Spatial Span Test Research Articles

An improved spatial span test of visuospatial memory

ABSTRACTIn the widely used Corsi Block Test and Wechsler Spatial Span Tests, participants must reproduce sequences of blocks in the order touched by the examiner until two trials are missed at the same sequence length. The examiner records either the maximum number of blocks correctly reported or the total number of correct lists. Here, we describe a computerized spatial span test (C-SST) that uses psychophysical procedures to quantify visuospatial mean span (MnS) with sub-digit precision. Results from 187 participants ranging in age from 18 to 82 years showed that accuracy declined gradually with list length around the MnS (by ∼30% per item). Simulation studies revealed high variance and biases in CBT and Wechsler measures, and demonstrated that the C-SST provided the most accurate estimate of true span (i.e., the sequence length producing 50% correct). MnS declined more rapidly with age than mean digit span (MnDS) measured in the same participants. Response times correlated with both MnS and MnDS scores. Error analysis showed that omission and transposition errors predominated, with weaker primacy and recency effects in spatial span than digit span testing. The C-SST improves the precision of spatial span testing and reveals significant differences between visuospatial and verbal working memory.

Assessment of verbal and visuospatial working memory in mild cognitive impairment and Alzheimer's dementia.

In addition to episodic memory impairment, working memory may also be compromised in mild cognitive impairment (MCI) or Alzheimer's dementia (AD), but standard verbal and visuospatial span tasks do not always detect impairments.ObjectiveTo examine whether more complex verbal and visuospatial working memory tasks result in more reliable impairment detection.MethodsThe Digit Span (forward, backward and sequencing), Spatial Span (forward and backward) and Spatial Addition test from the Wechsler batteries were administered to MCI and AD patients and performance compared to healthy older adult controls.ResultsResults showed that both the MCI and AD patients had impaired performance on the Spatial Addition test. Both groups also had impaired performance on all three Digit Span conditions, but no differences were found between forward and backward conditions in any of the groups. The sequencing condition differed from the backward condition only in the AD group. Spatial Span performance was impaired in AD group patients but not in MCI patients.ConclusionWorking memory deficits are evident in MCI and AD even on standard neuropsychological tests. However, available tests may not detect subtle impairments, especially in MCI. Novel paradigms tapping the episodic buffer component of working memory may be useful in the assessment of working memory deficits, but such instruments are not yet available for clinical assessment.

Peripheral Hearing and Cognition: Evidence From the Staying Keen in Later Life (SKILL) Study.

Research has increasingly suggested a consistent relationship between peripheral hearing and selected measures of cognition in older adults. However, other studies yield conflicting findings. The primary purpose of the present study was to further elucidate the relationship between peripheral hearing and three domains of cognition and one measure of global cognitive status. It was hypothesized that peripheral hearing loss would be significantly associated with poorer performance across measures of cognition, even after adjusting for documented risk factors. No study to date has examined the relationship between peripheral hearing and such an extensive array of cognitive measures. Eight hundred ninety-four older adult participants from the Staying Keen in Later Life study cohort were eligible, agreed to participate, and completed the baseline evaluation. Inclusion criteria were minimal to include a sample of older adults with a wide range of sensory and cognitive abilities. Multiple linear regression analyses were conducted to evaluate the extent to which peripheral hearing predicted performance on a global measure of cognitive status, as well as multiple cognitive measures in the domains of speed of processing (Digit Symbol Substitution and Copy, Trail Making Test Part A, Letter and Pattern Comparison, and Useful Field of View), executive function (Trail Making Test Part B and Stroop Color-Word Interference Task), and memory (Digit Span, Spatial Span, and Hopkins Verbal Learning Test). Peripheral hearing, measured as the three-frequency pure-tone average (PTA) in the better ear, accounted for a significant, but minimal, amount of the variance in measures of speed of processing, executive function, and memory, as well as global cognitive status. Alternative measures of hearing (i.e., three-frequency PTAs in the right and left ears and a bilateral, six-frequency PTA [three frequencies per ear]) yielded similar findings across measures of cognition and did not alter the study outcomes in any meaningful way. Consistent with literature suggesting a significant relationship between peripheral hearing and cognition, and in agreement with our hypothesis, peripheral hearing was significantly related to 10 of 11 measures of cognition that assessed processing speed, executive function, or memory, as well as global cognitive status. Although evidence, including the present results, suggests a relationship between peripheral hearing and cognition, little is known about the underlying mechanisms. Examination of these mechanisms is a critical need to direct appropriate treatment.

