Verbal Episodic Memory Tests Research Articles

The Association between Individual Food Groups, Limbic System White Matter Tracts, and Episodic Memory: Initial Data from the Aiginition Longitudinal Biomarker Investigation of Neurodegeneration (ALBION) Study.

(1) Background: Many studies link food intake with clinical cognitive outcomes, but evidence for brain biomarkers, such as memory-related limbic white matter (WM) tracts, is limited. We examined the association between food groups, limbic WM tracts integrity, and memory performance in community-dwelling individuals. (2) Methods: We included 117 non-demented individuals (ALBION study). Verbal and visual episodic memory tests were administered, and a composite z-score was calculated. Diffusion tensor imaging tractography was applied for limbic WM tracts (fornix-FX, cingulum bundle-CB, uncinate fasciculus-UF, hippocampal perforant pathway zone-hPPZ). Food intake was evaluated through four 24-h recalls. We applied linear regression models adjusted for demographics and energy intake. (3) Results: We found significant associations between (a) higher low-to-moderate alcohol intake and higher FX fractional anisotropy (FA), (b) higher full-fat dairy intake and lower hPPZ FA, and (c) higher red meat and cold cuts intake and lower hPPZ FA. None of the food groups was associated with memory performance. (4) Conclusions: Despite non-significant associations between food groups and memory, possibly due to participants' cognitive profile and/or compensatory mechanisms, the study documented a possible beneficial role of low-to-moderate alcohol and a harmful role of full-fat dairy and red meat and cold cuts on limbic WM tracts.

Neurocognitive Operations Underlying Working Memory Abilities: An Analysis of Latency and Time-Based Parameters.

The theory of executive attention (Fuster, 2015) suggests considerable plasticity regarding when specific neurocognitive operations are recruited to bring executive tasks to fruition. We tested the hypothesis that differing neurocognitive operations are recruited upon the initiation of a response, but that other distinct neurocognitive operations are recruited towards the middle or end of a response. The Backward Digit Span Test (BDST) was administered to 58 memory clinic patients (MCI, n = 22; no-MCI, n = 36). Latency to generate all correct 5-span responses was obtained. Statistical analyses found that optimal group classification was achieved using the first and third digit backward. First and third response latencies were analyzed in relation to verbal working memory (WM), visual WM, processing speed, visuospatial operations, naming/lexical access, and verbal episodic memory tests. For the first response, slower latencies were associated with better performance in relation to verbal WM and visuospatial test performance. For the third response, faster latencies were associated with better processing speed and visuospatial test performance. Consistent with the theory of executive attention, these data show that the neurocognitive operations underlying successful executive test performance are not monolithic but can be quite nuanced with differing neurocognitive operations associated with specific time epochs. Results support the efficacy of obtaining time-based latency parameters to help disambiguate successful executive neurocognitive operations in memory clinic patients.

Cognitive test performance in chronic cannabis flower users, concentrate users, and non-users

Extremely high-potency cannabis concentrates are becoming increasingly available and popular among consumers. While prior research indicates these products are perceived to have greater detrimental effects relative to cannabis flower, few studies have examined their relative objective effects, and no existing studies have compared the cognitive test performance of sober flower users, concentrate users, and non-users. A total of 198 healthy adults (98 non-users, 46 exclusive flower users, and 54 concentrate users) were administered a battery of tests of memory, psychomotor speed, attention, and executive functioning under sober laboratory-controlled conditions. Significant group differences were detected on tests of verbal free recall and episodic prospective memory, with both the flower users and concentrate users demonstrating significantly worse performance than non-users. Concentrate (but not flower) users performed worse than non-users on a measure of source memory, but contrary to our hypothesis, there were no significant differences between flower and concentrate users on any of the cognitive tests. Results indicate that, under sober conditions, individuals who regularly use concentrates are no more cognitively impacted than those who exclusively use flower. These null findings may reflect the tendency for concentrate users to self-titrate and use significantly lower quantities of concentrates than flower.

