Measures Of Verbal Fluency Research Articles

How does cognitive reserve impact on the relationships between mood, rumination, and cognitive function in later life?

Objectives: Higher levels of cognitive reserve (CR) are associated with better cognitive function in later life. In contrast, depressive symptoms, anxiety, and rumination are associated with diminished cognitive function. There has been limited research to date examining the influence of CR on the relationship between mood and cognitive function, and results are inconsistent. The aim of this study was to investigate the role CR plays in the relationships between mood, rumination, and cognitive function in later life.Method: Two hundred and thirty-six healthy people aged 60+ completed measures of CR, depression, anxiety, rumination, recall, and verbal fluency. Participants were dichotomised at the median into those with lower and higher levels of CR.Results: CR, mood, and rumination together accounted for between 13% and 15.6% of the variance in scores on the cognitive tasks in the sample as a whole. Mood and rumination explained a significant amount of variance in cognitive test scores in those with lower levels of CR, but not in those with higher levels of CR.Conclusion: The way in which mood and rumination are related to cognitive function differs depending on the individual's level of CR. These results support the view that it is important to continue to build on CR as people move into later life in order to maintain cognitive health.

The Effect of Concussion on Verbal Fluency and Verbal Learning and Memory in Youth Hockey Players

1) To explore trends in athlete-specific baseline data for measures of verbal fluency (VF) and verbal learning and memory (VLM); 2) To investigate the effects of age, gender and concussion history on VF and VLM in youth hockey players.

A-69 * Neuropsychological Change in Normal Pressure Hydrocephalus following Lumbar Drain

Objective: Ventriculoperitoneal (VP) shunting is a common procedure for treatment of idiopathic normal pressure hydrocephalus (NPH). As part of the workup for NPH, an external lumbar drain is commonly performed, with patients undergoing pre- and post-lumbar drain assessment of their symptoms. Neuropsychological assessment is often used to assist in the determination of candidates who might benefit from VP shunting. The present study was conducted to assess the cognitive effects of external lumbar drain (ELD) in a sample of patients with a clinical diagnosis of NPH who later received a VP shunt. Method: 44 participants were administered the Mini Mental State Exam (MMSE), Trail Making Test, Letter Fluency, Category Fluency, Hopkins Verbal Learning Test – Revised (HVLT-R), and Digit Span Forward and Backward. Assessments were conducted pre- and 72–96 hours post-ELD to determine the percent change in test-retest scores. Results: Subjects showed an improvement of >10% on both verbal fluency measures and a decrease of >10% on HVLT-R delay following ELD. Age effects were seen on Trails A, Category Fluency, and HVLT-R delay, with younger participants showing greater improvements than older subjects on Category fluency and HVLT-R delay. Conclusion(s): Measures of verbal fluency and delayed recall showed greatest sensitivity to ELD in participants with a clinical diagnosis of NPH. These results may have implications for the selection of NPH patients who might benefit from receiving a VP shunt. However, more research is needed to determine optimal cognitive test procedures for selecting appropriate candidates for VP shunting.

Cognitive dysfunction in postural tachycardia syndrome.

Mental clouding is an almost universal complaint among patients with postural tachycardia syndrome (POTS) but remains poorly understood. Thus, we have determined whether POTS patients exhibit deficits during neuropsychological testing relative to healthy subjects. A comprehensive battery of validated neuropsychological tests was administered to 28 female POTS patients and 24 healthy subjects in a semi-recumbent position. Healthy subjects were matched to POTS patients on age and gender. Selective attention, a primary outcome measure, and cognitive processing speed were reduced in POTS patients compared with healthy subjects (Ruff 2&7 Speed t-score: 40±9 compared with 49±8; P=0.009; Symbol Digit Modalities Test t-score: 45±12 compared with 51±8; P=0.011). Measures of executive function were also lower in POTS patients (Trails B t-score: 46±8 compared with 52±8; P=0.007; Stroop Word Color t-score: 45±10 compared with 56±8; P=0.001), suggesting difficulties in tracking and mental flexibility. Measures of sustained attention, psychomotor speed, memory function or verbal fluency were not significantly different between groups. The present study provides evidence for deficits in selective attention and cognitive processing in patients with POTS, in the seated position when orthostatic stress is minimized. In contrast, other measures of cognitive function, including memory assessments, were not impaired in these patients, suggesting selectivity in these deficits. These findings provide new insight into the profile of cognitive dysfunction in POTS and provide the basis for further studies to identify clinical strategies to better manage the mental clouding associated with this condition.