Objective assessment of attention in delirium: a narrative review.

Inattention is a core feature of delirium, and valid assessment of attention is central to diagnosis. Methods of measuring attention in delirium can be divided into two broad categories: (i) objective neuropsychological testing; and (ii) subjective grading of behaviour during interview and clinical examination. Here, we review and critically evaluate studies of objective neuropsychological testing of attention in delirium. We examine the implications of these studies for delirium detection and monitoring in clinical practice and research, and how these studies inform understanding of the nature of attentional deficits in delirium. Searches of MEDLINE and ISI Web of Knowledge databases were performed to identify studies in which objective tests of attention had been administered to patients with delirium, who had been diagnosed using DSM or ICD criteria. Sixteen publications were identified. The attention tests administered in these studies were grouped into the following categories: measures of attention span, vigilance tests, other pen-and-paper tests (e.g. Trail Making Test) and computerised tests of speeded reaction, vigilance and sustained attention. Patients with delirium showed deficits on all tasks, although most tasks were not considered pure measures of attention. Five papers provided data on differential diagnosis from dementia. Cancellation tests, spatial span tests and computerised tests of sustained attention discriminated delirium from dementia. Five studies presented reliability or validity statistics. The existing evidence base on objective assessment of attention in delirium is small. Objective testing of attention is underdeveloped but shows considerable promise in clinical practice and research.

Working memory performance and exposure to pleasant and unpleasant ambient odor: Is spatial span special?

Sensory influences on working memory (WM) performance were investigated in 86 healthy adults. Participants were exposed to an ambient pleasant odor (lemon), unpleasant odor (machine oil) or no odor during completion of three WM tests from the Wechsler Memory Scale-III: the letter–number sequencing, spatial span and digit span tests. A significant main effect of odor was found for spatial span but no other task: scores were significantly lower in the unpleasant odor condition than the pleasant odor condition. Significant odor × sex interactions were found for the spatial span, digit span and letter–number sequencing tasks: men's spatial span scores were lower in the unpleasant odor condition than in the control condition, and women's scores were significantly better in the pleasant odor condition than in the unpleasant odor condition. The results suggest that ambient odor may impair or facilitate specific types of WM depending on the task, sex of the participant and affective characteristics of the odor.

Attentional and executive functions are differentially affected by post-traumatic stress disorder and trauma

BackgroundAmong the neurocognitive impairments observed in patients with Post-traumatic Stress Disorder (PTSD), attentional and executive dysfunctions appear to correlate with negative effects on education, work, daily life activities, and social relations, as well as the re-experiencing, avoidance, and hyperarousal symptoms of PTSD. However, there is no consensus regarding which aspects of attentional and executive functions are impaired in PTSD patients. MethodsAttentional and executive functions were assessed using the digit span (WAIS-III) and spatial span (WMS-III) tests under forward and backward recall conditions, the Stroop Test, and the Wisconsin Card Sorting Test (WCST). Our sample was composed of victims of urban violence who developed PTSD (PTSD+) (n = 81), victims of urban violence who did not develop PTSD (PTSD−) (n = 70), and healthy controls not exposed to trauma (HC) (n = 50). ResultsThe PTSD+ group had poorer performance on the spatial span forward subtest (p = 0.023; eta2 = 0.038) and poorer execution time (p = 0.023; eta2 = 0.042) and accuracy (p = 0.019; eta2 = 0.044) on the Stroop Test compared to HC. ConclusionsThese data suggest that there are few differences between the PTSD+ and HC groups, which are restricted to less complex measures of attentional and executive functional processes (short term capacity, selective attention, processing speed, and inhibitory control) and are related to visual stimuli. Therefore, cognitive impairments directly correlated with the manifestation of PTSD.