A Cross-sectional Study on the Association of KIBRA Genetic Polymorphism with Episodic Memory in North Jordanian Adults

One of the cognitive processes most damaged by aging and thought to be the system most susceptible to neurodegenerative illnesses is episodic memory. Recently, episodic memory function has been linked to a single nucleotide polymorphism (rs17070145) in the ninth intron of the KIBRA gene (kidney and brain expressed gene). This study looked at the relationship between the KIBRA polymorphism (rs17070145) and the episodic memory abilities assessed by the Rey Auditory Verbal Learning Test and Rey Complex Figure Test at various time points (20-minute, 30-minute, 24-hours and 6-month). 112 healthy adult Jordanians between the ages of 18 and 45 were included in the study, and the genotypes at the KIBRA (rs17070145) polymorphic site were identified using the PCR-RFLP method. The outcomes did not reveal any statistically significant any assessment of verbal and visual episodic memory tests and the KIBRA polymorphism. The findings also indicated that KIBRA polymorphism had no statistically significant impact on short-term memory or learning capacity, indicating that KIBRA had no effect on a person's ability to pay attention or concentrate. Additionally, in the Jordanian population, the genotype percentages for KIBRA rs17070145 were: 10.7% for TT, 43.8% for TC, and 45.5% for CC, and the percentage of the T allele was 0.326. The current investigation discovered no statistically significant differences between the Jordanian population and either the European or the South Asian populations in terms of the percentages of alleles and genotypes of the KIBRA rs17070145 gene.

Apraxia testing to distinguish early Alzheimer’s disease from psychiatric causes of cognitive impairment

Objective: Mood- and stress-related disorders commonly cause attentional and memory impairments in middle-aged individuals. In memory testing, these impairments can be mistakenly interpreted as symptoms of dementia; thus, more reliable diagnostic approaches are needed. The present work defines the discriminant accuracy of the Dementia Apraxia Test (DATE) between psychiatric conditions and early-onset Alzheimer’s disease (AD) on its own and in combination with memory tests. Method: The consecutive sample included 50–70-year-old patients referred to dementia investigations for recent cognitive and/or affective symptoms. The DATE was administered and scored as a blinded measurement, and a receiver operating curve analysis was used to define the optimal diagnostic cut-off score. Results: A total of 24 patients were diagnosed with probable AD (mean age 61 ± 4) and 23 with a psychiatric condition (mean age 57 ± 4). The AD patients showed remarkable limb apraxia, but the psychiatric patients mainly performed at a healthy level on the DATE. The test showed a total discriminant accuracy of 87% for a total sum cut-off of 47 (sensitivity 79% and specificity 96%). The limb subscale alone reached an accuracy of 91% for a cut-off of 20 (sensitivity 83% and specificity 100%). All memory tests were diagnostically less accurate, while the combination of the limb praxis subscale and a verbal episodic memory test suggested a correct diagnosis in all but one patient. Conclusions: Apraxia testing may improve the accuracy of differentiation between AD and psychiatric aetiologies. Its potential in severe and chronic psychiatric conditions should be examined in the future.

Verbal Episodic Memory Test

<p>The decline of episodic memory is one of the earliest cognitive markers of mild cognitive impairment and various types of dementia. Until today, however, there is no standardized Hun&shy;garian episodic memory test that takes into account the characteristics of the Hungarian language. The study presents the structure and standardized use of a new memory test (Verbal Episodic Memory Test, VEMT) as well as normative data in Hungary.&nbsp;</p>. <p>The VEMT is suitable for the comprehensive examination of verbal learning abilities in a broader sense, and more specifically, for the neuropsychological measurement of verbal list learning abilities. In the present study, we constructed a normative database consisting of data from 385 participants.</p>. <p>We showed that the VEMT is sensitive to demographic factors (e.g., age) which are linked to differences in episodic memory performance. Open access to the test is provided, and the normative scores are presented as well.&nbsp;</p>. <p>The indicators of the test are suitable for drawing a learning curve, for showing the interaction of new and previously learned information (interference effects), and for measuring differences between free recall and cued recall. Furthermore, the test scores are appropriate for distinguishing the effects of different types of memory encoding forms (phonological, semantic, and episodic), for measuring the ability to reconstruct the presentation of a sequence (memory order information), for detecting the rate of forgetting, for measuring recognition abilities, and for detecting hippocampus-related mnemonic pattern separation and completion functions.&nbsp;</p>.