Embedded Measures of Performance Validity Using Verbal Fluency Tests in a Clinical Sample

The objective of this study was to determine to what extent verbal fluency measures can be used as performance validity indicators during neuropsychological evaluation. Participants were clinically referred for neuropsychological evaluation in an urban-based Veteran's Affairs hospital. Participants were placed into 2 groups based on their objectively evaluated effort on performance validity tests (PVTs). Individuals who exhibited credible performance (n = 431) failed 0 PVTs, and those with poor effort (n = 192) failed 2 or more PVTs. All participants completed the Controlled Oral Word Association Test (COWAT) and Animals verbal fluency measures. We evaluated how well verbal fluency scores could discriminate between the 2 groups. Raw scores and T scores for Animals discriminated between the credible performance and poor-effort groups with 90% specificity and greater than 40% sensitivity. COWAT scores had lower sensitivity for detecting poor effort. A combination of FAS and Animals scores into logistic regression models yielded acceptable group classification, with 90% specificity and greater than 44% sensitivity. Verbal fluency measures can yield adequate detection of poor effort during neuropsychological evaluation. We provide suggested cut points and logistic regression models for predicting the probability of poor effort in our clinical setting and offer suggested cutoff scores to optimize sensitivity and specificity.

Behavioral and neural correlates of executive functioning in musicians and non-musicians.

Executive functions (EF) are cognitive capacities that allow for planned, controlled behavior and strongly correlate with academic abilities. Several extracurricular activities have been shown to improve EF, however, the relationship between musical training and EF remains unclear due to methodological limitations in previous studies. To explore this further, two experiments were performed; one with 30 adults with and without musical training and one with 27 musically trained and untrained children (matched for general cognitive abilities and socioeconomic variables) with a standardized EF battery. Furthermore, the neural correlates of EF skills in musically trained and untrained children were investigated using fMRI. Adult musicians compared to non-musicians showed enhanced performance on measures of cognitive flexibility, working memory, and verbal fluency. Musically trained children showed enhanced performance on measures of verbal fluency and processing speed, and significantly greater activation in pre-SMA/SMA and right VLPFC during rule representation and task-switching compared to musically untrained children. Overall, musicians show enhanced performance on several constructs of EF, and musically trained children further show heightened brain activation in traditional EF regions during task-switching. These results support the working hypothesis that musical training may promote the development and maintenance of certain EF skills, which could mediate the previously reported links between musical training and enhanced cognitive skills and academic achievement.

The American Heart Association Life's Simple 7 and Incident Cognitive Impairment: The REasons for Geographic And Racial Differences in Stroke (REGARDS) Study

BackgroundLife's Simple 7 is a new metric based on modifiable health behaviors and factors that the American Heart Association uses to promote improvements to cardiovascular health (CVH). We hypothesized that better Life's Simple 7 scores are associated with lower incidence of cognitive impairment.Methods and ResultsFor this prospective cohort study, we included REasons for Geographic And Racial Differences in Stroke (REGARDS) participants aged 45+ who had normal global cognitive status at baseline and no history of stroke (N=17 761). We calculated baseline Life's Simple 7 score (range, 0 to 14) based on smoking, diet, physical activity, body mass index, blood pressure, total cholesterol, and fasting glucose. We identified incident cognitive impairment using a 3‐test measure of verbal learning, memory, and fluency obtained a mean of 4 years after baseline. Relative to the lowest tertile of Life's Simple 7 score (0 to 6 points), odds ratios of incident cognitive impairment were 0.65 (0.52, 0.81) in the middle tertile (7 to 8 points) and 0.63 (0.51, 0.79) in the highest tertile (9 to 14 points). The association was similar in blacks and whites, as well as outside and within the Southeastern stroke belt region of the United States.ConclusionsCompared with low CVH, intermediate and high CVH were both associated with substantially lower incidence of cognitive impairment. We did not observe a dose‐response pattern; people with intermediate and high levels of CVH had similar incidence of cognitive impairment. This suggests that even when high CVH is not achieved, intermediate levels of CVH are preferable to low CVH.

