Wechsler Memory Scale-Revised Indices Research Articles

Long-term influence of adjuvant breast radiotherapy on cognitive function in breast cancer patients treated with conservation therapy.

The mechanisms underlying cognitive decline after radiotherapy not directed at brain areas remains unclear. We previously suggested that adjuvant breast radiotherapy in breast conservation therapy could lower memory function soon after therapy, and that the process might be partially mediated by plasma interleukin (IL)-6 levels. The present study investigated how that relationship changes longitudinally. We performed the Wechsler Memory Scale-Revised (WMS-R) test and measured plasma IL-6 levels for 47 breast cancer surgical patients within 1year after the initial therapy (study 1) and more than 2years after study 1 (study 2). We also performed 2 × 2 mixed [the radiotherapy group (n = 25) or the no-radiotherapy group (n = 22) × study 1 or study 2] analysis of covariance on the WMS-R indices and plasma IL-6 levels. The association between changes in plasma IL-6 levels and changes in the WMS-R indices between the two studies was evaluated using Pearson's correlation coefficient. The Immediate Verbal Memory Index was significantly higher in study 2. The Delayed Recall Index was significantly higher in study 2 and significantly lower in the radiotherapy group only in study 1. There was a significant correlation between changes in plasma IL-6 levels and changes only in the Delayed Recall Index of the WMS-R. Memory decline in breast cancer patients soon after adjuvant breast radiotherapy was restored approximately 3years after treatment, and decreased plasma IL-6 levels might be involved in the recovery process.

Hippocampal Transection Plus Tumor Resection as a Novel Surgical Treatment for Temporal Lobe Epilepsy Associated with Cerebral Cavernous Malformations

The optimal surgical treatment for cavernous malformation-related temporal lobe epilepsy (CRTLE) is still controversial because it frequently involves the hippocampus as an epileptogenic zone. Here we describe our unique surgical strategy of performing hippocampal transection (HT) plus tumor resection for CRTLE to solve the question of how to balance postoperative seizure outcomes and neuropsychologic outcomes. From 2005 to 2016, 7 cases of HT (3 on dominant side) plus tumor resection were performed for patients with CRTLE. We routinely perform intraoperative electrocorticography just before and after the resection of the tumor with hemosiderin rim. In cases with residual spikes from the hippocampus after the resection, we add HT, considering laterality of the lesion, preoperative memory functions, and magnetic resonance imaging abnormalities in hippocampi. Patient information, including seizure outcomes and preoperative and postoperative (24months) Wechsler Memory Scale-Revised (WMS-R), were collected. In the mean follow-up of 62.7 months (range 20-119), the postoperative seizure outcome was as follows: Engel class I in 6 cases (85.7%) and II in 1 case (14.3%). Perioperative changes in WMS-R score were as follows: 93.5 preoperatively versus 99.5 postoperatively (P= 0.408) in verbal memory and 90.7 versus 98.0 (P=0.351) in delayed recall. Overall, no patient presented with more than 25% decline in any of the WMS-R indices postoperatively. Despite the small sample size and noncontrolled study design, postoperative seizure outcomes were deemed acceptable with favorable memory outcomes, which rather improved postoperatively with marginal statistical significance. In patients with CRTLE, additional HT is a reasonable treatment option.

Regional Cerebral Blood Flow in [123]I-IMP Single-photon Emission Computed Tomography and the Wechsler Memory Scale-revised in Nondemented Elderly Subjects with Subjective Cognitive Impairment.

