assessment could predict progression in MCI. Methods: A population of MCI (N = 251); mild (N = 178) and moderate AD (N = 114); and a sample of healthy participants (HP; N = 262) was investigated. The five-year follow-up of the MCI group was completed by 178 patients. Semantic and episodic memory measures were used, including a measure of the discrepancy between categorical and phonological verbal fluency, the semantic–phonological delta (SPD). The main outcome was the progression of MCI due to AD to dementia. Results: A general linear model showed a significant effect of diagnosis on SPD (Wilks’ Lambda = 0.591; p < 0.001). The estimated marginal means were –0.91 (SE = 0.185) in HP, –1.83 (SE = 0.187) in MCI, –1.16 (SE = 0.218) in mild AD, and –1.02 (SE = 0.275) in moderate AD. Post-hoc comparisons showed a significant difference between MCI and HP (p < 0.001). The follow-up was completed by 178 MCI individuals. SPD in MCI patients who progress to dementia was significantly lower than in MCI that will not progress (p = 0.003). Together with the Mini-Mental State Examination, the SPD was the only measure with a significant predicting effect at the five-years follow-up (p = 0.016). Conclusion: The SPD indicates the impairment of semantic memory in individuals with underlying AD at the MCI early stage, reflecting the early involvement of perirhinal and entorhinal cortices in the earliest stages of AD neuropathological process.

Phonological network fluency identifies phonological restructuring through mental search

We investigated network principles underlying mental search through a novel phonological verbal fluency task. Post exclusion, 95 native-language Mandarin speakers produced as many items that differed by a single segment or lexical tone as possible within one minute. Their verbal productions were assessed according to several novel graded fluency measures, and network science measures that accounted for the structure, cohesion and interconnectedness of lexical items. A multivariate regression analysis of our participants’ language backgrounds included their mono- or multi-lingual status, English proficiency, and fluency in other Chinese languages/dialects. Higher English proficiency predicted lower error rates and greater interconnectedness, while higher fluency in other Chinese languages/dialects revealed lower successive similarity and lower network coherence. This inverse relationship between English and other Chinese languages/dialects provides evidence of the restructuring of the phonological mental lexicon.

Nivel Educativo, Edad y Funcionamiento Ejecutivo: Relación en la vejez

El envejecimiento conlleva una serie de manifestaciones cognitivas que afectan las actividades de la vida diaria. Este estudio tuvo como propósito establecer la relación entre la escolaridad, la fluidez verbal, memoria viso espacial y memoria de trabajo, en el envejecimiento. Para ello se evaluaron 120 sujetos, de 55 a 89 años de edad, distribuidos en 3 grupos: 46 sujetos con escolaridad básica, 41 con escolaridad media y 33 con escolaridad alta. Los resultados de los análisis indicaron una fuerte asociación entre la escolaridad y el desempeño en tareas de fluidez verbal fonológica, observándose que a medida que disminuye la escolaridad disminuye el desempeño en tareas de fluidez verbal fonológica en los adultos mayores.En relación a la edad de los adultos mayores, se encontró un descenso en el desempeño de todas las pruebas a medida que aumenta la edad. Los hallazgos encontrados en esta investigación, entregaron evidencia de que la escolaridad es un factor asociado al deterioro cognitivo y a su vez a la funcionalidad en los adultos mayores, también entrega evidencia de la necesidad de considerar la escolaridad a la hora de realizar valoraciones cognitivas.