How do memory and attention change with pregnancy and childbirth? A controlled longitudinal examination of neuropsychological functioning in pregnant and postpartum women

Current literature on cognitive functioning in pregnancy and postpartum is mixed, with most research showing deficits in memory and attention during pregnancy or no difference between pregnant participants and controls with little emphasis on the postpartum period. In the current study, we used a longitudinal controlled design and 42 primarily not depressed participants to compare pregnant women in the third trimester and approximately three months postpartum with matched controls over the same time period on neuropsychological domains including memory, attention, learning, visuospatial, and executive functioning. We also evaluated the role of mood and quality of life as potential moderators of cognitive functioning in pregnancy/postpartum. Results indicated no differences between controls and pregnant/postpartum women on neuropsychological measures at any time points. Self-reported memory difficulties, however, were higher in the pregnant/postpartum women. Pregnant and postpartum women had worse self-reported mood and quality of life than controls. Mood and quality of life slightly moderated specific measures of attention and verbal fluency; however, neither mood nor quality of life moderated overall neuropsychological functioning in either group. Number of previous pregnancies had no effect on the study findings. Results suggest differences in subjective memory complaints, but no differences in objective neuropsychological test results between controls and pregnant/postpartum women who are primarily not diagnosed with depression.

Patterns of Cognitive Performance in Subcortical Ischemic Vascular Disease (SIVD)

Subcortical ischemic vascular disease (SIVD) is characterized by extensive white-matter lesions and lacunar infarcts in deep gray matter. The aim of this study was to investigate patterns of cognitive impairment in patients with SIVD. In a retrospective analysis, the authors compared the cognitive performance of 58 patients meeting MRI-defined criteria for SIVD (26 women; 47.3%) with age- and gender-matched control subjects. SIVD patients showed impairments in measures of verbal fluency, verbal memory, speed of cognitive processing, and divided attention. There were no significant differences in constructional praxis, figurative memory, verbal recognition memory, or semantic processing.

Transcranial Direct Current Stimulation (tDCS): Modulation of Executive Function in Health and Disease

Transcranial direct current stimulation (tDCS) is a noninvasive method of neuromodulation used in human basic and clinical neuroscience. In this article we review its use in the cognitive neurosciences to study executive function, and current preliminary explorations of its therapeutic value as a cognitive enhancer for patients with compromised dysexecutive symptoms. We discuss published studies analyzing their methodology and results. A number of experiments describe improvement in experimental measures of inhibitory control, working memory, and verbal fluency with anodal stimulation over the dorsolateral prefrontal cortex. Positive findings are also described in different clinical populations. Despite the growing promise and interest in tDCS given its safety, simplicity, and low cost, findings are not always consistent across studies due to a host of variables we discuss (study design, stimulation parameters, neuroanatomy, genetics, etc.), highlighting the need for a better mechanistic understanding of the effects of tDCS.

Evaluation of a virtual reality prospective memory task for use with individuals with severe traumatic brain injury

The current study aimed to evaluate the sensitivity, convergent validity and ecological validity of a newly developed virtual reality prospective memory (PM) task (i.e., the Virtual Reality Shopping Task; VRST) for use with individuals with traumatic brain injury (TBI). Thirty individuals with severe TBI and 24 uninjured adults matched on age, gender and education level were administered the VRST, a lexical decision PM task (LDPMT), an index of task-friendliness and a cognitive assessment battery. Significant others rated disruptions in the TBI participants' occupational activities, interpersonal relationships and independent living skills. The performance of the TBI group was significantly poorer than that of controls on event-based PM as measured by the LDPMT, and on time- and event-based PM as measured by the VRST. Performance on the VRST significantly predicted significant others' ratings of patients' occupational activities and independent living skills. The VRST was rated as significantly more reflective of an everyday activity, interesting and was afforded a higher recommendation than the LDPMT. For the TBI group, event and total PM performance on the VRST significantly correlated with performance on measures of mental flexibility and verbal fluency, and total PM performance correlated with verbal memory. These results provide preliminary but promising evidence of the sensitivity, as well as the convergent and ecological validity of the VRST.

