Verbal Learning Test Research Articles

The bridge between cognition and behavior in acquired brain injury: A graph theoretical approach.

BackgroundThe assumption is that executive dysfunctions (EF), associated with frontal lobe injury, are responsible for behavioral disturbances. Some studies do not find a relationship between EF and behavior following frontal lobe lesions. Our main goal of this study was to use a novel statistical method, graph theory, to analyze this relationship in different brain injury groups; frontal lobe damage, non‐frontal lobe damage, and controls. Within the frontal group, we expect to find a pattern of executive nodes that are highly interconnected.MethodsFor each group, we modeled the relationship between executive functions and behavior as a network of interdependent variables. The cognitive tests and the behavioral questionnaire are the “nodes” in the network, while the relationships between the nodes were modeled as the correlations between two nodes corrected for the correlation with all other nodes in the network. Sparse networks were estimated within each group using graphical LASSO. We analyzed the relative importance of the nodes within a network (centrality) and the clustering (modularity) of the different nodes.ResultsNetwork analysis showed distinct patterns of relationships between EF and behavior in the three subgroups. The performance on the verbal learning test is the most central node in all the networks. In the frontal group, verbal memory forms a community with working memory and fluency. The behavioral nodes do not differentiate between groups or form clusters with cognitive nodes. No other communities were found for cognitive and behavioral nodes.ConclusionThe cognitive phenotype of the frontal lobe damaged group, with its stability and proportion, might be theoretically interpreted as a potential “buffer” for possible cognitive executive deficits. This might explain some of the ambiguity found in the literature. This alternative approach on cognitive test scores provides a different and possibly complimentary perspective of the neuropsychology of brain‐injured patients.

Standardized Lycium chinense fruit extract enhances attention and cognitive function in healthy young people by a double-blind, randomized, placebo-controlled, crossover trial.

Background:Lycium chinense fruit (LCF) is widely distributed in East Asia that has been used traditionally for antiaging purposes. This study was performed to examine the effects of LCF on attention and cognitive function in healthy young people.Materials and Methods:An 11-week, double-blind, randomized, placebo-controlled, crossover trial of 74 patients was conducted and its data were collected on Kyung-Hee University Korean Medical Hospital, Seoul, Korea. In crossover treatment, LCF or placebo was administered three times a day, total 3600 mg as two capsules of 600 mg once for 4 weeks with 3-week washout each. The computerized neurocognitive function test (CNT), the Korean version of the attention-deficit/hyperactivity disorder rating scale-IV, the clinical global impression rating scale, and the Frankfurt attention inventory (FAIR) for two groups were conducted 0 week before and 4 week, 11 week after the experiment, and significant mean changes of these tests for within group or two groups were measured by paired t-test or unpaired t-test.Results:The administration of LCF or placebo crossover for 8 weeks in healthy young people presented significant improvement in the verbal learning test, digit span forward test, digit span backward test, auditory continuous performance task of CNT, and FAIR-performance value compared with the placebo group (each group n = 43, P < 0.05).Conclusion:Thus, the consumption of LCF might be beneficial to increase learning and memory through attention and cognitive enhancing effect in normal young people, at an average age of 18 years of age.

Neurocognitive dysfunction in adult cerebellar medulloblastoma.