Corpus callosum atrophy as a marker of clinically meaningful cognitive decline in secondary progressive multiple sclerosis. Impact on employment status

Cognitive impairment in Multiple Sclerosis (MS) is more frequent and pronounced in secondary progressive MS (SPMS). Cognitive decline is an important predictor of employment status in patients with MS. Magnetic Resonance Imaging (MRI) markers have been used to associate tissue damage with cognitive dysfunction. The aim of the study was to designate the MRI marker that predicts cognitive decline in SPMS and explore its effect on employment status. 30 SPMS patients and 30 healthy participants underwent neuropsychological assessment using the Trail Making Test (TMT) parts A and B, semantic and phonological verbal fluency task and a computerized cognitive screening battery (Central Nervous System Vital Signs). Employment status was obtained as a quality of life measure. Brain MRI was performed in all participants. We measured total lesion volume, third ventricle width, thalamic and corpus callosum atrophy. The frequency of cognitive decline for our SPMS patients was 80%. SPMS patients differed significantly from controls in all neuropsychological measures. Corpus callosum area was correlated with cognitive flexibility, processing speed, composite memory, executive functions, psychomotor speed, reaction time and phonological verbal fluency task. Processing speed and composite memory were the most sensitive markers for predicting employment status. Corpus callosum area was the most sensitive MRI marker for memory and processing speed. Corpus callosum atrophy predicts a clinically meaningful cognitive decline, affecting employment status in our SPMS patients.

THE MEASUREMENT OF BRAIN ACTIVITY BY NEAR-INFRARED SPECTROSCOPY IN SUBJECTS WITH MILD COGNITIVE IMPAIRMENT

The aim of this study was to probe the brain activity in subjects with mild cognitive impairment (MCI) while they performed various tests. Fifteen MCI subjects of 78.9±9.8 years of age, with a mean MMSE score of 27.3±1.4, and 17 control subjects of 72.3±7.3 years of age, with a mean MMSE score of 29.3±0.9, were investigated using NIRS. All of the subjects took three types of tests. 1) The Kana pick-up test (Kana are Japanese letters). The subjects were instructed to select 5 specified letters from randomly arranged Kana letters (Task 1); and old Japanese fairy tales written entirely in Kana letters (Task 2). The test consists of 10 s of rest followed by 60 s to perform Task 1, then 20 s of rest and 60 s to perform Task 2. Each of these tasks was repeated twice. 2) A modified Stroop test. The subjects were asked to name the color of ink (Task 1) and the color of Chinese letters (Task 2). The test consists of 10 s of rest followed by 30 s to perform each task; the test was repeated three times. 3) The phonological verbal fluency task. The subjects were instructed to generate words beginning with a specified letter. The test consists of 10 s of task followed by 5 s of rest; the test was repeated 10 times. We used a 16-probe, 46-channeled NIRS device (OMM 3000, Shimazu Corporation, Japan). The task achievement levels in the MCI subjects were lower than those of the control subjects in the following tasks: Kana pick-up Task 1 (P<0.01), Kana pick-up Task 2 (P<0.001), modified Stroop test Task 2 (P<0.05) by Cochran-cox analysis. With the exception of Kana pick-up Task 1, the oxyHb concentrations were significantly decreased in the MCI subjects in comparison to the controls in all of the tests. The results in this study indicate that the frontal brain function was impaired in the stage of “MCI due to Alzheimer’s disease”. The measurement of oxyHb using NIRS is useful in the diagnosis of MCI.

Task-dependent and polarity-specific effects of prefrontal transcranial direct current stimulation on cortical activation during word fluency

Targeted modulation of cortical functions by non-invasive brain stimulation is widely used for the investigation of the neurophysiological signatures of executive functions and put forward as a potential specific treatment for its disorders. To further investigate the underlying mechanisms, we performed two experiments involving 46 subjects that performed a semantic and a phonological verbal fluency task (VFT) as well as a simple speech-production task after application of 1mA anodal or cathodal transcranial direct current stimulation (tDCS) to the left inferior frontal gyrus (IFG). Brain activation was measured by functional near-infrared spectroscopy (fNIRS) during task performance. Neither preceding anodal nor cathodal tDCS was found to modulate VFT performance of either difficulty. However, preconditioning with anodal tDCS increased brain activity during the VFT whereas a trendwise decrease of activation was found after cathodal stimulation. Notably, this difference was not found with simple speech production. These findings support the notion of a polarity-specific malleability of neuronal network activity underlying speech production by tDCS. Most importantly, the task-specificity of the modulatory effect observed after the end of stimulation demonstrates lasting neurophysiological effects of tDCS that are reflected in modifications of cortical excitability by challenging cognitive tasks.

