Journal of clinical and experimental neuropsychology最新文献

Survival rates for non-central nervous system cancers (CNS) have markedly improved in recent decades due to advancements in early detection and treatment; however, this progress has also led to a rise in survivors living with long-term side effects, including cancer-related cognitive impairment (CRCI). Neuroimaging has been vital in understanding the impact of cancer and its treatments on brain functioning, revealing changes in brain activity, structure, and connectivity associated with cognitive decline. This review summarizes current neuroimaging research on adults with non-CNS cancers, focusing on alterations in gray and white matter and functional, metabolic, and vascular changes. Consistent findings of alterations in the prefrontal cortex have been observed, with both structural and functional changes observed in patients with CRCI, and limbic and temporal structures also appear to be impacted. These brain changes have been shown to correlate with functioning on objective and self-reported measures of executive functioning and memory. Future research should further explore novel complementary techniques and analytic approaches, to provide more in-depth knowledge on various potential mechanisms contributing to CRCI. Multimodal investigations of biomarkers including genomic interactions, neuroinflammatory processes, oxidative stress, blood-brain barrier disruption, and gut-brain axis effects could yield new insights. Neuroimaging will remain essential in elucidating these mechanisms and their roles in CRCI.

Introduction: Impairment in affect regulation continues even after remission from depression. However, little is known about whether difficulties in affect regulation persist or improve as time in remission grows and how they manifest in everyday life. With the aim of addressing this gap, we hypothesized that greater time in remission would correspond with more positive affect and perceived regulatory success, and with less negative affect, perseverative cognition, and momentary impulsivity. An exploratory aim was to determine whether executive dysfunction would mediate relationships between time in remission and regulatory outcomes.

Method: A sample of 42 young adults with remitted major depressive disorder completed ecological momentary assessments, which included measures of positive and negative affect, perseverative cognition (rumination and worry), perceived regulatory success, and momentary impulsivity multiple times per day across the assessment period. Each person's mean level and variability of these constructs was computed and time in remission was calculated using a semi-structured clinical interview.

Results: Regression analyses indicated that a shorter time in remission predicted higher levels of negative affect, perseverative cognition, and momentary impulsivity and less perceived success with regulating affect in everyday life (ps < .05). Shorter time in remission also predicted more variability in perseverative cognition and positive and negative affect.

Discussion: Although cognitive-affective processes often are conceptualized as traits, our data indicate that these measures are dynamic, fluctuating across the course of a week. Several of these processes also appear to attenuate and stabilize as depressive episodes become more distal. These findings have important clinical implications, suggesting that remitted individuals may continue to benefit from interventions to reduce impulsive and perseverative cognitive-behavioral patterns and improve regulation success and affective stability. Interventions may have particular utility earlier in remission when these skills may be more impaired, with the goal of restoring functioning and reducing the likelihood of relapse.

Introduction: Adverse childhood experiences (ACEs) are theorized to amplify the effects of poor executive functioning (EF) leading to rumination. Though, few studies test this hypothesis among adolescents. Rumination is a transdiagnostic risk factor linked to mental health problems. We tested the moderating effect of ACEs (across informants) on the association between EF (measured using neutral and negative stimuli) and depressive and anger rumination.

Method: Youth were initially recruited at 3-5 years-old for a longitudinal project examining the biopsychosocial consequences of child maltreatment. These analyses are based on a follow-up study that included adolescents (n = 48; ages 14-16; M = 14.86, SD = .50) who completed self-reports of lifetime ACEs, depressive and anger rumination, and the affective interference resolution task (a measure of EF). Additionally, a caregiver provided lifetime report of youth ACEs, and early childhood ACEs (3-5 years of age) were assessed using child protective records and caregiver interviews.

Results: Contrary to expectations, EF in the context of negative information was not associated with any form of rumination. Instead, poor EF in the context of neutral information was associated with more anger rumination for adolescents who experience two or more ACEs per adolescent report (b = .01, p = .011), or three or more ACEs per caregiver report (b = .01, p = .046) after controlling for gender and current mental health problems; however, these effects were no longer significant when mental health problems were removed as a covariate. Furthermore, the interaction utilizing early childhood ACEs was not significant. Lastly, the interactions between ACEs and EF assessed with neutral information on depressive rumination and brooding were null.

Conclusions: There is some support for the interactive relationship between EF and ACEs on rumination. However, statistical significance varies based on model specification and assessment of constructs. It is important to utilize multi-informants to assess ACEs, EF measured across valenced stimuli, and broad conceptualizations of rumination.