Impaired neurocognitive function (NCF) is a well-established consequence of pediatric medulloblastoma (MB) and its treatments. However, the frequency and features of neurocognitive dysfunction in adult-onset MB patients are largely unknown. Adult patients (≥ 18years) with MB who had received formal neurocognitive evaluation (N=27) were identified. Demographic, medical, and treatment histories were extracted from the medical record. Lesion properties on MRI were analyzed and used to evaluate lesion-symptom mapping further. Demographically adjusted z-scores were calculated for each neurocognitive test and used to assess impairment frequency. Regression analyses were conducted to identify clinical and paraclinical factors associated with impaired NCF. Mean age of the patient sample was 33years (SD=11) at the time of MB diagnosis. Prior therapy included surgical resection (89%), radiation (70%), and chemotherapy (26%). A significant proportion of patients were impaired on tests of verbal learning and memory (32%), executive function (29%), and naming (18%). Age, education, lesion size, time from surgery, and number of chemotherapy cycles had the greatest contribution to test performance in random-forest regression models. This study identifies frequent impairment of NCF in adult patients with MB, particularly in the domains of learning and memory and executive function. Neurocognitive impairment is influenced by patients' demographic, disease, and treatment history. Further study is warranted to characterize the clinical impact of adult MB more fully.

Modified Criteria for Diagnosing “Cognitive Frailty”

The concept of cognitive frailty has recently been proposed by an International Consensus Group as the presence of physical frailty and cognitive impairment [defined using the Clinical Dementia Ratings (CDR)=0.5], without concurrent dementia. However, CDR is difficult to implement and not often available in epidemiologic studies or busy clinical settings, and an alternative to CDR is required. We suggest an alternative definition of cognitive frailty as: 1) physical frailty, 2) more than 1.5 standard deviation below the mean for age-, gender-, and education-adjusted norms on any cognitive function test (e.g., the Montreal Cognitive assessment test, the Alzheimer’s disease assessment scale-cognitive subscale, verbal learning test, Digit Span, Boston Naming Test, Trail Making Test, and Frontal Assessment Battery), and 3) no dependency in instrumental activities of daily living. The redefined criteria for cognitive frailty would be more feasible to implement and thus more applicable in epidemiologic studies and busy clinical settings.

Sex differences across age in cognitive tests in the Rhineland study

Introduction Neurodegeneration and memory decline are of growing concern due to population aging. It is well known that both age and educational history impact cognitive function. Furthermore, a growing body of evidence suggests that biological sex may also play a role. Various studies have reported that women tend to outperform men in episodic memory tasks, whereas men tend to outperform women in numerical working memory tasks. However, sex differences are less clear for tests that measure executive function or processing speed, with previous work reporting either no sex differences or a marginally better performance of men. Spatial working memory and premorbid IQ seem not to be influenced by sex. Only limited and inconclusive data exist as to whether the associations of sex and cognition change with aging. We aimed to examine the effects of sex over a wide adult age range and across different cognitive domains in a population-based cohort. Methods The study is based on cross-sectional data from the first 1306 participants of the Rhineland Study. The Rhineland Study is a population-based cohort study that includes participants from the age of 30, living in and around the city of Bonn. We excluded participants > 90 years of age (n = 4) which left n = 1302 to be included in the current analyses. In addition to advanced biological phenotyping, the study protocol includes a cognitive test battery. Episodic memory was assessed using the Verbal Learning and Memory Test (VLMT) immediate and delayed recall, working memory through the Corsi block-tapping test (forward and backward) and the digit span test (forward and backward), processing speed and executive function through the trail-making test A and B (TMT-A, TMT-B), and crystallized intelligence (as a measure of premorbid IQ) through a multiple choice vocabulary test (MWT-B). We performed multi-factor analysis of variance on whether sex or age (in 10-year age groups: 30–39, 40–49, 50–59, 60–69, 70–79, 80–89) were associated with cognitive test performance (z-standardized), either independently or through interaction. All analyses were adjusted for educational attainment. We corrected for multiple testing using the Holm-Bonferroni method. Tukey's test was administered post-hoc to assess the direction of group differences. Results Mean age in our sample was 56 years (SD = 14 years) and 56% were women. Age group was significantly associated with performance for all tests. Compared to younger participants older participants performed better in crystalline intelligence, but worse on all other tests. Men performed significantly better than women on tests of executive function (TMT-B: Mdiff = −0.17; 95% CI: −0.26, −0.08) and working memory (Corsi: forward Mdiff = 0.28; 95% CI: 0.17, 0.38; backward Mdiff = 0.23; 95% CI: 0.12, 0.33; digit span: forward Mdiff = 0.20; 95%CI 0.10, 0.31; backward Mdiff = 0.16; 95%CI 0.05, 0.26). On the other hand, women performed significantly better than men on the episodic memory test (VLMT: immediate Mdiff = 0.45; 95% CI: 0.36, 0.54; delayed Mdiff = 0.42; 95% CI: 0.33, 0.52). We observed no interaction between age and sex across all tests, indicating no sex differences in how cognitive performance changes over the adult age range. Conclusion Our results confirm previously observed sex differences in episodic memory (women outperform) and working memory tasks (men outperform). We also found suggestive evidence for men outperforming women in measures of executive function. Notably, we found no evidence for any variations in these associations across the adult lifespan.