125. Adiposity-related low-grade inflammation and working memory alterations in obese patients before and after bariatric surgery

Obesity is related to an increased prevalence of cognitive alterations, including deficits in working memory. Recent evidences suggest that the low-grade inflammatory state characterizing obesity may be involved in these alterations. The objective of our study was to investigate the association of systemic inflammation with working memory performance in obese patients, before and after weight loss induced by bariatric surgery. Forty obese patients were followed before and eleven weeks, on average, after bariatric surgery. A group of twenty healthy volunteers were included to compare working memory performance at baseline. Working memory performance was evaluated using the spatial span test (SSP) from the CANTAB (Cambridge-Neuropsychological-Test-Automated-Battery). Inflammatory markers, CRP and leptin, were measured in obese patients at baseline and at follow-up. As expected, obese patients at baseline exhibited reduced working memory performance compared to healthy subjects, reflected by increased response latency in the SSP. Interestingly, lower SSP performance in obese patients was associated with greater systemic levels of CRP and leptin. Bariatric surgery was associated with a reduction in inflammatory markers concentrations, as well as with decreased response latency in the SSP. The evolution of CRP levels predicted the improvement in working memory performance. These findings are consistent with the involvement of low-grade inflammation in working memory alterations associated with obesity. Improvement of inflammatory profile following weight loss could contribute to reduce cognitive alterations in obese patients.

Working Memory Tasks in Relation to Phonological Processes of Arab Dyslexics in the State of Kuwait

The current study investigated the relationship between the working memory tasks and the phonological processes of Arab dyslexics in the primary stage in the State of Kuwait. The researchers used the descriptive research design. The sample of the study consists of 500 pupils (250 males and 250 females), their ages range from (9.05 ± 0.49) years old. The researchers used the working memory scale, the phonological awareness scale and the dyslexia examination scale. Findings of the study revealed that there is a negative correlation between Rapid Object Naming Test and both Forward Spatial Span Test and Backward Digit Recall Test. Also, there is a negative correlation between Backward Digit Recall Test and Rapid Letter Naming Test. Results also show that there is no correlation between some phonological processes (Syllables &Sound Deletion Test, Non-Word Repetition Test, and Non-Word Reading Accuracy Test) and the working memory tasks. It is shown that male pupils were slower than their female counterparts in the Rapid Object Naming Test and the Rapid Letter Naming Test. In addition, male pupils better performed in the Syllables & Sound Deletion Test, Non-Word Repetition Test, Non-Word Reading Accuracy Test, Forward Spatial Span Test and Backward Spatial Span Test tasks, Forward Digit Recall Test and Backward Digit Recall Test. It is also revealed that there is no significant difference between males and females in the tests of Sentence Repetition Test and Listening Span Test. With regard to nationality, it is revealed that there are significant differences between Kuwaiti and non-Kuwaiti pupils in the Syllables & Sound Deletion Test, Non-Word Repetition Test, Non-Word Reading Accuracy Test, Sentence Repetition Test and Forward Digit Recall Test in favor of non-Kuwaiti pupils. It is also revealed that there is no significant difference between males and females in the tests of Sentence Repetition Test and Listening Span Test. In addition, it is revealed that the performance of Kuwaiti pupils is slower than that of their non-Kuwaiti counterparts in the tests of Rapid Object Naming, Rapid Letter Naming. Whereas, no significant differences were detected regarding to nationality variable in the Forward Spatial Span Test, Backward Spatial Span Test and Backward Digit Recall Test.

The cortisol awakening response and memory performance in older men and women

The activity and regulation of the hypothalamus-pituitary-adrenal axis has been related to cognitive decline during aging. This study investigated whether the cortisol awakening response (CAR) is related to memory performance among older adults. The sample was composed of 88 participants (44 men and 44 women) from 55 to 77 years old. The memory assessment consisted of two tests measuring declarative memory (a paragraph recall test and a word list learning test) and two tests measuring working memory (a spatial span test and a spatial working memory test). Among those participants who showed the CAR on two consecutive days, we found that a greater CAR was related to poorer declarative memory performance in both men and women, and to better working memory performance only in men. The results of our study suggest that the relationship between CAR and memory performance is negative in men and women when memory performance is largely dependent on hippocampal functioning (i.e. declarative memory), and positive, but only in men, when memory performance is largely dependent on prefrontal cortex functioning (i.e. working memory).

Semantic fluency and executive functions as candidate endophenotypes for the early diagnosis of schizophrenia in Han Chinese

