Journal of clinical and experimental neuropsychology最新文献

Background: Executive dysfunction occurs in 15% to 20% of multiple sclerosis (MS) patients and verbal fluency tests are frequently used to assess this deficit. The Word List Generation (WLG) is one of the most used measures in MS. This study aims to compare the performance of WLG of MS patients and healthy controls and to analyze the influence of clinical and demographic factors on the performance of MS patients.

Methods: One hundred and nine MS patients and an age- and gender-matched group of 138 healthy controls were evaluated with WLG Portuguese version, as well as other tests from the Brief Repeatable Battery of Neuropsychological Tests (BRBN-T), subtests from WAIS, a phonemic fluency test (M, R, and P), and measures of psychological symptomatology and cognitive fatigue. The MS group (70.6% females) was mainly diagnosed with RRMS (89.2%).

Results: The MS group performed significantly lower than healthy controls on the WLG. In the MS group, this performance was significantly correlated with the level of education. Significant differences were found between the two groups regarding cognitive fatigue, with MS patients reporting higher levels than healthy controls. However, this variable was not related to the performance on the WLG for MS patients.

Conclusions: This study suggests that MS is associated with large levels of cognitive decline on the phonemic verbal fluency tests. These results are consistent with other studies and highlight the importance of verbal fluency and cognitive speed measures in the neuropsychological assessment of MS. Deficits on this task seem to be highly related to the level of education of the patient rather than other demographic and clinical factors.

Objective: Prior research on the Noise Pareidolia Test (NPT) has demonstrated its clinical utility in detecting patients with mild cognitive impairment and dementia due to Lewy Body Disease (LBD). However, few studies to date have investigated the neuropsychological factors underlying pareidolia errors on the NPT across the clinical spectrum of LBD. Furthermore, to our knowledge, no research has examined the relationship between cortical thickness using MRI data and NPT subscores. As such, this study sought to explore the neuropsychological and neuroanatomical factors influencing performance on the NPT utilizing the National Alzheimer's Coordinating Center Lewy Body Dementia Module.

Methods: Our sample included participants with normal cognition (NC; n = 56), LBD with mild cognitive impairment (LBD-MCI; n = 97), and LBD with dementia (LBD-Dementia; n = 94). Archival data from NACC were retrospectively analyzed for group differences in neuropsychological test scores and cognitive and psychiatric predictors of NPT scores. Clinicoradiological correlates between NPT subscores and a small subsample of the above LBD participants were also examined.

Results: Analyses revealed significant differences in NPT scores among groups. Regression analysis demonstrated that dementia severity, attention, and visuospatial processing contributed approximately 24% of NPT performance in LBD groups. Clinicoradiological analysis suggests a potential contribution of the right fusiform gyrus, but not the inferior occipital gyrus, to NPT pareidolia error scores.

Conclusions: Our findings highlight the interplay of attention and visuoperceptual functions in complex pareidolia in LBD. Further investigation is needed to refine the utility of NPT scores in clinical settings, including identifying patients at risk for visual illusions and hallucinations.

Objectives: Patients with Somatic Symptom and Related Disorders (SSRD) report subjective cognitive concerns, and research indicates that they show objective cognitive impairment. This study explored the value of subjective concerns flagging objective impairment. Furthermore, we investigated whether coping moderated this relationship, and the role of depressive symptomatology.

Method: In a cross-sectional design, objective impairment was measured with an extensive neuropsychological assessment; subjective concerns with the Cognitive Failure Questionnaire; coping styles with the Coping Inventory of Stressful Situations; and symptoms of depression with the Patient Health Questionnaire- 9.

Results: The results show that subjective concerns are of limited value in signaling objective impairment in patients with SSRD. Regression analyses performed on data from 225 patients showed that symptoms of depression (β = .32) were the main predictor of subjective concerns, which were unrelated to objective impairment. Coping was not a moderator, but patients with emotion-oriented coping styles had more subjective concerns (β=.40), and conversely, patients with avoidance- and/or task-oriented coping styles had less (respectively, β=-.27 and β=-.24).