Thalamic atrophy predicts cognitive impairment in relapsing remitting multiple sclerosis. Effect on instrumental activities of daily living and employment status

IntroductionCognitive impairment is an important predictor of quality of life at all stages of MS. Magnetic Resonance Imaging (MRI) markers have been used to associate tissue damage with cognitive dysfunction. ObjectiveThe aim of the study was to designate the MRI marker that predicts cognitive decline and explore its effect on every day activities and employment status. Methods50 RRMS patients and 31 healthy participants underwent neuropsychological assessment using the Trail Making Test (TMT) parts A and B, semantic and phonological verbal fluency task and a computerized cognitive screening battery (Central Nervous System Vital Signs). Everyday activities were evaluated with the instrumental activities of daily living (IADL) scale and employment status. Brain MRI was performed in all participants. We measured total lesion volume, third ventricle width, corpus callosum and thalamic atrophy. ResultsThe frequency of cognitive dysfunction for our RRMS patients was 38%. RRMS patients differed significantly from controls on the TMTA, TMTB, phonological verbal fluency task, memory, psychomotor speed, reaction time and cognitive flexibility. Neuropsychological measures had a strong correlation with all MRI atrophy measures and a weak or moderate correlation with lesion volume. Psychomotor speed was the most sensitive marker for IADL, while memory and TMTB for employment status. Thalamic area was the most sensitive MRI marker for memory, psychomotor speed and TMTB.. ConclusionThalamic atrophy predicts the clinically meaningful cognitive decline in our RRMS patients.

DIVERSITYC-05Different Performance Depending of the Letters used for Phonological Verbal Fluency Tasks in Basque-Spanish Bilinguals

DIVERSITYC-05Different Performance Depending of the Letters used for Phonological Verbal Fluency Tasks in Basque-Spanish Bilinguals

Genetic and Environmental Influences On Brain Function in Schizophrenia. an FMRI Study of the Maudsley Twin and Family Cohorts.

Introduction The heritability of the brain’s structure and function in schizophrenia remains elusive Objectives/Aims To assess the influence of genetic and environmental factors on executive function in schizophrenia. Method A twin-sibling study of 206 subjects; 163 twins, varying in their zygosity and concordance for schizophrenia, and 43 singletons from sibling clusters varying in their concordance for schizophrenia. We assessed performance and regional brain activation using functional magnetic resonance imaging, during a phonological verbal fluency task. Results Patients and their unaffected relatives developed greater activation in the left inferior frontal gyrus, and greater deactivation in the middle temporal gyri bilaterally. These features were maximally evident in subjects with schizophrenia. When the analysis was restricted to the unaffected relatives and healthy controls, a similar pattern was evident. Heritability was greatest in the left hippocampus and the right middle temporal gyrus. Genetic modelling indicated a phenotypic correlation between schizophrenia and increased activity in the inferior frontal gyrus and reduced activity in the left middle temporal gyrus and left hippocampus, which appeared principally due to shared genetic effects. Conclusions Both schizophrenia and its familial vulnerability were associated with altered frontal, parahippocampal and temporal activation during verbal fluency. The altered left inferior frontal activity was particularly associated with schizophrenia, while altered left medial temporal and right middle temporal activity were more heritable. The latter was more intimately linked to the genetic risk for schizophrenia, and thus the better candidate intermediate phenotype.

Cognitive impairment in relapsing remitting and secondary progressive multiple sclerosis patients: efficacy of a computerized cognitive screening battery.