Normative data for the story recall subtest of the BEM-144 in the Quebec-French population aged 50 years and over

Objective The story recall subtest of the Batterie d’Efficience Mnésique (BEM-144) is a verbal episodic memory test that assesses immediate and episodic memory. Variables such as age, sex, and education level can impact performance on this type of memory test, as can cultural differences. Therefore, the purpose of this study was to establish normative data for the story recall subtest of the BEM-144 in the elderly French-Quebec population. Method The normative sample consisted of 260 healthy individuals aged 50–90 years, all from the province of Quebec, Canada. Analyses were performed to estimate the association between age, sex, and education level on one hand, and immediate and delayed recall performance, on the other hand. Results The results show that all sociodemographic variables are significantly associated with story recall performance. Normative data are proposed in the form of regression equations. Conclusions Overall, these norms will be beneficial for the evaluation and detection of episodic memory impairment in middle-aged and older adults.

Distinct neuroanatomical correlates of interference-related verbal episodic memory test in healthy older adults

ABSTRACT Verbal learning test can include a trial of interference process that intrude initial learning and impose additional cognitive stress. However, it has been unclear whether the multiple memory processes underly different brain structural bases. We measured performances of word retrieval that represents distinct memory processes (initial learning, interference, and retention) and regional gray matter morphology from 230 cognitively unimpaired older adults. We identified three distinct multivariate pattern modes using canonical correlation analysis that map correspondence between memory and brain morphometry. The first mode comprised weights highly loaded on temporal lobe and overall performances. The second mode reflected subcortical volumes and initial learning performances. The third mode comprised thickness in the lateral prefrontal and parietal cortex and captured an ability to resist retroactive interference effect. While overall test performance reflected the temporal lobe and whole-gray matter volume, the interim trial of interference signifies neural correlates extending to subcortical and frontoparietal regions.

Remote self-administration of digital cognitive tests using the Brief Assessment of Cognition: Feasibility, reliability, and sensitivity to subjective cognitive decline.

Cognitive impairment is a common and pervasive feature of etiologically diverse disorders of the central nervous system, and a target indication for a growing number of symptomatic and disease modifying drugs. Remotely acquired digital endpoints have been recognized for their potential in providing frequent, real-time monitoring of cognition, but their ultimate value will be determined by the reliability and sensitivity of measurement in the populations of interest. To this end, we describe initial validation of remote self-administration of cognitive tests within a regulatorily compliant tablet-based platform. Participants were 61 older adults (age 55+), including 20 individuals with subjective cognitive decline (SCD). To allow comparison between remote (in-home) and site-based testing, participants completed 2 testing sessions 1 week apart. Results for three of four cognitive domains assessed demonstrated equivalence between remote and site-based tests, with high cross-modality ICCs (absolute agreement) for Symbol Coding (ICC = 0.75), Visuospatial Working Memory (ICC = 0.70) and Verbal Fluency (ICC > 0.73). Group differences in these domains were significant and reflected sensitivity to objective cognitive impairment in the SCD group for both remote and site-based testing (p < 0.05). In contrast, performance on tests of verbal episodic memory suggested inflated performance during unmonitored testing and indicate reliable use of remote cognitive assessments may depend on the construct, as well as the population being tested.

The structural brain network topology of episodic memory.

Episodic memory is supported by a distributed network of brain regions, and this complex network of regions does not operate in isolation. To date, neuroscience research in this area has typically focused on the activation levels in specific regions or pairwise connectivity between such regions. However, research has yet to investigate how the complex interactions of structural brain networks influence episodic memory abilities. We applied graph theory methods to diffusion-based anatomical networks in order to examine the structural architecture of the medial temporal lobe needed to support effective episodic memory functioning. We examined the relationship between performance on tests of verbal and non-verbal episodic memory with node strength, which indexes how well connected a brain region is in the network. Findings mapped onto the Posterior Medial memory system, subserved by the parahippocampal cortex and overlapped with findings of previous studies of episodic memory employing different methodologies. This expands our current understanding by providing independent evidence for the importance of identified regions and suggesting the particular manner in which these regions support episodic memory.