Neurocognitive deficits are recognized as core features of schizophrenia. The aim of this study was to compare the cognitive performance of antipsychotic, drug-naive patients with first-episode schizophrenia (FES patients) to their healthy siblings and to healthy controls from the Han Chinese population for exploring potential endophenotypes for the early detection of schizophrenia. A battery of cognitive assessment tools was used to measure seven cognitive domains in matched groups consisting of 56 subjects each. Cognitive tests included the grooved pegboard test (GPT), the category fluency test (CFT), the trail making test A (TMT-A), the Wechsler memory scale-III spatial span test (WMS-III SST), the Hopkins verbal learning test-revised (HVLT-R), the brief visuospatial memory test-revised (BVMT-R), the paced auditory serial addition test (PASAT), and the Wisconsin card sorting test-64 cards version (WCST-64). The performances of FEP patients were inferior to normal controls on all neuropsychological tests, while siblings were lower than healthy controls in many of the same tasks. Patients’ performances were lower than siblings’ on all tests except for the CFT, the WMS-III SST backward test, and four subtests of the WCST-64. Our data suggest that FEP patients exhibited pronounced impairment of fine motor skills, speed of processing, attention, verbal memory, visual memory, and executive function, while siblings exhibited deficits intermediate between those of schizophrenic patients and the control group. Semantic fluency function and executive function may be potential endophenotypes for the early diagnosis of schizophrenia.

Memory span measured by the spatial span tests of the Cambridge Neuropsychological Test Automated Battery in a group of Brazilian children and adolescents.

The neuropsychological tests of spatial span are designed to measure attention and working memory. The version of the spatial span test in the Cambridge Neuropsychological Test Automated Battery (CANTAB) evaluates these functions through the recall of sequences of spatial locations presented to the subject.ObjectiveThe present study investigated how age, gender and educational level might affect the performance of the non-verbal system.MethodsA total of 60 children and adolescents aged 6 to 18 years were assessed (25 males and 35 females).ResultsThe results showed no gender differences in test performance. Children with six or more years of education showed better performance than children with less than three years of education. Older children had more schooling and thus were able to recall a greater number of items. Span length values proved similar to a previous large normative study which also employed the CANTAB Spatial Span (De Luca et al., 2003).ConclusionThe similarity in performance of the Brazilian children and adolescents studied and the group of Australian participants examined by the cited authors, despite the socio-cultural and economical differences, points to the suitability of the task for the assessment of attention and working memory in Brazilian children.

Abnormalities in parentally rated executive function in methamphetamine/polysubstance exposed children

Methamphetamine/polysubstance abuse in women of childbearing age is a major concern because of the potential long-term detrimental effects on the brain function of the fetus following in utero exposure. A battery of established tests, including the Wechsler Abbreviated Scale of Intelligence, Conners' Continuous Performance Test II, Behavioral Rating Inventory of Executive Function, the CMS Family Pictures and Dot Location tests, the Spatial Span test from the WISC-IV-Integrated, and a recently developed spatial learning and memory measure (Memory Island), was used to assess the effects of prenatal drug exposure on neurobehavioral performance. Participants were 7 to 9year old children from similar socioeconomic backgrounds who either had (N=31) or had not (N=35) been exposed to methamphetamine/polysubstance during pregnancy. Compared to unexposed children, exposed children showed pronounced elevations (i.e. more problems) in parental ratings of executive function, including behavioral regulation and metacognition. Exposed children also exhibited subtle reductions in spatial performance in the Memory Island test. In contrast, IQ, Spatial Span, Family Pictures, Dot Location, and vigilance performance were unaffected by prenatal drug exposure history. Thus, children of women who reported using methamphetamine and other recreational drugs during pregnancy showed a selective profile of abnormalities in parentally rated executive function.

White Matter Correlates of Apathy in HIV-Positive Subjects: A Diffusion Tensor Imaging Study

White Matter Correlates of Apathy in HIV-Positive Subjects: A Diffusion Tensor Imaging Study

The computerized object and abstract designs test (COAD): A pilot study of a new test of visual working memory

To investigate the clinical and theoretical validity of a new computerized test of visual working memory; the computerized object and abstract designs (COAD) test. The COAD test was designed to be consistent with Baddeley's inclusion of the 'episodic buffer' in the 'multicomponent model' of working memory. A cross-sectional design was used with two brain lesion groups (left N=9 and right hemisphere N=12) and a control group N=18. The participants had to complete the new test, along with standardized tests of visual working memory in current clinical use (visual patterns test and spatial span test). Differences between groups, as well as between tests were investigated. Correlations were performed across tests. Regression models were used to further evaluate the COAD clinical sensitivity in comparison with the other tests of visual working memory. Significant differences were observed, as predicted, between groups and between design types. The COAD test was significantly correlated with both the visual patterns Test and the spatial span test. The COAD test also proved to be more sensitive in detecting brain injury resulting in visual working memory deficits, than the standardized tests. The results are discussed in relation to the COAD test's potential utility in the early detection of specific degenerative neurological disorders as well as the potential to be used in identifying deficits in visual working memory and in neurorehabilitation. It is concluded that the COAD test is a clinically valid psychometric test and is a more sensitive instrument than current standardized tests of visual working memory in clinical use.