Objective. To investigate the pattern of cognitive impairment in relapsing remitting multiple sclerosis (RRMS) and secondary progressive multiple sclerosis (SPMS) patients using a computerized battery. Methods. RRMS patients (N = 50), SPMS patients (N = 30), and controls (N = 31) were assessed by Central Nervous System Vital Signs (CNS VS) computerized battery, Trail Making Tests (TMT) A and B, and semantic and phonological verbal fluency tasks. Results. The overall prevalence of cognitive dysfunction was 53.75% (RRMS 38%, SPMS 80%). RRMS patients differed from controls with large effect size on reaction time, medium effect size on TMT A and small on TMT B, phonological verbal fluency, composite memory, psychomotor speed, and cognitive flexibility. SPMS patients differed from controls in all neuropsychological measures (except complex attention) with large effect sizes on TMT A and B, phonological verbal fluency, composite memory, psychomotor speed, reaction time, and cognitive flexibility. Between patient groups, medium effect sizes were present on TMT B and psychomotor speed, while small effect sizes were present on composite memory and processing speed. Conclusion. CNS VS is sensitive in detecting cognitive impairment in RRMS and SPMS patients. Significant impairment in episodic memory, executive function, and processing speed were identified, with gradual increment of the frequency as disease progresses.

108 Altered Fronto-Temporal Neuroanatomy in Very Preterm Born Adults During Completion of a Verbal Fluency Task

Background and aimsSeveral studies have described poorer cognitive performance in various aspects of language such as comprehension, naming, expressive language and verbal fluency in individuals who were born very preterm...

Brain activity patterns during phonological verbal fluency performance with varying levels of difficulty: A functional magnetic resonance imaging study in Portuguese-speaking healthy individuals

A large number of functional neuroimaging studies have investigated the brain circuitry which is engaged during performance of phonological verbal fluency tasks, and the vast majority of these have been carried out in English. Although there is evidence that this paradigm varies depending on the language spoken, it is unclear if this difference is associated with differences in brain activation patterns. Also, there is neuroimaging evidence that the patterns of regional cerebral activation during verbal fluency tasks may vary with the level of task demanded. In particular, the engagement of the anterior cingulate cortex seems to be relative to cognitive demand. We compared functional magnetic resonance imaging data in healthy Portuguese-speaking subjects during overt production of words beginning with letters classified as easy or hard for word production in Portuguese. Compared to the baseline condition, the two verbal fluency tasks (with either easy or hard letters) engaged a network including the left inferior and middle frontal cortices, anterior cingulate cortex, putamen, thalamus and cerebellum (p < .001). The direct comparison between the two verbal fluency conditions showed greater cerebellar activation in the easy condition relative to the hard condition. In the anterior cingulate cortex, there was a direct correlation between activity changes and verbal fluency performance during the hard condition only. Despite grammatical differences, the changes in patterns of brain activity during verbal fluency performance observed in our study are in accordance with findings of previous neuroimaging studies of verbal fluency carried out in English and other languages, with recruitment of a set of distributed cerebral areas during word production.

Pattern of neural responses to verbal fluency shows diagnostic specificity for schizophrenia and bipolar disorder

BackgroundImpairments in executive function and language processing are characteristic of both schizophrenia and bipolar disorder. Their functional neuroanatomy demonstrate features that are shared as well as specific to each disorder. Determining the distinct pattern of neural responses in schizophrenia and bipolar disorder may provide biomarkers for their diagnoses.Methods104 participants underwent functional magnetic resonance imaging (fMRI) scans while performing a phonological verbal fluency task. Subjects were 32 patients with schizophrenia in remission, 32 patients with bipolar disorder in an euthymic state, and 40 healthy volunteers. Neural responses to verbal fluency were examined in each group, and the diagnostic potential of the pattern of the neural responses was assessed with machine learning analysis.ResultsDuring the verbal fluency task, both patient groups showed increased activation in the anterior cingulate, left dorsolateral prefrontal cortex and right putamen as compared to healthy controls, as well as reduced deactivation of precuneus and posterior cingulate. The magnitude of activation was greatest in patients with schizophrenia, followed by patients with bipolar disorder and then healthy individuals. Additional recruitment in the right inferior frontal and right dorsolateral prefrontal cortices was observed in schizophrenia relative to both bipolar disorder and healthy subjects. The pattern of neural responses correctly identified individual patients with schizophrenia with an accuracy of 92%, and those with bipolar disorder with an accuracy of 79% in which mis-classification was typically of bipolar subjects as healthy controls.ConclusionsIn summary, both schizophrenia and bipolar disorder are associated with altered function in prefrontal, striatal and default mode networks, but the magnitude of this dysfunction is particularly marked in schizophrenia. The pattern of response to verbal fluency is highly diagnostic for schizophrenia and distinct from bipolar disorder. Pattern classification of functional MRI measurements of language processing is a potential diagnostic marker of schizophrenia.

