Journal of Neuropsychology最新文献

Creative cognition involves linking weakly or unrelated concepts, enabled by semantic control (inhibiting dominant associations to retrieve weaker ones) or through spreading activation within the semantic system. Semantic aphasia (SA) patients have impaired semantic control despite relatively preserved semantic representations. To date, no studies have examined creativity in SA. It remains unclear how impaired control affects patients' creative potential, and whether spreading activation alone supports this. Creative potential was assessed across three experiments. Experiments 1 and 2 involved 11 SA patients and 25 controls; Experiment 3 included 13 SA patients and 14 controls. In Experiment 1 (category judgement), participants selected five targets from distractors across 24 categories with differing coherence levels (shared features among members). Experiment 2 (constrained category fluency) involved generating five exemplars per category. Creative potential was measured via uniqueness, flexibility, semantic distance and creativity ratings. Experiment 3 (unconstrained fluency) asked participants to name as many Animals as possible in 1 minute, with additional measures of clustering and switching. Although SA cases were unable to shape retrieval to pre-defined associations (in the category judgement task), they showed creative potential in the constrained fluency task. In the unconstrained fluency task, patients were less able to use strategies. However, with fluency controlled, no group differences in creative potential existed. These findings provide the first neuropsychological evidence that spreading activation, even with impaired semantic control, can support creative responses. Creative potential in SA depends on task demands, aligning with broader findings of patients' sensitivity to context.

People with Parkinson disease (PD) after surgery for deep brain stimulation (DBS) of the subthalamic nucleus (STN-DBS) often decline in animal fluency due to impairments in executive functions and/or language. Item-based measures of animal fluency may shed light on the specific nature of this decline, and into the strategies used when performing this task. We aimed to investigate the mechanisms of decline in animal fluency by revealing impairments in language and/or executive functions in people with PD before and after STN-DBS by using item-based characteristics, the total number of correct words, average cluster size, number of switches and scores on tests for language and executive functions. People with PD (N = 61) produced fewer words and switches than healthy controls (N = 40) before and after STN-DBS surgery. After surgery they additionally produced smaller clusters and shorter words than healthy controls. Comparing pre- and post-surgery, people with PD produced fewer words, fewer switches, smaller clusters, more frequent and earlier-acquired words after surgery. Average cluster size predicted total number of words before surgery. No item-based measures predicted total number of words after surgery. Average cluster size before surgery correlated with object naming, not with executive functions. Item-based measures indicated difficulties in executive functions and language processing. New to the literature, the correlation of cluster size with object naming may stress difficulties in lexical retrieval before surgery. Finding no item-based measures predicting the total number of words after surgery may indicate a different type of impairment not accounted for in our analyses. Replication is needed.

Neuropsychological assessment in mild cognitive impairment (MCI) increasingly includes executive functions evaluation to improve diagnostic accuracy. Handwriting analysis, though common in dementia studies, is less explored in MCI. This single-centre study aimed to compare neuropsychological tests and handwriting parameters, assessing their individual diagnostic value. The study included two groups: MCI (n = 46, female/male ratio 41/5, mean age 76.87 ± 5.08) and controls without cognitive impairment (n = 46, ratio 42/4, mean age 75.70 ± 5.97). The assessment included MoCA, MMSE, Comprehensive Trail Making Test (CTMT), verbal fluency test and handwriting analysis using Livescribe Echo Smartpen. Logistic Regression (LR), K-Nearest Neighbours (KNN) and Linear Discriminant Analysis (LDA) models were used to identify patients with MCI. Patients with MCI performed worse on neuropsychological tests, generating fewer words in verbal fluency (p < .01) and taking longer on CTMT (p < .01). Neuropsychological tests outperformed handwriting measures in MCI classification (AUC: CTMT = .81, semantic fluency = .76, phonemic fluency = .72). Among the handwriting measures, text height (AUC = .68) showed the best performance, while other kinematic features ranged from .63 to .64. After combining all neuropsychological tests, KNN achieved the best classification of MCI (AUC = .84, ACC = .82, MCC = .63), while handwriting-based models performed worse, with LR reaching the highest AUC (.64), ACC (.62) and MCC (.23). CTMT and verbal fluency tests are useful in diagnosing MCI, while handwriting measures showed limited classification value.