Spin Exercise Improves Semantic Fluency in Previously Sedentary Older Adults

Studies suggest improvements of neurocognitive function among older adults who undergo aerobic exercise training. This study sought to examine the impact of an aerobic exercise intervention on verbal fluency in sedentary older adults. Twenty community-dwelling older adults were recruited and enrolled in either a spin exercise group or a control condition. Participants were evaluated with an estimated V02max test and on measures of letter, category, and switching verbal fluency both before and after a 12-week intervention period. Spin exercise resulted in a significant improvement in category (semantic) verbal fluency when compared with the control group (15% vs. 2% increase, respectively; P = .001). Spin exercise also resulted in a significant improvement in estimated V02max (P = .005). Also important, the spin exercise group demonstrated a high level of adherence (mean adherence = 82.5%). Spin exercise can be an effective mode of aerobic exercise to improve semantic fluency in previously sedentary older adults.

Parents of Children with Dyslexia: Cognitive, Emotional and Behavioural Profile

Within a dimensional view of reading disorders, it is important to understand the role of environmental factors in determining individual differences in literacy outcome. In the present study, we compared a group of 40 parents of children with dyslexia (PDys) with a group of 40 parents of typically developing children. The two parent groups did not differ in socioeconomic status or nonverbal IQ. Participants were assessed on cognitive (IQ, digit span) and literacy (reading fluency and accuracy) tasks, phonological awareness and verbal fluency measures. Questionnaires addressed reading history, parental distress, family functioning, anxiety and depression. The PDys group performed worse in all literacy measures and more frequently reported a history of poor reading; they also showed more parental distress. There were no differences between the two groups in depression or family functioning and no differences between mothers and fathers. Findings indicate that PDys show a cognitive profile consistent with the broader phenotype of dyslexia (i.e. reading impairment and poor phonological awareness), whereas, considering the emotional profile, the impact of dyslexia on the family system is limited to parental distress associated with the perception of having a child with specific needs.

Age as a Predictor of Cognitive Decline in Bipolar Disorder

Cognitive dysfunction is a core feature of bipolar disorder (BD) in both adult and geriatric patients. However, little is known about whether cognitive functioning declines at a faster rate in patients with BD, and there are conflicting reports regarding the relationship between age and cognitive functioning in this population. This cross-sectional study examined the relationship between age and cognitive functioning in patients with BD. Patients with BD I (N= 113) and healthy adults (N= 64) ages 18-87 completed measures of processing speed, attention, executive functioning, verbal fluency, and clinical symptomatology. Groupwise comparisons were used to examine differences between patients and the comparison group and adult and geriatric BD cohorts. A series of linear regressions was conducted to examine the relationship of age and cognitive functioning and clinical variables and cognition. Patients performed significantly worse than the comparison group on all neuropsychological measures. Age was a significant predictor of Trails A scores with older age associated with worse performance. Older age was associated with poorer performance on Trails A in patients with BD but not healthy adults. These results are suggestive of greater dysfunction in processing speed with older age in patients with BD compared with a healthy comparison group. Because cognitive functioning is associated with community outcomes, these findings suggest a need for treatments targeting cognitive symptoms across the life span. Future research exploring neurobiologic evidence for neurodegenerative processes in BD will pave the way for potential therapeutic interventions.

Neuropsychological measures of declarative memory and verbal fluency predict clinical response to cognitive behavioral treatment in patients with unipolar depression

Neuropsychological measures of declarative memory and verbal fluency predict clinical response to cognitive behavioral treatment in patients with unipolar depression