Blood Metals and Cognitive Function in Chinese Workers

Background/Aim: The relationship of co-exposure to manganese, aluminum, and copper on neurotoxicity is still unclear. Therefore, our aim was to determine the association of these metals with learning and memory. Methods: We completed a cross-sectional study of 60 Chinese male workers from a ferroalloy or manufacturing factory. Whole blood samples were analyzed for metals using inductively coupled plasma-mass spectrometry. Animal naming, fruit naming, and WHO/UCLA-Auditory Verbal Learning Tests (AVLT) assessed learning and memory. Additional information was obtained via questionnaire. Linear regression models were constructed for each metal with each test, adjusting for age, education, smoking, and alcohol use; a final model included all three metals. Blood lead was assessed, but was not associated with any cognitive tests. Results: Geometric mean blood manganese was 14.0 µg/L (95% confidence interval (CI): 13.0, 15.0), aluminum was 306.1 µg/L (286.2, 327.5), and mean copper was 78.6 µg/dL (76.4, 80.7). Ferroalloy factory workers had significantly higher blood aluminum and manganese, but not higher copper, compared to manufacturing workers. In adjusted models, manganese was significantly associated with poorer AVLT first 5 trial average (β=-1.93; 95% CI: -3.82, -0.03), but was not significant after adjustment for other metals (β=-1.27; -3.10, 0.55). There was a similar pattern for aluminum with AVLT. Aluminum was significantly associated with improved performance on the fruit naming test in adjusted models including manganese, and copper. In models adjusting for covariates, manganese and aluminum, an increase in copper was associated with significantly poorer performance on animal naming (β=-0.238; -0.377, -0.099) and AVLT (β=-0.070; -0.128, -0.013). There was a non-significant association for copper with fruit naming (β=-0.102; -0.207, 0.003). Conclusions: Blood copper was consistently associated with decreased performance on cognitive function testing even after adjustment for manganese and aluminum; this should be verified with studies using metal biomarkers reflecting cumulative exposure.

Neural response to working memory demand predicts neurocognitive deficits in HIV.

Human immunodeficiency virus (HIV) continues to have adverse effects on cognition and the brain in many infected people, despite a reduced incidence of HIV-associated dementia with combined antiretroviral therapy (cART). Working memory is often affected, along with attention, executive control, and cognitive processing speed. Verbal working memory (VWM) requires the interaction of each of the cognitive component processes along with a phonological loop for verbal repetition and rehearsal. HIV-related functional brain response abnormalities during VWM are evident in functional MRI (fMRI), though the neural substrate underlying these neurocognitive deficits is not well understood. The current study addressed this by comparing 24 HIV+ to 27 demographically matched HIV-seronegative (HIV-) adults with respect to fMRI activation on a VWM paradigm (n-back) relative to performance on two standardized tests of executive control, attention and processing speed (Stroop and Trail Making A-B). As expected, the HIV+ group had deficits on these neurocognitive tests compared to HIV- controls, and also differed in neural response on fMRI relative to neuropsychological performance. Reduced activation in VWM task-related brain regions on the 2-back was associated with Stroop interference deficits in HIV+ but not with either Trail Making A or B performance. Activation of the posterior cingulate cortex (PCC) of the default mode network during rest was associated with Hopkins Verbal Learning Test-2 (HVLT-2) learning in HIV+. These effects were not observed in the HIV- controls. Reduced dynamic range of neural response was also evident in HIV+ adults when activation on the 2-back condition was compared to the extent of activation of the default mode network during periods of rest. Neural dynamic range was associated with both Stroop and HVLT-2 performance. These findings provide evidence that HIV-associated alterations in neural activation induced by VWM demands and during rest differentially predict executive-attention and verbal learning deficits. That the Stroop, but not Trail Making was associated with VWM activation suggests that attentional regulation difficulties in suppressing interference and/or conflict regulation are a component of working memory deficits in HIV+ adults. Alterations in neural dynamic range may be a useful index of the impact of HIV on functional brain response and as a fMRI metric in predicting cognitive outcomes.