Introduction: Research demonstrates visuospatial dysfunction as an early marker of neurocognitive disorders (NCDs) in older adults (OAs). The Benton Judgment of Line Orientation is a commonly administered visuospatial task, and error analysis of the degree of misjudgment has been validated to distinguish between cognitively normal and clinical populations in OAs. This study evaluates the utility of applying this previously established error analysis to the RBANS Update: Line Orientation (RBANS-LO).

Methods: This study used a retrospective review of OAs (age ≥60) of varying levels of cognitive functioning, who were administered a neuropsychological assessment (N = 197; M age = 74.28). Multiple regression was used to evaluate whether three error types (interquadrant errors [IQE], horizontal errors [HE], and horizontal switch errors [HSE]) were associated with NCD severity, other neurocognitive performances, and etiology of cognitive decline.

Results: All three error types were significantly more common in the major NCD group. HSEs were associated with NCD etiology, such that non-Alzheimer's Disease participants were more likely to commit these errors. Two error types (IQEs and HEs) were associated with measures of working memory, while only one error type (HSEs) was related to visuospatial performance.

Conclusions: All three error types differentiated between cognitive severities and were almost exclusively observed in the major NCD group. RBANS-LO error analysis can thus provide additional data to support severity determinations, which supports the utility of applying it to this task. Only one error type was associated with visuospatial performance, suggesting that other cognitive abilities potentially impact RBANS-LO in a major NCD population. Additional work exploring the relationship of error types to biomarker-defined etiologies or other markers of neurodegeneration could provide information about the underlying mechanisms of these errors. Further research could also assess the utility of modifications to the RBANS-LO to reduce the occurrence of these errors.

Introduction: Multiple sclerosis (MS) is a demyelinating disease of the central nervous system (CNS) that features multifocal white and gray matter lesions. Cognitive impairments in working memory (WM) and processing speed (PS) are common features of MS. Cognitive training has shown promise for improving cognitive deficits in MS. The purpose of the present study was to investigate the effects of WM and PS training on performance of a 2-back WM task and 4 × 4 matrix Visual Search (VS) task and to determine the effectiveness of training as measured by a number of purported behavioral indices of neural efficiency, such as RT variability.

Method: Forty three Relapsing-Remitting MS participants (PwMS) completed the study. Participants visited the laboratory for pre-testing, were assigned to a training group (WM group,VS group), or a MS control group (no-training) and returned to the laboratory for post-testing after approximately 4-5 weeks of home training. At pre- and post-testing, all participants were administered the WM and VS Tasks. Behavioral measures of accuracy, reaction time (RT), and RT-variability were obtained to these tasks.

Results: Analyses revealed that the WM training group had significantly improved behavioral measures at posttest on the 2-back WM task compared to the other two groups, and improvement on the VS task, indicative of transfer of training from WM to VS. The VS training group showed significantly improved behavioral measures on the VS task at posttest, and improved RT on the 2-back task at posttest. The control group improved significantly only for accuracy on the VS Task from pre- to posttest and failed to show significant improvements on any RT measures for either the VS or WM tasks. RT variability (purported markers of neural efficiency) provided unique information related to training effects and signified improved neural efficiency due to training.

Conclusion: The findings suggest that training, particularly on WM, leads to increased neural efficiency, reflected by decreased RT variability, increased PS, and transfer of training across tasks.

Introduction: Many studies have established the relationship between greater burden of beta-amyloid (aβ), a marker of Alzheimer's disease (AD), and poorer neuropsychological performance. However, it is poorly understood whether neuropsychological test scores predict aβ deposition. This study aimed to evaluate the predictive utility of neuropsychological test scores on aβ deposition in a sample of older adults across the late-life cognitive spectrum.

Method: One hundred and sixty-five older adults classified as cognitively intact (n = 68), single- or multi-domain amnestic mild cognitive impairment (MCI; n = 52) or mild dementia (n = 45) completed amyloid positron emission topography (PET), and neuropsychological measures including Hopkins Verbal Learning Test - Revised (HVLT-R), Brief Visual Memory Test - Revised (BVMT-R), Trail Making Test (TMT) Parts A and B, and Symbol Digit Modalities Test (SDMT). A series of hierarchical regression were evaluated to assess the predictive association of cognitive test scores to aβ deposition.

Results: In a predominantly non-Hispanic White, college-educated sample, HVLT-R Total and Delayed Recall were negatively associated with aβ deposition above and beyond demographic covariates (i.e. age, sex, years of education, estimated premorbid functioning), accounting for 31% and 39% of variance in aβ, respectively (p < .001). Similarly, BVMT-R Total and Delayed Recall scores each accounted for 31% of variance (p < .001). Effect sizes for processing speed and executive functioning scores were smaller, with SDMT explaining 12% of the variance and TMT-A and TMT-B explaining 7% and 9% of the variance, respectively (p < .001).