Acquisition and consolidation of verbal learning and episodic memory as predictors of the conversion from mild cognitive impairment to probable Alzheimer’s disease

ABSTRACT Verbal episodic memory tests assess memory performance using total learning scores. The analysis of inter-trial indices such as gained (GA) and lost (LA) access can provide additional information on the acquisition and consolidation processes. The main objetive was to determine whether the GA and LA indices, derived from a word-list verbal episodic memory test are useful for predicting cognitive impairment in aging. 60 older people aged was divided into 3 groups: cognitively healthy, stable Mild Cognitive Impairment (MCI) and MCI converting to probable Alzheimer's disease (MCI-conv). The results showed that GA and LA measures are independent from the traditional measures -total score of correct answers-. Logistic regression showed that these values are predictive of the conversion over time and could be a cognitive marker of conversion from MCI to AD. This suggests that the GA index, which shows acquisition processes in word-list tests, may be a marker of cognitive impairment.

Episodic and prospective memory difficulties in 13-year-old children born very preterm.

Children born very preterm (VP) are susceptible to a range of cognitive impairments, yet the effects of VP birth on long-term, episodic, and prospective memory remains unclear. This study examined episodic and prospective memory functioning in children born VP compared with their term-born counterparts at 13 years. VP (n = 81: born <30 weeks' gestation) and term (n = 26) groups were aged between 12 and 14 years. Children completed: (i) standardized verbal and visuospatial episodic memory tests; and (ii) an experimental time- and event-based prospective memory test that included short-term (within assessment session) and long-term (up to 1-week post-session) tasks. Parents completed a questionnaire assessing memory functions in everyday life. The VP group performed worse on all measures of verbal and visuospatial episodic memory than the term group. While there were no group differences in event-based or long-term prospective memory, the VP group performed worse on time-based and short-term prospective memory tasks than term-born counterparts. Parents of children born VP reported more everyday memory difficulties than parents of children born at term, with parent-ratings indicating significantly elevated rates of everyday memory challenges in children born VP. Children born VP warrant long-term surveillance, as challenges associated with VP birth include memory difficulties at 13 years. This study highlights the need for greater research and clinical attention into childhood functional memory outcomes.

Automatized FACEmemory\xae scoring is related to Alzheimer\u2019s disease phenotype and biomarkers in early-onset mild cognitive impairment: the BIOFACE cohort

BackgroundFACEmemory® is the first computerized, self-administered verbal episodic memory test with voice recognition. It can be conducted under minimal supervision and contains an automatic scoring system to avoid administrator errors. Moreover, it is suitable for discriminating between cognitively healthy and amnestic mild cognitive impairment (MCI) individuals, and it is associated with Alzheimer’s disease (AD) cerebrospinal fluid (CSF) biomarkers. This study aimed to determine whether FACEmemory scoring is related to performance on classical memory tests and to AD biomarkers of brain magnetic resonance imaging (MRI) and CSF in patients with early-onset MCI (EOMCI).MethodsNinety-four patients with EOMCI from the BIOFACE study completed FACEmemory, classical memory tests (the Spanish version of the Word Free and Cued Selective Reminding Test -FCSRT-, the Word List from the Wechsler Memory Scale, third edition, and the Spanish version of the Rey–Osterrieth Complex Figure Test), and a brain MRI. Eighty-two individuals also underwent a lumbar puncture.ResultsFACEmemory scoring was moderately correlated with FCSRT scoring. With regard to neuroimaging MRI results, worse execution on FACEmemory was associated with lower cortical volume in the right prefrontal and inferior parietal areas, along with the left temporal and associative occipital areas. Moreover, the total FACEmemory score correlated with CSF AD biomarkers (Aβ1-42/Aβ1-40 ratio, p181-tau, and Aβ1-42/p181-tau ratio). When performance on FACEmemory was compared among the ATN classification groups, significant differences between the AD group and normal and SNAP groups were found.ConclusionsFACEmemory is a promising tool for detecting memory deficits sensitive to early-onset AD, but it also allows the detection of memory-impaired cases due to other etiologies. Our findings suggest that FACEmemory scoring can detect the AD endophenotype and that it is also associated with AD-related changes in MRI and CSF in patients with EOMCI. The computerized FACEmemory tool might be an opportunity to facilitate early detection of MCI in younger people than 65, who have a growing interest in new technologies.