Objective Regional cerebral blood flow (rCBF) imaging with single-photon emission computed tomography (SPECT) is useful in the early diagnosis of dementia. We aimed to investigate the association between the rCBF and various domains related to the memory function in elderly subjects with subjective cognitive impairment (SCI). Methods Thirty-two subjects with SCI were included in the present study. Patients with dementia and mild cognitive impairment (MCI) were excluded based on the presence of logical memory impairment. N-isopropyl-p-[123I]-iodoamphetamine SPECT was performed and Wechsler Memory Scale-Revised (WMS-R) was administered to all subjects (mean age, 68.4 years; average Mini-Mental State Examination score, 27.6). The SPECT results were analyzed using the easy Z-score imaging system and the voxel-based stereotactic extraction estimation method. Correlation analyses were performed to investigate the correlation between the mean positive Z-scores in the decrease of the rCBF and the WMS-R indices. Results The SPECT study indicated marked hypoperfusion in some areas, including the bilateral temporal areas, the caudate, and the thalamus, in these subjects in comparison to the normal database. The decrease in the rCBF that was observed in several regions, including the left precuneus and left inferior frontal gyrus (LIFG), showed a significant negative correlation with several indices of the memory function, particularly visual memory. Conclusion The regional hypoperfusion observed in the study using the voxel-based stereotactic extraction estimation method suggest that the regional cerebral dysfunction is associated with the memory function of patients with SCI, even though the subjects in the present study were cognitively intact. The correlation analysis with the WMS-R suggested the contribution of the LIFG to the memory function and indicated the significance of visual memory dysfunction in the neuropsychological assessment to determine the stage of SCI.

Moderating effect of schizotypy on the relationship between smoking and neurocognition

PurposeSmoking rates in schizotypic individuals are shown to be elevated, as in patients with schizophrenia, although findings on the association of smoking with different symptomatology of schizotypy have been mixed. Moreover, possible moderating effects of schizotypy on the relationship between smoking and cognition have not been well documented. Subjects and methodsThe Schizotypal Personality Questionnaire (SPQ) and the full version of the Wechsler Memory Scale-Revised (WMS-R) were administered to 501 healthy adults. Subjects were divided into smokers (n=85) and non-smokers (n=416) based on the presence/absence of current smoking. ResultsThe analysis of covariance (ANCOVA) on the three factor scores as well as the total score of the SPQ, controlling for age and gender, revealed that cognitive-perceptual factor was significantly associated with an increased rate of smoking (P=0.048). The ANCOVA on the WMS-R indices, with smoking group as a fixed factor and age, gender and total SPQ score as covariates, revealed that the schizotypy-by-smoking interaction was significant for attention/working memory (P=0.029). Discussion and conclusionPositive schizotypy may be associated with more smoking. Schizotypy and smoking could interact with each other to negatively affect attention/working memory.

P2‐305: Donepezil for memory decline in mild cognitive impairment: Efficacy and limitations in a seven‐year follow‐up study

Background: Donepezil hydrochloride (Aricept) is a selective acetylcholinesterase inhibitor for the treatment of Alzheimer’s disease (AD). However, the memory domains for which the agent is effective, especially in very early phase of the disease, have not been clarified.We observed patients with amnestic mild cognitive impairment (aMCI) for seven years to determine the efficacy and limitations of donepezil. Methods: Ten patients with aMCI were diagnosed on the basis of intact daily activity, normal Mini-Mental State Examination (MMSE) score, and deviated memory reduction (less than 85) on at least one index of the Wechsler Memory Scale Revised (WMS-R). Single photon emission tomography (SPECT) showed AD patterns in the Three-Dimensional Stereotactic Surface Projection (3DSSP) analysis. All patients received Aricept, 5 mg/day, with informed consent. The WMS-R and a set of spatial memory tests (SMT) we devised were administered at baseline and at months 6, 12, 36, 60, and 84. The SMT comprised two subtests: (a) a spatial source memory test, assessing the memory of the agent of an action (who acted) and the reality of an action (acted or imagined) using line drawings of furniture on small pieces of paper and a virtual room and (b) a line drawing furniture completion test, assessing the ability to organize spatial representations, in which patients were requested to insert an important part of a piece of furniture in the appropriate position. Both subtests assess cognitive ability to manipulate three-dimensional ideations underlying memory of a space. Results: At baseline, all patients showed one or moreWMS-R index scores below 85 along with errors on SMT. At month 6, all patients scored WMS-R index scores higher than 85, and this improvement was preserved till month 84. However, the error on SMT remained in all patients throughout the study.Conclusions:Donepezil hydrochloride, prescribed early in the course of AD, improves general (verbal and visual) memory function, as assessed by a standardized memory test, and preserves it for a considerable period of time; however, it does not affect spatial memory function, which requires three-dimensional ideation. The memory impairment related to manipulation of spatial representations might be germane to AD.