Conclusion: Cognitive test scores significantly predicted aβ deposition, with memory measures in particular accounting for approximately a third of the variance. These results provide a proof of concept for use of neuropsychological test scores as tools for estimating biomarkers in neurodegenerative disease.

Background: Standardized episodic memory tests often impose time limits, obscuring whether poor performance in Multiple Sclerosis (MS) is due to cognitive or Information Processing Speed (IPS) deficits.

Method: We assessed episodic memory performance on the Selective Reminding Test (SRT) in 157 persons with MS (pwMS) and 109 healthy controls using survival analysis to examine the number of trials required for two consecutive full recalls of a word list (SRT-goal). Survival analysis focuses on when a particular event occurs and appears appropriate to characterize the slow vs. rapid progression of learning in pwMS.

Results: Results showed a significant difference among pwMS and control: the mean survival times decreased from 10.23 trials in patients to 8.52 trials in controls, indicating that controls achieved the task sooner than patients (p < .001). Among pwMS, those with preserved IPS reached the SRT-goal in a median of 9.71 trials, while those with impaired IPS took 10.67 trials on average (p < .001). Only 12.5% of IPS-impaired pwMS achieved the SRT goal, compared with 60% of those with preserved IPS. Comparing MS-subtypes, 60% of relapsing-remitting MS (RRMS) patients reached the SRT goal, whereas only 15.8% of secondary progressive MS (SPMS) and 15% of primary progressive MS (PPMS) patients did.

Conclusions: Survival analysis provides a complementary assessment of episodic memory to traditional paradigms and an innovative way to address slow-learning in MS. This study presents clinical lessons in the assessment of episodic memory and cognitive rehabilitation of pwMS.

Insomnia is a prevalent sleep disorder associated with cognitive difficulties, including reduced performance in executive control and semantic memory. This study explores the impact of insomnia on language retrieval processes using the Chinese Verbal Fluency Test (VFT), addressing the need for cognitive research beyond English-speaking populations. We hypothesised that insomnia-related difficulties in semantic memory and executive control would result in reduced VFT performance. Participants with insomnia (N=20) and matched healthy controls (N=20) were recruited from a community outpatient clinic in China to complete an online Chinese VFT, generating words for semantic categories (e.g., animals) and phonemic conditions (e.g., words beginning with "bai" [, "white"]). Compared with controls, the insomnia group produced fewer correct responses across both tasks; the between-group gap was larger for semantic correct responses. Clustering and switching analyses showed fewer switches in the semantic task for the insomnia group and a reduced phonemic mean cluster size, suggesting difficulties in executive control processes. Together, these convergent results indicate reduced efficiency in both semantic memory retrieval and control-guided search during word production. By employing a Chinese VFT and parallel semantic and phonemic tasks, the study extends current evidence beyond alphabetic languages and highlights how language-specific demands can shape fluency performance. Overall, the findings clarify how sleep disturbances may influence core components of language processing and support the value of process-level fluency measures in characterising cognitive difficulties linked to insomnia.

Objective: The goal of this study, by using factor analyses, was to reveal the structure of the interrelations between the various total and composite scores generated by the Rey AVLT. A second goal was to address the question: does this structure remain constant across the lifespan?

Method: This study consists of three phases: In Phase I, six total scores were submitted to Exploratory Factor Analysis (EFA) conducted on the entire sample (n = 1471) with an age range of 8-91. In Phase II, EFA was conducted on seven composite scores - five process scores and two total scores, applied to the entire sample. In Phase III, the same scores were then submitted to separate Confirmatory Factor Analysis for five age cohorts (8-12, 13-17, 20-29, 30-59, & 60-91).

Results: In Phase I, when total scores were used, unconstrained rotation yielded a single factor. Only under constraining to a three-factorial model did Learning, Storage, and Retrieval emerge. In Phase II, when process scores were used, under unconstrained rotation, a three-factorial model, Learning, Storage, and Retrieval, emerged. The results in Phase III confirmed that the three-factor model shows a developmental trajectory throughout the lifespan. Furthermore, the factors' loading parameters were found to be similar across all age groups.

Conclusions: This study has major theoretical and clinical/diagnostic implications. On the theoretical level, it confirmed that there are three distinct memory processes underlying the Rey AVLT: Learning, Storage, and Retrieval. Furthermore, these processes remain constant across the entire age range, 8-91 years old. On a clinical level, the current results could lead the diagnostician to a conceptually driven diagnosis by pinpointing the exact impaired or preserved memory process, based on the constellation of the various Rey AVLT scores, according to the factor on which they are loaded.