A Combination of Nootropic Ingredients (CAF+) Is Not Better than Caffeine in Improving Cognitive Functions

Many nootropic compounds claim to have positive effects on cognitive performance. In this study, we tested the effects of the nootropic compound CAF+ on cognitive functioning. CAF+ contains a combination of ingredients that has separately shown to boost cognitive performance, including caffeine, l-theanine, vinpocetine, l-tyrosine, and vitamin B6/B12. We examined whether CAF+ would improve cognitive functions in healthy young participants, and whether it would be more effective than caffeine. We used a randomized double-blind placebo-controlled three-way cross-over design to examine the performance of 21 healthy young participants on a test battery aimed to measure memory performance, attention, and sensorimotor speed. Our main outcome measure was participant’s performance on the Verbal Learning Test (VLT). Subjective alertness, heart rate, and blood pressure were also monitored. Participants were tested at 30 and 90 min after treatment. We found that after 90 min, the delayed recall performance on the VLT after caffeine was better than after CAF+ treatment. Further, caffeine, but not CAF+, improved the performance in a working memory task. In a complex choice reaction task caffeine improved the speed of responding. Subjective alertness was increased as a result of CAF+ at 30 min after administration. Only caffeine increased diastolic blood pressure. We conclude that in healthy young students, caffeine improves memory performance and sensorimotor speed, whereas CAF+ does not affect the cognitive performance at the dose tested.

Neurocognitive functioning is associated with functional independence in newly diagnosed patients with temporal lobe glioma.

Cancer and treatment-related neurocognitive dysfunction has the potential to significantly disrupt the lives of survivors. While neurocognitive functioning is known to predict aspects of patient-reported quality of life in individuals with glioma, little is known regarding the association between neurocognitive functioning and clinician-rated functional independence. Newly diagnosed patients with glioma in the left (n = 73; 49% glioblastoma) or right (n = 30; 57% glioblastoma) temporal lobe completed comprehensive neuropsychological testing. Clinicians rated patient functional independence using the Functional Independence Measure (FIM) and Karnofsky Performance Status (KPS) scale. Correlational and regression analyses were conducted to determine relationships between neurocognitive functioning and functional independence. Tests of verbal learning, executive function, and language comprehension were moderately to strongly associated with clinician-rated functional independence, particularly for items pertaining to need for assistance with memory, problem-solving, and language functions. Stepwise linear regression showed that tests of verbal learning, executive functioning, and language comprehension predicted FIM ratings, together accounting for 40% of variance (P < .001). A test of executive functioning also predicted KPS scores and accounted for 19% of variance (P < .001). In patients with newly diagnosed temporal lobe glioma, neurocognitive functioning is associated with functional independence. Verbal learning, executive functioning, and language comprehension demonstrated the strongest associations across both measures of functional independence. These findings provide support for the ecological validity of neuropsychological assessment by demonstrating the real-world clinical significance of objectively assessed neurocognitive functioning in glioma patients.