Hippocampal and Amygdalar Volumes in Breast Cancer Survivors with Posttraumatic Stress Disorder

Hippocampal and Amygdalar Volumes in Breast Cancer Survivors with Posttraumatic Stress Disorder

Hippocampal and Amygdalar Volumes in Breast Cancer Survivors with Posttraumatic Stress Disorder

Although smaller hippocampi and amygdalae were found in cancer survivors with intrusions, associations between cancer-related posttraumatic stress disorder (PTSD) and these volumes are unknown. The authors performed MRI volumetric analyses of these regions in 15 cancer survivors with PTSD, 15 cancer survivors without PTSD, and 15 healthy comparison subjects. The authors also examined the correlation between PTSD symptom scores of the Impact of Event Scale and these volumes in the PTSD group. These volumes were not significantly different among the groups, but the intrusion score was inversely associated with the hippocampal volume. Results suggest intrusions, not PTSD diagnosis, might be associated with hippocampal volume.

Clinical Utility of Wechsler Memory Scale-Revised and Predicted IQ Discrepancies in Closed Head Injury

Comparisons between Wechsler Memory Scale-Revised (WMS-R) indexes and Wechsler Adult Intelligence Scale-Revised (WAIS-R) IQ scores have been proposed to identify severity of memory deficits. However, many neurologic conditions reduce both intellectual and memory functioning, and thus, examining differences between these scores may be of little value. Closed head injured subjects who completed the WMS-R were divided into either mild injury (MI, n = 41) or moderate/severe (SI, n = 41) injury groups based on trauma severity indicators and were matched on age and level of education. The Oklahoma Premorbid Intelligence Estimation (OPIE), a regression formula that takes into account demographic variables as well as IQ performance, was calculated for each subject. Discrepancy scores were calculated between predicted IQ scores and WAIS-R IQ and WMS-R indexes. SI head-injured subjects displayed significantly larger discrepancies (19 points) between OPIE scores and Delayed Recall Indexes from the WMS-R than the MI subjects (10 points). Significantly larger percentages of subjects in the SI group displayed significant (>SD) reductions in many of the WMS-R and WAIS-R scores from estimates than subjects in the MI group. Comparing current memory functioning to estimates of premorbid intellectual ability appears to be a sensitive indicator of presence and degree of intellectual and memory dysfunction in head trauma patients. Results also provide evidence that estimates of premorbid intellectual ability can serve as estimates of premorbid memory functioning. © 1997 National Academy of Neuropsychology. Published by Elsevier Science Ltd

Cross-validation of a method for predicting wechsler memory scale-revised index scores

Equations for prorating Wechsler Memory Scale-Revised General Memory (GM) and Delayed Recall (DR) index scores (Woodward & Axelrod, 1995) were confirmed in clinical samples of patients who were seen for comprehensive neuropsychological testing with (1) moderate or severe closed-head injuries (n = 53); (2) mild head injury/concussion (n = 47); and (3) patients with intractible seizures who were seen for neuropsychological testing prior to neurosurgical resection (n = 24). Fifty-one of the closed-head injury (CHI) patients were involved in litigation related to their injury at the time of this evaluation. Predicted GM and DR index scores fell within 6 points of the obtained scores for 91% and 92%, respectively, of the CHI sample, and 100% of the seizure resection sample. This is well within the standard error of measurement of these index scores. There were no significant differences in accuracy of estimated index scores between litigants and non-litigants or between levels of head injury severity. These findings confirm the earlier cross-validation results reported by Axelrod et al. (1996) in a mixed sample of traumatic brain injury and other neurological insult.

Relationship of iq to verbal learning and memory: Test and retest

The relationship between Wechsler Adult Intelligence Scale-Revised (WAIS-R) IQ and performance on measures of memory was examined in 64 adults tested twice at a 2-week interval. Repeated measures analyses of variance revealed that individuals with Low-Average WAIS-R Full Scale IQ scores performed significantly more poorly than did individuals with Average and High-Average Full Scale IQs on memory measures including the Wechsler Memory Scale-Revised (WMS-R) General Memory and Delayed Recall indices, as well as California Verbal Learning Test (CVLT) Total Words, Learning Slope, and Discriminability. Although all three groups demonstrated significant practice effects on each memory measure, group differences in performance persisted at retest. Multiple regression analyses revealed that WAIS-R factor scores Verbal Comprehension and Freedom from Distractibility accounted for up to 42% of the variance in WMS-R and CVLT indices. Moreover, WAIS-R performance at initial testing accounted for 22–41 % of the variance in memory performance at retest These results are discussed in the context of the construct stabilities of intelligence and memory, as well as the psychometric precision of the tests used to measure these constructs.