Associations between air pollution exposure and subtypes of cognitive performance in older women

AbstractBackgroundAir pollution exposure is a novel environmental risk factor in brain aging. It remains unclear whether long‐term exposure in older adulthood is associated with profiles of cognitive performance across multiple domains.MethodParticipants included 2,185 women (aged 66‐83 years) without dementia from the Women’s Health Initiative Study of Cognitive Aging. Baseline neuropsychological assessment included tests of verbal episodic memory (California Verbal Learning Test), figural memory (Benton’s Visual Recognition Test), language (letter and category fluency), attention (Digit Span Forward and Backwards), and visuospatial ability (Card Rotations Test). Testes were adjusted for demographic age, education, and race/ethnicity. Average annual levels of particulate matter of aerodynamic diameter&lt;2.5 (PM2.5) and nitrogen dioxide (NO2) were estimated at the participant’s residence using regionalized national universal kriging models and averaged over the 3‐year period before the baseline assessment. Latent class structural equation models (SEM) were constructed to identify latent classes of women who had similar patterns of performance across cognitive tests. After identifying the number of latent classes extract in the model, we constructed a second SEM to examine associations between air pollution exposure and latent class membership using multinomial regression while adjusting for demographic, lifestyle, and clinical confounders.ResultFive significant latent classes were identified (Figure 1): multidomain cognitive impairment (n=247; 11%), amnestic cognitive impairment (n=263; 12%), superior memory (n=407; 19%), superior attention (n=351; 16%), and average cognitive ability (n=917; 42%). Women living in locations with higher levels of PM2.5 (per interquartile range [IQR] = 3.63 μg/m3) or NO2 (per IQR = 10.33) were more likely to be classified as having amnestic cognitive impairment compared to having average cognitive ability (OR=1.27; p=.021). One IQR increase in NO2 was also associated with decreased likelihood of having superior memory (OR=.81; p=.024) compared to average cognitive ability.ConclusionOur cross‐sectional study illustrates that long‐term exposure to PM2.5 and NO2 may be associated with specific patterns of cognitive performance; mainly worse episodic memory relative to performance in other domains. Our findings provide further evidence that air pollution may exert neurotoxic effects on brain areas underlying episodic memory in older women.

A smartphone‐based self‐administered test of verbal episodic memory: Development and initial validation

AbstractBackgroundRemote, self‐administered assessment of cognitive impairment offers immense value to all those impacted by Alzheimer’s disease: patients, carers, healthcare professionals, researchers and pharmaceutical companies alike. The high cost, slow pace and inaccessibility of traditional methods for evaluating novel assessment tools maintains a chasm between innovation and real‐world impact. Focusing on user‐centered design development and technical feature optimisation, we present the next generation of a digitisation of the examiner‐administered Rey Auditory Verbal Learning Test (RAVLT) (Morrison et al., 2018; Mackin et al., 2017) as a smartphone‐based self‐administered test of verbal episodic memory.MethodA smartphone‐based version of RAVLT was developed, integrating artificial intelligence (AI), psychometric assessment principles and user‐centric design. Key risks to user acceptability were identified with moderated and unmoderated testing of the user interface (UI) in 11 users (aged 50+). AI speech‐recognition solutions implemented to replace traditional human components of RAVLT were tested for accuracy, via comparison to a human listener, in a real‐world environment (N = 13).ResultAll testers were able to complete the assessment without additional assistance, indicating high UI acceptability. Qualitative outcomes highlighted potential patient anxiety, insights which were used to iterate the UI design. AI solutions, when implemented alongside data‐driven adjustment features, achieved speech‐recognition accuracy of over 92%.ConclusionWe present extrapolatable principles for developers of remote assessment tools. Thorough inclusion of patients in the development process is essential to ensure that technical and clinical accuracy can be mirrored by optimal adherence and patient experience. Novel technical solutions required to adapt clinic‐based tests for remote use must be validated in ecologically appropriate environments. A fully remote validation study is underway to assess user acceptability and speech‐recognition accuracy at scale in people with subjective memory complaints (SMC). These methods and results hold promise for the continued development of effective at‐home digital tools for remote assessment and reduction of time‐to‐market for innovations in Alzheimer’s disease and beyond.