Hot and cold cognition in unmedicated depressed subjects with bipolar disorder

Neuropsychological studies in subjects with bipolar disorder (BD) have reported deficits on a variety of cognitive measures. However, because the majority of subjects were medicated at the time of testing in previous studies, it is currently unclear whether the pattern of deficits reported is related to BD itself or to psychotropic medication. We addressed this issue by examining cognitive performance in a group of unmedicated, currently depressed subjects with BD. Forty-nine unmedicated subjects who met DSM-IV criteria for BD, depressed phase, and 55 control subjects participated in this study. Most patients were diagnosed with bipolar II disorder. Performance on emotion-dependent, or 'hot', and emotion-independent, or 'cold', cognitive tasks was assessed using tests from the Cambridge Neuropsychological Test Automated Battery. The groups were well matched with respect to general intelligence and demographic variables. Deficits in the unmedicated depressed BD group were apparent on tests tapping 'hot' cognitive processing, for example the Cambridge Gamble task and the Probabilistic Reversal Learning task. However, other than a deficit on the Spatial Span test in the depressed BD subjects, the groups performed equivalently on most measures of 'cold' cognitive processing, for example visual memory, attention, and working memory. These data suggest that deficits on tests involving reward processing, short-term spatial memory storage, and sensitivity to negative feedback in depressed BD subjects represent an effect of the illness itself and not mood-stabilizing medication.

Cognitive Dysfunction, Hippocampal Atrophy and Glucocorticoid Feedback in Alzheimer’s Disease

The hippocampal formation is damaged early in Alzheimer's disease (AD). An association between temporal lobe volume and cognitive function has been shown in several studies. Increased limbic-hypothalamic-pituitary-adrenal (LHPA) axis function has been suggested to be related to hippocampal atrophy and cognitive impairment. Our hypothesis was that there is a clear link between hippocampal volume -- notably of the CA1 region -- memory (episodic and visuospatial) and decreased feedback sensitivity in the LHPA axis in AD. Sixteen medication-free outpatients with mild to moderate AD were included. Hippocampal volume was measured with magnetic resonance imaging. Dexamethasone suppression tests were performed using .5 mg and .25 mg dexamethasone. Three different components in the neuropsychological battery -- Rey 15 item memory test, Alzheimer's Disease Assessment Scale (ADAS) word recall and spatial span from Wechsler Adult Intelligence Scale - Revised neuropsychological instrument (WAIS-R NI) -- were found to represent episodic and visuospatial memory. Low hippocampal CA1 volume and high post-dexamethasone cortisol levels in combination were significantly associated with Rey 15 item memory and spatial span test outcomes. No association was found between LHPA feedback and hippocampal volume. Low hippocampal volume and a disturbed negative feedback in the LHPA axis link to specific cognitive impairments in Alzheimer's disease.

Working Memory Span and Situation Model Processing

This study looked at how comprehension and memory processing at the situation model level is related to traditional measures of working memory capacity, including the word span, reading span, operation span, and spatial span tests. Issues of particular interest were the ability to remember event descriptions, the detection and memory of functional relationships, the detection of inconsistencies, sensitivity to causal connectivity, and memory for surface form, textbase, and situation-specific content. There was little evidence that traditional measures of working memory span were directly related to processing at the situation model level. However, working memory span was related to our few textbase-level tests.

Effects of age, education and sex on two tests of immediate memory: a study of normal subjects from 20 to 99 years of age.

Spatial span (Corsi's block-tapping test) and verbal span (Wechsler Digits Forward) were measured in 1354 normal subjects, aged from 20 to 99 yr., who were subdivided into seven age groups, into three groups according to education, and according to sex. Analysis of variance showed that the three main factors were significant for the spatial span test. The two spans examined held well up to the 60s, and only after this age did significant differences appear in the other age groups. On both tests there were significant differences between the groups divided according to education.

Sex differences in a children's spatial serial-learning task.

Boys (n = 80) and girls (n = 80) aged 9 to 10 completed a spatial-span test and a spatial serial-learning task. Corsi's block-tapping test was used for both. Sex differences were found on each: males performed better in both cases. The better performance of males on the spatial serial-learning task was independent of their superiority in the spatial-span test.