Exploration of the Underlying Dimensions and Overlap between the Kaufman Adolescent and Adult Intelligence Test and the Wechsler Memory Scale-Revised

The canonical relationship between the Kaufman Adolescent and Adult Intelligence Test (KAIT) and the Wechsler Memory Scale-Revised (WMS-R) was studied. Two significant canonical variates accounted for approximately 53% of the overlap in variance between the two measures. The WMS-R was found to offer unique and valuable information beyond the KAIT when assessing individuals classified as learning disabled (LD). Principal components analysis, using the KAIT Composite IQs and the WMS-R Index scores, yielded a two-factor solution. The addition of a specific measure of memory during the psychoeducational evaluation of adolescents and adults classified as LD was supported. Implications for clinical practice and recommendations for future research are discussed.

Estimating memory function: Disparity of wechsler memory scale-revised and California verbal learning test indices in clinical and normal samples

Abstract Although a high degree of convergence has been reported between the California Verbal Learning Test (CVLT) and the Wechsler Memory Scale-Revised (WMS-R), standard scores from these tests may not provide commensurate global estimations of memory function. Data were reviewed from 161 subjects who had taken both tests, including schizophrenic (n = 33) and temporal-lobe epilepsy (n = 31) patients and 97 normal volunteers. The patient group performed approximately one standard deviation below the normal mean on the WMS-R indexes, but three standard deviations below the normal mean on CVLT indices. The normal volunteers, who were well-educated as a group, performed approximately one standard deviation above the population-based mean on the WMS-R (commensurate with their IQ level), but at the mean of the CVLT reference sample. These findings suggest that the standardization samples for these two tests are not representative of the same population. The CVLT normative reference sample appears to have been...

Wechsler Memory Scale-Revised in closed head injury

This study was undertaken to determine the ability of the Wechsler Memory Scale-Revised (WMS-R) to differentiate a group of closed head injury patients from a group of controls and determine how injury severity and attentional deficits are associated with WMS-R performance. The relationship of WMS-R performance to everyday memory also was assessed. The head injured group performed more poorly than controls on all five WMS-R indices and exhibited greater impairments on tasks that measure retention. In the original sample only the Visual Memory Index correlated with injury severity; in a larger sample, all four memory indices correlated modestly with injury severity. Patients who performed more poorly on the WMS-R also received poorer ratings on an independent assessment of everyday memory.

Identification of malingered head injury on the Wechsler Memory Scale--Revised.

Thirty-nine head-injured outpatients were compared with 39 age-matched subjects who were instructed to malinger head trauma symptoms on the Wechsler Memory Scale-Revised (WMS-R) and Wechsler Adult Intelligence Scale-Revised. Head-injured patients were selected who were not involved in litigation or pursuing a Worker's Compensation claim. Groups did not differ significantly on IQs or memory indexes. Discriminant function analyses based on the WMS-R subtests and indexes were able to accurately classify 91% and 83% of the cases, respectively. Decision rules were cross-validated on published data from several independent studies and statistically by means of the jackknife procedure. Head-injured patients appear to show a pattern of WMS-R scores that can be discriminated from the profile produced by individuals who attempt to malinger head trauma symptoms

The performance of patients with schizophrenia on the wechsler memory scale-revised

Abstract The performance of 45 patients with schizophrenia was examined on the Wechsler Memory Scale-Revised (WMS-R). The patients demonstrated a relatively flat performance profile across the five major WMS-R index scores suggesting similar levels of impairment in memory and attentional processes, in memory for visual and verbal materials, and in immediate and delayed recall. The General Memory Index (GMI) was lower than Full Scale IQ (FSIQ) scores in the majority of cases, and a large portion of the sample demonstrated fairly severe differential impairments of memory with FSIQ exceeding the GMI by 15 or more points. These results are consistent with prior findings of memory impairment in schizophrenia and support the validity of the WMS-R as a measure of memory deficits in schizophrenia.