A comparative study of 18F‐FDG PET brain metabolism and cognitive performance between normal controls and amnestic Alzheimer’s disease patients

AbstractBackground18F‐fluorodeoxyglucose Positron Emission Tomography (18F‐FDG PET) allows the measurement of brain metabolism in vivo. In neurodegenerative diseases, hypometabolism´s topography patterns usually correlate with certain types of cognitive dysfunction. In the amnestic presentation of Alzheimer’s Disease (AD), the temporoparietal hypometabolism is the typical 18F‐FDG PET signature. However, much less is known about its spatial correlation with other cognitive manifestations typically seen in the clinical setting. Objectives: To compare the distribution of 18F‐FDG PET between Normal Controls (NC), patients with Mild Cognitive impairment due to AD (MCI‐AD), and patients with AD Dementia (ADD) and to analyze each cognitive test as a covariate.MethodCross‐sectional study, including 14 NC (13 PET‐PIB ‐, 1 PET‐PIB +), 25 MCI, and 28 ADD patients, (all PET‐PIB +) matched by age and education. Images were normalized to a template using non‐linear methods. The metabolic differences between the 3 groups were evaluated by a voxel‐wise analysis based on Statistical Parametric Mapping. Statistical models were applied using neuropsychological tests as covariates, and VOIS statistics were generated using the Boogle‐DKT atlas.ResultDifferences were observed between the groups analyzed in middle and inferior temporal, posterior parietal, posterior cingulate, and precuneus cortical regions, among other areas of interest (p &lt;0.005). Some of these areas correlated with a worse performance in verbal episodic memory tests (left temporoparietal regions), visuospatial tests (right parietal regions) and phonological fluency tests (left frontal and temporoparietal regions), among other results (p&lt;0.005).ConclusionIn this study, 18F‐FDG PET voxel‐wise analysis showed metabolic differences between the groups included, following the severity spectrum of each amnestic AD stage considered. Although these differences correlated with some cortical areas usually reported as the “AD metabolic signature”, some cortical regions were associated with cognitive functions that weren´t previously reported, allowing a better understanding of the cortical networks involved in the clinical manifestations of AD.

A grocery list learning and memory screening test: Initial performance data stratified by age and IQ

Patients frequently verbalize memory complaints that require evaluation. A brief objective screening test of short-term aka episodic memory would be useful. Assessment of verbal episodic memory is a central factor in neurocognitive status, frequently evaluated with list learning and memory tests. Currently, normed list learning tests of verbal episodic memory are mostly high demand, long, and composed of unrelated items and thus can be onerous and disinteresting for certain populations, such as those who are cognitively limited, elderly, or poorly motivated. Presented here are initial performance data for a brief, low demand, readily accepted nine-item grocery list test, derived from the Dementia Assessment Battery, including three learning trials and one delayed recall trial. With this data set, the test can thus be useful in a wide range of assessment circumstances including screening, brief evaluations, mental status evaluations, and bedside deployment.

Can Cochlear Implantation in Older Adults Reverse Cognitive Decline Due to Hearing Loss?

Older adults with late-onset hearing loss are at risk for cognitive decline. Our study addresses the question of whether cochlear implantation (CI) can counteract this potential influence. We investigated whether cognitive performance in older adults with severe and profound hearing loss improves 12 months after CI to a level comparable to controls with normal hearing, matched for age, sex, and education level. This cohort study was performed at two tertiary referral centers. The study included 29 patients, of age between 60 and 80 years, with adult-onset, severe to profound bilateral sensorineural hearing loss and indication for CI (study group), as well as 29 volunteers with age-adjusted hearing abilities, according to the norm curves of ISO-702 9:2000-01, (control group). Before CI and 12 months after CI, participants completed a neurocognitive test battery including tests of global cognition, verbal and figural episodic memory, and executive functions (attentional control, inhibition, and cognitive flexibility). Twelve months after CI, the performance of the study group improved significantly in global cognition, compared to the situation before CI. Differences in verbal episodic memory, figural episodic memory, and executive function were not significant. Moreover, the improvement of the study group was significantly larger only in global cognition compared to the control group. Noninferiority tests on the cognitive performances of the study group after CI revealed that comparable levels to normal hearing controls were reached only in global cognition, figural episodic memory (immediate recall), and attentional control. The improvement in global cognition was significantly associated with speech recognition 3 months after CI, but not with speech recognition 12 months after CI. One year after CI, cognitive deficits in older individuals with adult-onset hearing loss, compared to normal-hearing peers, could only improve some cognitive skills.