Interpreter-mediated assessments are increasingly common in paediatric neuropsychology, both globally and within the United Kingdom, due to the rising linguistic and cultural diversity of service users. However, limited research has examined how interpreters and clinicians navigate the complexities of delivering developmentally appropriate, culturally sensitive and psychometrically valid assessments. This qualitative study explored the experiences of 10 paediatric neuropsychologists and nine professional interpreters across NHS services in the United Kingdom. Semi-structured interviews examined the challenges, role expectations and collaborative practices within interpreter-mediated cognitive assessments. Data were analysed using reflexive thematic analysis, with key themes highlighting tensions between access and standardisation, differing interpretations of the interpreter's role and the unique demands of neuropsychological testing in children. Participants consistently emphasised the value of structured collaboration, such as pre-assessment briefings and post-assessment debriefs, though these practices were inconsistently applied. A two-round structured consensus-building exercise, informed by Delphi methodology but adapted for a smaller, profession-specific sample, was subsequently conducted with 13 participants to generate consensus-based recommendations. Nine statements reached an agreement of ≥80%, including the need for joint preparation, interpreter access to sample materials and tailored training for both interpreters and clinicians. These findings underscore the distinct cognitive, relational and linguistic challenges inherent to interpreter-mediated paediatric neuropsychological assessment and call for more explicit guidance and professional development. The study contributes to cross-cultural neuropsychology by providing practice-oriented recommendations to enhance the quality and equity of assessments. Future work should focus on implementation, particularly within resource-constrained or multilingual settings.

Sleep plays a vital role in cognitive regulation, memory consolidation and brain health. In Colombia, sleep patterns may be influenced by cultural and socioeconomic factors such as co-sleeping, occupational stress and limited healthcare access, which can exacerbate sleep-related disorders like sleep apnoea. This study examined the relationship between objectively measured sleep quality and cognitive performance in Colombian adults with sleep apnoea. We hypothesised that poorer sleep quality, which is characterised by lower efficiency and more apnoea (hypopnoea events), would be associated with poorer memory and executive performance, and that age would intensify this effect. Thirty adults aged 30-59 years underwent overnight polysomnography and a comprehensive neuropsychological evaluation. A composite sleep quality index was derived through principal component analysis and analysed using gamma regression controlling for age and gender. Results showed that better sleep quality predicted superior performance on the Wisconsin Card Sorting Test (β = 4.04, p = .032) and the Wechsler Memory Scale (β = 4.43, p = .032), supporting the primary hypothesis. These findings suggest that disrupted sleep architecture selectively affects neural systems underlying executive control and memory. Integrating sleep assessments into neuropsychological evaluations may enhance diagnosis and guide interventions to improve cognitive resilience in Colombian adults with sleep-related disorders.

Following an increased need for remote cognitive screening solutions, we aimed to investigate the construct validity and determine initial sensitivity/specificity estimates of the Tele-OCS, a stroke-specific remotely administered cognitive screening tool. To this end, a secondary data analysis is presented from 98 stroke survivors from the OX-CHRONIC longitudinal study (average 4.5 years. post-stroke). Convergent validity was examined for overall Tele-OCS performance against MoCA total score, and separately for each of the subtasks against matched neuropsychological tasks. Divergent validity was examined against different neuropsychological tests and presumed to be unrelated self-reported anxiety, as measured with HADS-A. Overall, we found that the Tele-OCS subtasks had good convergent/divergent validity. All subtasks also showed excellent specificity (min 80%), and whilst the cancellation task also showed good sensitivity (80%), all other subtasks came at a cost of lower sensitivity, compared to a more sensitive neuropsychological assessment. The Tele-OCS provides a brief, remote, first-line cognitive screening tool that reliably detects cognitive changes where these are clearly present, specifically and validly measuring distinct cognitive domains, which contrasts with a domain-general cognitive screening approach.