S34-04 - Genetic and non-genetic influences on brain function in schizophrenia: an fMRI study in twins

IntroductionAltered neurocognitive function in schizophrenia could reflect both genetic and illness-specific effects.ObjectivesTo use functional magnetic resonance imaging to discriminate between the influences of the genetic risk for schizophrenia and environmental factors on the neural substrate of verbal fluency, a candidate schizophrenia endophenotype using a case control twin design.MethodsWe studied 23 monozygotic twin pairs: 13 pairs discordant for schizophrenia and 10 pairs of healthy volunteer twins. Groups were matched for age, gender, handedness, level of education, parental socio-economic status, and ethnicity. Behavioural performance and regional brain activation during a phonological verbal fluency task were assessed.ResultsRelative to healthy control twins, both patients and their non-psychotic co-twins produced fewer correct responses and showed less activation in the medial temporal region and inferior frontal gyrus. Twins with schizophrenia showed greater activation than both their non-psychotic co-twins and controls in right lateral temporal cortex, reflecting reduced deactivation during word generation while their non-psychotic co-twins showed greater activation in the left temporal cortex.ConclusionsBoth genetic vulnerability to schizophrenia and schizophrenia were associated with impaired verbal fluency performance, reduced engagement of the medial temporal region and dorsal inferior frontal gyrus. Schizophrenia was specifically associated with an additional reduction in deactivation in the right temporal cortex.

Different roles of cytoarchitectonic BA 44 and BA 45 in phonological and semantic verbal fluency as revealed by dynamic causal modelling

The interactions of left cytoarchitectonic BA 44 and BA 45 during semantic and phonological verbal fluency tasks were investigated using dynamic causal modelling (DCM). Three different models were tested, all of which featured BA 44 and BA 45 as top-down driven interconnected nodes projecting to the motor cortex as the final output region. Model #1 represents the hypothesis that BA 45 is involved in lexical retrieval including both semantic and phonological processes, while BA 44 supports other phonological processes. Model #2 reflects the notion of a clear-cut segregation of computational processes sustained by BA 44 (phonological processing) and BA 45 (semantic processing). Model #3 was based on the hypothesis that both BA 44 and BA 45 support semantic and phonological processing. When these models were compared against each other by Bayesian model selection, evidence emerged in favour of the first model, implying that BA 45 supports word retrieval processes whereas BA 44 is involved in processing phonological information during word generation. In a subsequent analysis of the derived model parameters for model #1, all connection strengths were significantly positive except for the inhibitory coupling between BA 44 and BA 45. This inhibition may reflect how the phonological analysis in BA 44 during word generation constrains lexical word retrieval in BA 45. To conclude, DCM provided additional insights into the roles of BA 44 and BA 45 during verbal fluency revealing the involvement of BA 45 in lexical retrieval and the relevance of BA 44 for phonological processing during word generation.