Predicting progression of amnesic MCI: The integration of episodic memory impairment with perfusion SPECT

The present study aimed at assessing if the ability to predict progression from amnesic Mild Cognitive Impairment (aMCI) to dementia is improved by considering the presence at the baseline of Single Photon Emission Computed Tomography (SPECT) perfusion abnormalities in addition to a defect of long term memory.The Episodic Memory Score (EMS), a global index which integrates results obtained in subtests of the Rey's Verbal Learning Test and the Rey-Osterrieth Figure recall, were taken into account to evaluate defects of long term memory. The study sample consisted of 42 subjects affected by aMCI, who were followed-up during a two-year period. At the final follow-up 15 subjects progressed to AD. The EMS predicted progression from aMCI to dementia with a high level of sensitivity and a lower level of specificity, but the association of neuropsychological (EMS) and SPECT data (hypoperfusion in the Posterior Cingulate Cortex) increased the accuracy in predicting conversion from aMCI to AD. The association of results obtained by aMCI patients on memory tests and perfusion SPECT may improve the accuracy in detecting subjects who will progress to dementia. The use of currently available and low-cost investigations could be advantageous in terms of public health policies.

Assessment of hearing aid algorithms using a master hearing aid: the influence of hearing aid experience on the relationship between speech recognition and cognitive capacity

Objectives: Model-based hearing aid development considers the assessment of speech recognition using a master hearing aid (MHA). It is known that aided speech recognition in noise is related to cognitive factors such as working memory capacity (WMC). This relationship might be mediated by hearing aid experience (HAE). The aim of this study was to examine the relationship of WMC and speech recognition with a MHA for listeners with different HAE. Design: Using the MHA, unaided and aided 80% speech recognition thresholds in noise were determined. Individual WMC capacity was assed using the Verbal Learning and Memory Test (VLMT) and the Reading Span Test (RST). Study sample: Forty-nine hearing aid users with mild to moderate sensorineural hearing loss divided into three groups differing in HAE. Results: Whereas unaided speech recognition did not show a significant relationship with WMC, a significant correlation could be observed between WMC and aided speech recognition. However, this only applied to listeners with HAE of up to approximately three years, and a consistent weakening of the correlation could be observed with more experience. Conclusions: Speech recognition scores obtained in acute experiments with an MHA are less influenced by individual cognitive capacity when experienced HA users are taken into account.

P054 The evaluation of transcranial magnetic stimulation rTMS in corticobasal degeneration (CBD): PET, QEEG and neuropsychological correlates

Background CBD is a neurodegenerative disorder characterized by asymmetric motor parkinsonism symptomatology and impairment in language, personality and affective functions that are related to frontoparietal atrophy. To date, there is still no effective treatment for CBD. In this respect, TMS may be a novel therapeutic candidate for CBS. Considering all of this evidence, we aimed to evaluate the pre and post-treatment electrophysiological, neurometabolic and neuropsychometric correlates of TMS application in four CBS patients. Methods We have evaluated the pre and post treatment EEG, FDG-PET and detailed clinical behavioral and neuropsychometric test correlates of TMS in four CBD patients who were admitted to our dementia outpatient at the University of Medipol-Istanbul. The following detailed neuropsychometric test procedures were applied to patients; Digit Span (Forward/Back) Test, Verbal Fluency Test, Lexical Fluency Test, Clock Drawing Test, Similarities and Comprehension test, Verbal Learning Test (SBSTTA-Oktem), Wechsler Memory Scale (WMS-Logical Memory Test), Benton Face Recognition Test (BFR), Line Orientation Identification Test (BLOT), Neuropsychiatric Inventory (NPI), Geriatric Depression Scale (GDS), Frontal Behavioral Inventory Test (FBI), Standardized Mini Mental State Examination (MMSE) and Clinical Dementia Rating-Scale (CDR). Results & conclusion We have found that increased pretreatment theta activity was significantly decreased after the TMS treatment in frontal, central and parietal regions that was associated with the normalized glucose metabolism and neurobehavioral test scores after the TMS treatment.