Clinical Utility of Auditory Memory Testing in a Heart Failure Population

The self-care regimen necessary in heart failure (HF) is notably complex. A complication to integrating new knowledge and behaviors is that impaired cognition has been frequently reported in patients with HF, which significantly impacts patients' health, admission and mortality rates, and instrumental activities of daily living. The identification of reliable cognitive screening tools to assess potential difficulties in performing self-care for cardiac populations is essential. As such, the current purposes were to evaluate the validity and stability of the International Shopping List (ISL) auditory learning subtest from the computerized CogState battery as a screening tool in HF populations, determine the ISL's ability to predict functional declines, and evaluate the task's sensitivity in myocardial infarction. Forty patients with chronic HF were enrolled in a longitudinal study evaluating the impact of a cognitive training intervention. Baseline neuropsychological and behavioral measurements before treatment were used in the current study, including measures of auditory memory, orientation, verbal fluency, processing speed, and activities of daily living, and a subset of patients (n = 17) received repeat testing at 8 weeks on some tasks. Analyses also were performed with patients organized based on myocardial infarction status. The current study indicated that the ISL performed comparably with an established measure of auditory memory (Hopkins Verbal Learning Test-Revised; r = 0.70, P < .001), displayed adequate coefficients of stability (r = 0.53-0.68), and successfully predicted declines over time in daily functioning (β = .47, P < .001) in our HF sample. The computerized CogState auditory memory subtest, the ISL, seems to be a beneficial tool in evaluating cognitive change in HF patients. Particularly given its cross-cultural sensitivity and ease of administration and scoring, this task may provide assistance to quickly and reliably monitor memory functioning in these vulnerable patients and gauge their potential for self-care behaviors.

Establishment of a Phonemic Clustering System for American Sign Language

Executive functioning, the self-regulatory or control system that governs all cognitive, behavioral, and emotional activity, may be measured by means of a variety of psychological and neuropsychological tests, including tests of verbal fluency. A subset of these tasks, phonemic fluency, requires a person to generate words based on a letter cue (e.g., words that begin with the letter f ). However, such tests are designed for users of spoken language. This article reports on the use of a measure of verbal fluency for American Sign Language (ASL) for which, in addition to the traditional score based on the total number of words produced during the task, an analysis of ASL-based “clusters” (related signs produced in succession) and “switches” (transitions from one cluster to another) was developed. Previous research with standard verbal fluency tasks has suggested that cluster and switching analysis reflects mental flexibility and cognitive search skills. A system for analyzing phonemic clusters in ASL is described, and its application is demonstrated using a case example.

COGNITIVE IMPAIRMENTS IN ALS RELATE TO WHITE MATTER INTEGRITY IN SPECIFIC REGIONS OF INTEREST

ObjectiveCognitive impairment in amyotrophic lateral sclerosis is characterized primarily by deficits in executive functioning, and structural and functional imaging studies have revealed changes in extra-motor areas which are consistent with...

Spoken expository discourse of children and adolescents: Retelling versus generation

This cross-sectional study investigated the spoken expository discourse skills of children and adolescents elicited in generation and retelling conditions. There were three groups of participants: young school-age children (M = 7.0 years; n = 64); intermediate-school-age children (M = 11.3 years; n = 18) and high-school-age students (M = 17.6 years; n = 18). Participants were asked to generate expository discourse using the favourite game or sport (FGS) task and to retell an expository passage about the game of curling. All samples were transcribed and analysed on measures of verbal productivity (number of utterances), syntactic complexity (mean length of utterance in T-units [MLU] and clausal density) and verbal fluency (percent maze words). Results indicated that although all age groups produced longer samples in the generation condition, MLU was significantly longer in the retelling condition. The results suggest that the expository retelling task may be a clinically useful addition to a language assessment battery for children and adolescents.

Verbal fluency deficits in clinically isolated syndrome suggestive of multiple sclerosis

BackgroundLittle is known about relationships between Cognitive Impairment (CI) and verbal fluency measures in patients with a Clinically Isolated Syndrome (CIS) suggestive of Multiple Sclerosis. The aim of this study was to assess the extent of verbal fluency deficits and their predictive value for the presence of a CI in a population of CIS patients. MethodsCI was detected by the Rao's Brief Repeatable Battery (BRB) and the Stroop Test (ST) in 100 CIS patients. The BRB includes the Word List Generation (WLG) test for semantic verbal fluency. The FAS test was used to investigate phonemic verbal fluency. CI was defined as the failure in at least 3 tests on BRB (without WLG to exclude criterion contamination bias) and ST. ResultsEleven patients failed in at least 3 of the BRB tests and were classified as cognitively impaired. The comparison of Receiver Operating Characteristic curves showed that the Area Under the Curve (AUC) of the WLG was not significantly different from the AUC of the FAS (0.787 vs 0.755; p=N.S.). A cut-off <17 words for the WLG achieved 64% of sensitivity and a 79% of specificity, and a cut-off <28 words achieved 82% of sensitivity and a 66% of specificity in discriminating patients with CI. ConclusionsVerbal fluency deficits occur early in the disease course and may predict the presence of CI in CIS patients.