Conclusions: These results align with the Somatosensory Amplification Theory; patients with SSRD may amplify benign cognitive failures and experience them as intrusive, noxious, and more intense. In patients with SSRD, subjective cognitive concerns are more related to psychological constructs (symptoms of depression and coping styles) than to objective impairment.

Objectives: Interest in teleneuropsychology services increased considerably after the COVID-19 pandemic. However, the utility of unsupervised administration of computerized tests remains largely unexplored. In the present study, we developed a brief computerized battery that assesses self-reported cognitive abilities and performances on executive functioning and verbal memory. We investigated the equivalence of the self-administration online (SAO) procedure and the face-to-face (FTF) administration. Preliminary normative data were developed and the acceptance of the SAO procedure was explored.

Methods: A community sample of 169 Greek adults [94 women; mean age: 41.95 (SD = 13.40) years, mean years of education: 15.10 (SD = 2.65)] completed the SAO assessment. A subgroup of 40 participants was tested in a counterbalanced way both with SAO and FTF. Participants' performances were compared with paired sample t-tests and the agreement between the two methods was estimated with intraclass correlation coefficients (ICCs). Multiple linear regression analyses were applied to investigate the effect of demographic characteristics on SAO measures.

Results: No difference between SAO and FTF scores was observed. ICCs indicated moderate to good agreement (.418-.848) for most measures. Age was positively associated with self-reported cognitive state and negatively with neuropsychological performances and the level of acceptance of the SAO procedure. Approximately 80% of participants reported satisfaction from the SAO assessment, 69% good compliance with the instructions, but less than 30% belief that the FTF assessment could be adequately replaced.

Conclusion: SAO testing is feasible and well accepted among Greek adults yielding equivalent results with FTF testing. Despite the wide satisfaction, though, notable reluctance was noted for the substitution of FTF with SAO procedures.

Introduction: Intraindividual variability across a battery of neuropsychological tests (IIV-dispersion) can reflect normal variation in scores or arise from cognitive impairment. An alternate interpretation is IIV-dispersion reflects reduced engagement/invalid test data, although extant research addressing this interpretation is significantly limited.

Method: We used a sample of 97 older adult (mean age: 69.92), predominantly White (57%) or Black/African American (34%), and predominantly cis-gender male (87%) veterans. Examinees completed a comprehensive neuropsychological battery, including measures of reduced engagement/invalid test data (a symptom validity test [SVT], multiple performance validity tests [PVTs]), as part of a clinical evaluation. IIV-dispersion was indexed using the coefficient of variance (CoV). We tested 1) the relationships of raw scores and "failures" on SVT/PVTs with IIV-dispersion, 2) the relationship between IIV-dispersion and validity/neurocognitive disorder status, and 3) whether IIV-dispersion discriminated the validity/neurocognitive disorder groups using receiver operating characteristic (ROC) curves.

Results: IIV-dispersion was significantly and independently associated with a selection of PVTs, with small to very large effect sizes. Participants with invalid profiles and cognitively impaired participants with valid profiles exhibited medium to large (d = .55-1.09) elevations in IIV-dispersion compared to cognitively unimpaired participants with valid profiles. A non-significant but small to medium (d = .35-.60) elevation in IIV-dispersion was observed for participants with invalid profiles compared to those with a neurocognitive disorder. IIV-dispersion was largely accurate at differentiating participants without a neurocognitive disorder from invalid participants and those with a neurocognitive disorder (areas under the Curve [AUCs]=.69-.83), while accuracy was low for differentiating invalid participants from those with a neurocognitive disorder (AUCs=.58-.65).

Conclusions: These preliminary data suggest IIV-dispersion may be sensitive to both neurocognitive disorders and compromised engagement. Clinicians and researchers should exercise due diligence and consider test validity (e.g. PVTs, behavioral signs of engagement) as an alternate explanation prior to interpretation of intraindividual variability as an indicator of cognitive impairment.

Background: The rod and frame test (RFT), a measure of field dependence-independence, recently has reemerged as a measure of research interest and potential diagnostic value in neuropsychology. In the standard RFT, the subject experiences offsetting visual cues from a frame surrounding an embedded rod, while the subject's postural/vestibular cues provide the sense of verticality as the subject attempts to set the rod to vertical. The paper shows that RFTs not adhering to RFT parameters can reduce the test's visual framework impact experienced by the subject. Comparisons of neuropsychological studies will highlight that correct adherence to RFT testing conditions can strengthen RFT effects.