The Bay Area Verbal Learning Test (BAVLT): Normative Data and the Effects of Repeated Testing, Simulated Malingering, and Traumatic Brain Injury

Verbal learning tests (VLTs) are widely used to evaluate memory deficits in neuropsychiatric and developmental disorders. However, their validity has been called into question by studies showing significant differences in VLT scores obtained by different examiners. Here we describe the computerized Bay Area Verbal Learning Test (BAVLT), which minimizes inter-examiner differences by incorporating digital list presentation and automated scoring. In the 10-min BAVLT, a 12-word list is presented on three acquisition trials, followed by a distractor list, immediate recall of the first list, and, after a 30-min delay, delayed recall and recognition. In Experiment 1, we analyzed the performance of 195 participants ranging in age from 18 to 82 years. Acquisition trials showed strong primacy and recency effects, with scores improving over repetitions, particularly for mid-list words. Inter-word intervals (IWIs) increased with successive words recalled. Omnibus scores (summed over all trials except recognition) were influenced by age, education, and sex (women outperformed men). In Experiment 2, we examined BAVLT test-retest reliability in 29 participants tested with different word lists at weekly intervals. High intraclass correlation coefficients were seen for omnibus and acquisition scores, IWIs, and a categorization index reflecting semantic reorganization. Experiment 3 examined the performance of Experiment 2 participants when feigning symptoms of traumatic brain injury. Although 37% of simulated malingerers showed abnormal (p < 0.05) omnibus z-scores, z-score cutoffs were ineffective in discriminating abnormal malingerers from control participants with abnormal scores. In contrast, four malingering indices (recognition scores, primacy/recency effects, learning rate across acquisition trials, and IWIs) discriminated the two groups with 80% sensitivity and 80% specificity. Experiment 4 examined the performance of a small group of patients with mild or severe TBI. Overall, both patient groups performed within the normal range, although significant performance deficits were seen in some patients. The BAVLT improves the speed and replicability of verbal learning assessments while providing comprehensive measures of retrieval timing, semantic organization, and primacy/recency effects that clarify the nature of performance.

Neurocognitive Dysfunction According to Hypoperfusion Territory in Patients With Moyamoya Disease.

ObjectiveTo demonstrate the prevalence of cerebral hypoperfusion without focal cerebral lesions in patients with Moyamoya disease (MMD), and the relationship between areas of hypoperfusion and cognitive impairment.MethodsTwenty-six MMD patients were included. Patients were categorized according to the presence/absence of hypoperfusion in the frontal, parietal, temporal, and occipital lobes on brain single-photon-emission computed tomography (SPECT) after acetazolamide challenge. Computerized neuropsychological test (CNT) results were compared between groups.ResultsOnly 3 patients showed normal cerebral perfusion. Baseline characteristics were similar between groups. Patients with frontal lobe hypoperfusion showed lower scores in visual continuous performance test (CPT), auditory CPT, forward digit span test, backward digit span test, verbal learning test, and trail-making test. Patients with parietal lobe hypoperfusion showed lower backward digit span test, visual learning test, and trail-making test scores. Related to temporal and occipital lobes, there were no significant differences in CNT results between the hypoperfusion and normal groups.ConclusionMMD patients without focal cerebral lesion frequently exhibit cerebral hypoperfusion. MMD patients with frontal and parietal hypoperfusion had abnormal CNT profiles, similar to those with frontal and parietal lesions. It is suggested that the hypoperfusion territory on brain SPECT without focal lesion may affect the characteristics of neurocognitive dysfunction in MMD patients.

Cognitive Decline in Patients with Anorexia Nervosa: Which Cognitive Domains are Most Vulnerable and Need to be Considered?