Word Meaning Contributes to Free Recall Performance in Supraspan Verbal List-Learning Tests.

Supraspan verbal list-learning tests, such as the Rey Auditory Verbal Learning Test (RAVLT), are classic neuropsychological tests for assessing verbal memory. In this study, we investigated the impact of the meaning of the words to be learned on three memory stages [short-term recall (STR), learning, and delayed recall (DR)] in a cohort of 447 healthy adults. First, we compared scores obtained from the RAVLT (word condition) to those of an alternative version of this test using phonologically similar but meaningless items (pseudoword condition) and observed how each score varied as a function of age and sex. Then, we collected the participants’ self-reported strategies to retain the word and pseudoword lists and examined if these strategies mediated the age and sex effects on memory scores. The word condition resulted in higher memory scores than pseudoword condition at each memory stage and even canceled out, for the learning stage, the detrimental effect of age that was observed for the short-term and DR. When taking sex into account, the word advantage was observed only in women for STR. The self-reported strategies, which were similar for words and pseudowords, were based on the position of the item on the list (word: 53%, pseudoword: 37%) or the meaning of the item (word: 64%, pseudoword: 58%) and were used alone or in combination. The best memory performance was associated with the meaning strategy in the word condition and with the combination of the meaning and position strategies in the pseudoword condition. Finally, we found that the word advantage observed in women for STR was mediated by the use of the meaning strategy. The RAVLT scores were thus highly dependent on word meaning, notably because it allowed efficient semantic knowledge-based strategies. Within the framework of Tulving’s declarative memory model, these results are at odds with the depiction of the RAVLT as a verbal episodic memory test as it is increasingly referred to in the literature.

Neuropsychological findings related to the presence of pre-surgical comorbid depression in Latin-American patients with mesial temporal lobe epilepsy and hippocampal sclerosis

PurposeTo evaluate the neuropsychological findings related to the presence of pre-surgical comorbid depression in Latin-American patients with mesial temporal lobe epilepsy (MTLE) and unilateral hippocampal sclerosis (HS). MethodPatients with drug-resistant MTLE and unilateral, left (L-) or right (R-) HS were studied. To diagnose depression, psychiatrists with expertise in epilepsy applied a semi-structured interview based on DSM. The depression group (DG) included patients with a psychiatric diagnosis in addition to a Beck Depression Inventory (BDI) score >16 points, and the non-depression group (NDG) included those without this diagnosis and with a BDI score ≤16. We analysed two clusters of neuropsychological tests, which evaluated memory (Complex Rey Figure III, Logical Memory II and RAVLT VII) and attention plus executive functions (Stroop I/II/III and Trail Making A/B). Moreover, we calculated the z-scores (Zs) using a local control group. The DG was compared to the NDG, independently and according to the HS side, using non-parametrical analyses. Due to the multivariate analysis, the p-value was corrected by applyingpost hoc Bonferroni adjustment. ResultsWe analysed 65 patients. The NDG included 51 (78.4 %) patients, and the DG included 14 (21.5 %) patients. Pre-surgical comorbid depression occurred in eight patients with L- (n = 29) and in six patients with R-MTLE-HS (n = 36). All of these groups had similar gender, age, IQs, and years of schooling. Compared to the healthy subjects, the L-MTLE-HS patients had lower Zs in verbal episodic memory tests [Logical Memory II (p < 0.001), and RAVLT VII (p < 0.001)], and the R-MTLE-HS patients had lower scores in visual episodic memory [Complex Rey Figure III (p < 0.001)]. In the analysis of the DGvs. NDG, there were no differences in the clusters of tests of memory or in those of attention and executive functions. Moreover, when we analysed the patients according to HS side, no neuropsychological difference was observed in the DG and NDG in terms of L- and R-MTLE-HS. ConclusionsThe patients with MTLE and unilateral HS in this study showed no differences in memory, attention and executive functions in relation to the presence of pre-surgical comorbid depression and independently of HS side. In this series from Latin-America, this psychiatric comorbidity did not affect cognition more than epilepsy alone.