Reassessments with the Rey Auditory Verbal Learning Test (RAVLT) may generate learning effects, compromising the validity of the results. In Brazil, there are still no comparative studies between adapted versions of the test in healthy individuals. This study compared scores obtained on versions A and B of the RAVLT-A, routinely used in the neuropsychological assessment of patients with epilepsy and investigated the effects of age, education and version used. A prospective study with 188 cognitively healthy adults was randomly assigned to two groups (version A or B). Comparative analyses between groups and multivariate linear regression models were conducted to examine the impact of age, education and version on RAVLT-A scores. No significant differences were observed between versions A and B of the RAVLT-A (p > .05). Regression indicated a significant influence of age and, especially, education on performance on the test variables. The version used had no statistically relevant impact on the scores. This is the first Brazilian study to examine two adapted versions of the RAVLT-A in healthy adults. The findings demonstrate comparability between versions A and B, supporting their alternate use in reassessments to reduce practice effects. Age and, especially, education significantly influenced performance, emphasizing the need for normative data stratified by both variables, since those commonly used in Brazil are stratified only by age.

There remains a lack of appropriately adapted neuropsychological tests for culturally, linguistically and educationally diverse populations, particularly for the evaluation of social cognition, as its assessment is essential for the early diagnosis of diseases such as frontotemporal dementia and Alzheimer's disease. To address this gap, we designed the TIE-93, an emotion recognition test based on Ekman's emotion recognition test, which was adapted to be better suited for culturally, linguistically and educationally diverse populations. However, in a previous study, we found that despite modifications to the test format, culture still had a significant effect on TIE-93 test performance. The present study aimed to further investigate this effect by comparing performances and analysing item-level accuracy and error patterns between participants from individualistic and collectivistic cultures. In total, 205 participants from individualistic countries and 91 participants from collectivistic countries, aged 50 to 90, were included in this study. Results were mostly consistent with existing research literature and showed that the individualistic group performed significantly better than the collectivistic group. However, unlike our previous findings, education-rather than culture-accounted for the largest proportion of variance (34.91%), followed by age (14.94%) and, finally, cultural group (4.2%). This study highlights the importance of considering both educational and cultural factors in the development of emotion recognition tests for diverse populations.

The serial position effect is a well-established phenomenon characterised by better recall of items at the beginning and end of a list compared to those in the middle. A reduced primacy effect-reflected by diminished recall of items from the initial positions-has frequently been reported in individuals with Alzheimer's disease (AD) and Mild Cognitive Impairment (MCI). This study aimed to examine the serial position curve in the Prose Memory test and to assess whether recall accuracy from the primacy portion of the story can predict progression from MCI to AD. Sixty-two patients diagnosed with MCI were included. After 3 years, 30 patients progressed to AD (cMCI), while 32 remained stable (sMCI). Immediate and delayed recall performance for the three segments of the story (Primacy, Middle and Recency) was analysed. In the immediate recall trial, both MCI groups and healthy controls showed enhanced recall accuracy only for the Primacy portion of the story. In the delayed trial, a reduced primacy effect significantly distinguished cMCI from sMCI patients. Receiver Operating Characteristic (ROC) analysis indicated acceptable diagnostic accuracy of delayed Primacy recall in differentiating converters from stable MCI patients. Delayed Primacy recall in the Prose Memory test predicted conversion from MCI to AD. These results suggest that delayed Primacy recall in prose memory may serve as a non-invasive marker for identifying individuals at risk for AD progression.

Obsessive-compulsive disorder (OCD) is a heterogeneous disorder, and approximately 70% of patients with OCD experience sensory phenomena (SP). Previous studies have revealed that patients with OCD exhibit a deficit in response inhibition (RI). However, few studies have investigated the relationship between SP and RI in patients with OCD. This study aimed to investigate differences in RI between non-comorbid, medication-free patients with OCD with and without SP. Thirty-seven patients with OCD with SP (OCD + SP), 27 without SP (OCD-noSP), and 50 controls (HCs) were compared in terms of RI using the stop-signal task. Both OCD groups had a deficit in RI compared with HCs, and no difference in RI was found between the OCD + SP and OCD-noSP groups. No correlation was observed between SP and stop-signal reaction time in the OCD + SP group. Our findings suggest that a deficit in RI is not related to SP in OCD.