Objective: Besides physical complaints, patients with anorexia nervosa (AN) often suffer from cognitive problems. However, it is still a matter of debate whether a specific profile of cognitive disturbances underlies the disease, and if so, whether this profile contributes to the maintenance of the illness and also leads to the development of different subtypes of AN. The aim of the present study was to provide a more detailed knowledge on neuropsychological profiles in patients with AN using an extension of the Ravello Profile test-battery by working memory (WM) tests. Method: Twenty-nine AN patients and 20 healthy controls (HC) participated in the study. Neuropsychological performance was assessed by the Ravello Profile and WM tasks such as Digit Span and Corsi Blocks, 2- and 3-Back tasks, Symbol Digit Modalities Test, Paced Auditory Serial and Addition Task, as well as the Verbal Learning and Memory Test. Results: AN patients showed subtle cognitive problems on certain measures including WM performance. Compared to HC, the AN group showed significantly worse performance in verbal short-term and long-term memory, visuospatial WM, inhibition, and switching abilities, subserving successful self-regulation. Discussion: Our results speak in favour of relevance for WM decline in the context of AN. Therefore, tasks assessing visuospatial WM and information processing speed (IPS) should be added to existing test batteries such as the Ravello Profile.

Long-term health outcomes after exposure to repeated concussion in elite level: rugby union players

BackgroundThere is continuing concern about effects of concussion in athletes, including risk of the neurodegenerative disease chronic traumatic encephalopathy. However, information on long-term health and wellbeing in former athletes is...

Meta-Analysis of the Effects of Neuropsychological Interventions on Cognitive Function in Non-Central Nervous System Cancer Survivors.

Background. Cognitive impairment is a common complaint among cancer survivors, significantly impacting working memory, attention, executive function, and information processing speed. This meta-analysis aims to evaluate the effect of neuropsychological interventions on the cognitive function of non–central nervous system (non-CNS) cancer survivors. Methods. Three databases (PubMed, PsycInfo, and CAJ Full-text Database) were searched from January 2010 to September 2015. Controlled clinical trials of neuropsychological interventions for the treatment of cognitive impairment in cancer survivors were considered for inclusion. Results. A total of 10 eligible trials were included in this meta-analysis. Three trials assessed the effects of cognitive rehabilitation (CR) interventions, and the weighted mean difference (WMD) for the overall intervention effect was −0.19 (95% confidence interval [CI] = −2.98 to 2.61). Two trials examined the effects of cognitive training (CT) interventions on the cognitive function of cancer survivors; the standardized mean difference (SMD) for the overall effect was 0.52 (95% CI = 0.06 to 0.98). The overall effect of CR interventions on neuropsychological status at postintervention was 5.66 (95% CI = 2.97 to 8.35). The SMD of CR and CT intervention for objective function by verbal learning tests was 0.50 (95% CI = 0.19 to 0.81) at postintervention, and 0.58 (95% CI = 0.19-0.98) at follow-up assessment within 6 months. Conclusion. Findings from this meta-analysis indicate that neuropsychological interventions can improve cognitive function in non-CNS cancer survivors, and support the need for future research. However, the conclusion from this meta-analysis was based on trials with small sample sizes. Future research should be conducted using a larger sample size. Relevant clinical implications were discussed accordingly.

Validation of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) in Greek population with multiple sclerosis