Mayo's older americans normative studies: WMS-R norms for ages 56 to 94

Abstract Data obtained in Mayo's Older Americans Normative Studies (MOANS) provide age-specific norms for the Wechsler Memory Scale-Revised (WMS-R) on a sample of 441 cognitively normal persons age 56 to 94. Memory Indices derived from these norms are termed “MAYO Verbal Memory (MVeMI), MAYO Visual Memory (MViMI), MAYO General Memory (MGMI), MAYO Attention/Concentration (MACI), MAYO Delayed Recall (MDRI) and MAYO Percent Retention (MPRI) Indices” to differentiate them from traditional WMS-R Memory Indices. MVeMI, MViMI, MGMI and MACI values are, by design, estimates of WMS-R Indices. Test administration and index computation differences employed in these projects prohibit extension of the WMS-R Delayed Memory Index to older ages. However, two new indices (MDRI and MPRI) are presented to serve similar purposes. Tables needed to convert WMS-R subtests raw scores to age-corrected scaled scores and to determine the summary MAYO Indices are presented for ages 56 through 94. A different methodology was used to compute MAYO indices than is used to compute WMS-R indices. Nonetheless, concordance rates suggest that the performance characteristics of the comparable MAYO and WMS-R Verbal Memory, Visual Memory, General Memory and Attention/Concentration Indices are very similar at ages where both can be validly calculated.

The relationship between intelligence and memory following minor or mild closed head injury: greater impairment in memory than intelligence

This study investigated the performance of patients with minor or mild closed head injury and age/education-matched normal controls on the Wechsler Adult Intelligence Scale-Revised (WAIS-R) and the Wechsler Memory Scale-Revised (WMS-R). The results demonstrated that the control group had significantly higher scores than the patients with closed head injury on all WAIS-R and WMS-R index scores. Further analysis revealed that the patients with closed head injury showed a greater impairment in delayed memory when directly compared to intellectual performance that was not seen in the control group. These results are discussed in relation to findings in patients with more severe closed head injury, the construction of the WAIS-R and the WMS-R, and the performance patterns of the two groups.

Concurrent use of the Wechsler Memory Scale‐Revised and the WAIS–R*

The Wechsler Memory Scale-Revised (WMS-R) is often used in combination with the Wechsler Adult Intelligence Scale-Revised (WAIS-R). The clinician must determine whether variation between Indexes and IQs is due to measurement error, or whether it reflects real discrepancies in underlying abilities. This article presents a table of statistically significant differences between WMS-R Indexes and WAIS-R IQs. Although psychometric difficulties and procedural limitations render the tabled values somewhat inaccurate, the values can nevertheless be used to augment clinical decision.

Residual neuropsychological deficits following head-injury on the wechsler memory scale-revised

Abstract The Wechsler Memory Scale-Revised (WMS-R) was administered to 13 individuals with normal premorbid abilities who had experienced moderate to severe head injuries at least 1 year previously. Results were compared to performance on the Rey Auditory-Verbal Learning Test (RAVLT), the Rey-Osterrieth Complex Figure Test (ROCFT), and the Paced Auditory Serial-Addition Task (PASAT). The findings in the present sample of head-injured individuals indicated greater construct validity for the WMS-R Indexes of Verbal, Visual, and Delayed Memory than for the Attention Concentration Index. Further research is suggested to replicate and clarify these findings, and it is further recommended that additional measures of attention and concentration be used to supplement the WMS-R in clinical practice.

Using the wechsler memory scale-revised to detect and characterize memory deficits in multiple sclerosis

Abstract The Wechsler Memory Scale-Revised (WMS-R) and measures of word-finding, vocabulary, and depression were administered to 45 patients with definite multiple sclerosis (MS) and to 25 age-, sex-, and education-matched normal controls. MS patients performed significantly more poorly as a group than did normal controls on all five WMS-R indexes, demonstrating the sensitivity of the WMS-R to memory impairment in MS. Three subgroups of MS patients with different levels and patterns of WMS-R performance were identified using cluster analysis. One subgroup (20%) exhibited marked global impairment in attention/short-term memory, learning, and long-term memory. Another subgroup (56%) had intact attention/short-term memory but displayed milder deficits in learning and long-term memory. Performance of the remaining 24% was intact. There was suggestive evidence that relapsing/progressive MS patients were more likely than others to be globally impaired, but extent of impairment was not related to other demograph...