Method: This review presents the parameters that have been studied which impact on subject performance on the RFT. It identifies how computer administered RFTs have been applied to enhance the study of the RFT parameters and make the RFT more accessible to the study of different diagnostic groups. The article also critiques studies by identifying how the RFT's parameters, study's design and statistical analysis may have diminished identifying the full effects of the RFT experience.

Results: Parameters impacting judgments of verticality of the rod can include: perceived size of rod and frame, the gap between the ends of the rod and surrounding frame, presentation of the rod within an encompassing 3D visual framework that visually blocks out the surrounding environment, a dark room, instructions stressing egocentric vs allocentric strategies, double frame surrounding the rod to assess global perception effects, etc. Details are presented how gap size likely affected results in neuropsychology studies. Potentially, these and other experiments may be studied using computer administered RFTs.

Conclusions: Based on the descriptions of computer administered RFTs, this article suggested that incorporating these technologies can provide better understanding underlying the RFT, and in turn, understanding neuropsychology processes.

Objective: This study examined the impact of impairment in two specific cognitive abilities, processing speed and memory, on Dot Counting Test (DCT) classification accuracy by evaluating performance validity classification accuracy across cognitively unimpaired, single-domain impairment, and multidomain impairment subgroups within a mixed clinical sample.

Method: Cross-sectional data were analyzed from 348 adult outpatients classified as valid (n = 284) or invalid (n = 64) based on four independent criterion performance validity tests (PVTs). Unimpaired (n = 164), single-domain processing speed impairment (n = 24), single-domain memory impairment (n = 53), and multidomain processing speed and memory impairment (n = 43) clinical subgroups were established among the valid group. Both the traditional DCT E-score and unrounded E-score were examined.

Results: Overall, the DCT demonstrated acceptable to excellent classification accuracy across the unimpaired (area under the curve [AUC] traditional E-score=.855; unrounded E-score=.855) and single-domain impairment groups (traditional E-score AUCs = .690-.754; unrounded E-score AUCs = .692-747). However, it did not reliably discriminate the multidomain processing speed and memory impairment group from the invalid performers (traditional and unrounded E-scores AUC = .557).

Conclusions: Findings support the DCT as a non-memory-based freestanding PVT for use with single-domain cognitive impairment, with traditional E-score ≥17 (unrounded E-score ≥16.95) recommended for those with memory impairment and traditional E-score ≥19 (unrounded ≥18.08) with processing speed impairment. Moreover, results replicated previously established optimal cutoffs for unimpaired groups using both the traditional (≥14) and unrounded (≥13.84) E-scores. However, the DCT did not reliably discriminate between invalid performance and multidomain cognitive impairment, indicating caution is warranted when using the DCT with patients suspected of greater cognitive impairment.

Introduction: Ambulatory assessment of executive function - particularly in the form working memory (WM) - is increasingly common. Few studies to date, however, have also incorporated ambulatory measures of inhibitory control. Critically, the extended within-person reliability of ambulatory tasks tapping each of these constructs has been largely overlooked.

Method: Participants (N = 283, M_age = 23.74 years, SD = 9.04) received notifications every 3 days (for 4 weeks) to undertake ambulatory assessment versions of the n-Back and Stop-Signal Tasks (SST) via the smartphone application CheckCog. Within-person reliability of these measures was explored.

Results: Compliance ranged from 66% (for eight sessions) to 89% (for four sessions). Our results reveal significant changes in performance within the first two sessions for both the n-Back and SST, with performance remaining largely consistent across the remaining (two to eight) sessions. In terms of test-retest reliability, the ICC (C, 1) values ranged from .29 to .68 on the n-Back (with overall accuracy being .51) and .31-.73 on the SST (with stop-signal reaction time being .53).

Conclusion: The results of the current study contribute to the literature by demonstrating the reliability of brief measures of executive function - in the form of inhibitory control and WM - delivered using smartphones in participants' natural environments. Based on our findings, the CheckCog app reliability tracks baseline systematic changes in WM and response inhibition across multiple time points and for an extended period in healthy individuals.