BackgroundCognitive impairment is experienced by about 50% of patients with Multiple Sclerosis (MS) worldwide and affects their employment, disease management and quality of life in general. The Brief International Cognitive assessment for MS (BICAMS) is a brief, practical and potentially universal battery for cognitive impairment in MS patients. It consists of three tests: the Symbol Digit Modalities Test (SDMT), the California Verbal Learning Test-2 (CVLT-2) and the Brief Visuospatial Memory Test-Revised (BVMT-R). ObjectiveThe objective of this study was to validate the BICAMS in Greek MS patients and controls. MethodsForty four MS patients and seventy nine healthy control (HC) participants were recruited and tested. They were group matched for age, education, gender and also premorbid cognitive reserve. All of them completed the three tests of the BICAMS battery. Instead of CVLT-2, the Greek validated form (Greek Verbal Learning Test, GVLT), was used. In addition, cognitive reserve was assessed using the Cognitive Reserve Index questionnaire (CRIq) standardized for the Greek population. ResultsSignificant difference was found in the performance of the two groups in all tests (p<0.0001, p<0.02, p<0.009 for SDMT, GVLT and BVMT-R respectively). Test-retest reliability was good for all the tests. Based on the criterion of 1 or more tests below the 5th percentile of healthy controls performance, 47% of patients were found impaired. ConclusionsThe study provides validation of BICAMS in Greek population and therefore facilitates the use of this battery in clinical practice and in future studies of MS patients in Greece.

Detecting Memory Impairment in Deaf People: A New Test of Verbal Learning and Memory in British Sign Language.

Most existing tests of memory and verbal learning in adults were created for spoken languages, and are unsuitable for assessing deaf people who rely on signed languages. In response to this need for sign language measures, the British Sign Language Verbal Learning and Memory Test (BSL-VLMT) was developed. It follows the format of the English language Hopkins Verbal Learning Test Revised, using standardized video-presentation with novel stimuli and instructions wholly in British Sign Language, and no English language requirement. Data were collected from 223 cognitively healthy deaf signers aged 50-89 and 12 deaf patients diagnosed with dementia. Normative data percentiles were derived for clinical use, and receiver-operating characteristic curves computed to explore the clinical potential and diagnostic sensitivity and specificity. The test showed good discrimination between the normative and clinical samples, providing preliminary evidence of clinical utility for identifying learning and memory impairment in older deaf signers with neurodegeneration. This innovative video testing approach transforms the ability to accurately detect memory impairments in deaf people and avoids the problems of using interpreters, with international potential for adapting similar tests into other signed languages.

PS89. Influence of anxiety symptoms on improvement of neurocognitive functions in patients with major depressive disorder: A 12-week, multicenter, randomized trial of tianeptine versus escitalopram, the CAMPION study

Background: Previous research has reported evidence that patients with major depressive disorder (MDD) show anxiety symptoms and neurocognitive impairments. However, the influence of anxiety on neurocognitive function in MDD patients during antidepressant treatment is unclear. Method: MDD patients (n¼164) completed a 12-week, multicenter, randomized trial assigned in a 1:1 ratio to either tianeptine or escitalopram. Changes of anxiety symptoms were assessed by the Hamilton Anxiety Rating Scale (HAM-A), and the Hamilton Depression Rating Scale (HAM-D), self-rated subjective cognitive impairment on memory and concentration, the Mini-Mental Status Examination (MMSE), Continuous Performance Test (CPT), Verbal Learning Test (VLT), and Raven's Progressive Matrices (RPM) were assessed every 4 weeks. Results: During 12 weeks of treatment, decrease in the HAM-A score was significantly associated with improvement of subjective cognitive impairments on memory (po0.001) and concentration (po0.001), and objective measures on delayed memory (p¼0.006) and reasoning ability (p ¼0.002), after adjusting for covariates such as baseline HAM-A scores, time, sex, age, education years and assigned medication using the Mixed effects and Generalized Estimated Equation model analysis. However, the other cognitive outcome variables, immediate memory, commission error, and MMSE, which showed significant improvement through 12-week study period, showed no significant association with improvement of anxiety. Conclusion: Improvement of anxiety symptoms was significantly associated with improvement in subjective and objective neurocognitive functions such as delayed memory and reasoning ability in elderly MDD patients during antidepressant treatment, but not significantly associated with improvement of immediate memory and commission error. Trial registration: ClinicalTrials.gov identifier NCT01309776