Effect of acute tryptophan depletion on pre-frontal engagement

Serotonin is known to modulate cognitive functioning and has been implicated in the cognitive deficits associated with affective disorders. The present study examined regional brain activation during two tasks that are known to engage the pre-frontal cortex and are performed poorly by patients with depression and bipolar disorder. We tested the hypothesis that acute tryptophan depletion (ATD) would attenuate pre-frontal activation during both tasks. Ten healthy right-handed volunteers were studied using functional MRI whilst performing a 2-back verbal working memory task and a phonological verbal fluency task. Subjects were studied in two separate sessions, after either a tryptophan-free or a balanced amino acid drink, in a double-blind design. Task performance and mood were measured online. Relative to sham depletion, ATD attenuated activation in the right superior frontal gyrus during the 2-back task and in the medial frontal gyrus and precuneus during the verbal fluency task. ATD lowered total plasma tryptophan by 79% but had no significant effect on either task performance or mood. The engagement of pre-frontal cortex during verbal working memory and verbal fluency tasks is significantly modulated by central serotonergic activity. The different location of these modulatory effects within the frontal cortex may reflect the engagement of distinct cognitive processes by the respective tasks.

Frontal and anterior cingulate activation during overt verbal fluency in patients with first episode psychosis

Functional neuroimaging studies using phonological verbal fluency tasks allow the assessment of neural circuits relevant to the neuropsychology of psychosis. There is evidence that the prefrontal cortex and anterior cingulate gyrus present different activation patterns in subjects with chronic schizophrenia relative to healthy controls. We assessed the functioning in these brain regions during phonological verbal fluency in subjects with recent-onset functional psychoses, using functional magnetic resonance imaging (FMRI). Seven patients with functional psychoses (3 schizophreniform, 4 affective) and 9 healthy controls were studied. We compared functional magnetic resonance images acquired during articulation of words beginning with letters classified as easy for word production in Portuguese. Statistical comparisons were performed using non-parametric tests. There were no differences between patients and controls in task performance. Controls showed greater activation than patients in the left rostral anterior cingulate gyrus and right inferior prefrontal cortex, whereas patients showed stronger activation than controls in a more dorsal part of the anterior cingulate gyrus bilaterally and in a more superior portion of the right prefrontal cortex. Our preliminary findings of attenuated engagement of inferior prefrontal cortex and anterior cingulate gyrus in patients with recent onset psychosis during phonological verbal fluency are consistent with those of previous studies. The greater activation found in other parts of the anterior cingulate gyrus and prefrontal cortex in patients may be related to a compensatory response that is required to maintain normal task performance, and suggests a pattern of disorganized activity of different functional anterior cingulate gyrus units in association with psychotic conditions.

Bottom-Up Driven Speechreading in a Speechreading Expert: The Case of AA (JK023)

This case study tested the threshold hypothesis (Rönnberg et al., 1998), which states that superior speechreading skill is possible only if high-order cognitive functions, such as capacious verbal working memory, enable efficient strategies. In a case study, a speechreading expert (AA) was tested on a number of speechreading and cognitive tasks and compared with control groups (z scores). Sentence-based speechreading tests, a word-decoding test, and a phoneme identification task were used to assess speechreading skill at different analytical levels. The cognitive test battery used included tasks of working memory (e.g., reading span), inference-making, phonological processing (e.g., rhyme-judgment), and central-executive functions (verbal fluency, Stroop task). Contrary to previous cases of extreme speechreading skill, AA excels on both low-order (phoneme identification: z = +2.83) and high-order (sentence-based: z = +8.12 and word-decoding: z = +4.21) speechreading tasks. AA does not display superior verbal inference-making ability (sentence-completion task: z = -0.36). Neither does he possess a superior working memory (reading span: z = +0.80). However, AA outperforms the controls on two measures of executive retrieval functions, the semantic (z = +3.77) and phonological verbal fluency tasks (z = +3.55). The performance profile is inconsistent with the threshold hypothesis. Extreme speechreading accuracy can be obtained in ways other than via well-developed high-order cognitive functions. It is suggested that AA's extreme speechreading skill, which capitalizes on low-order functions in combination with efficient central executive functions, is due to early onset of hearing impairment.