Journal of Neuropsychology最新文献

Neuropsychology's place in diagnosing dementia is still up for debate. With the advent of disease-modifying therapies, the optimisation of diagnostic pathways is increasingly urgent, particularly in the early stages of Alzheimer's disease. Yet, biomarker-driven frameworks eclipse neuropsychological testing as an ancillary tool rather than recognising it as a core component of clinical assessment. Emerging evidence indicates that relying solely on biomarkers does not provide a dependable forecast for the onset or progression of dementia. This drawback underscores how important neuropsychology is. Nonetheless, the clinical adoption of neuropsychological tests for diagnostic purposes requires a paradigm shift towards a more rigorous methodology. Despite its recognised diagnostic potential, the current neuropsychological framework is constrained by thresholds derived from normative distributions rather than Clinimetrics. Many existing tests rely on arbitrary cut-offs that do not account for disease prevalence, personological variability, or real-world cognitive performance. This oversimplified approach reduces the sensitivity of neuropsychological assessments and limits their integration into clinical practice. The development of population-specific clinimetric studies that establish weighted cut-offs for sensitivity and specificity based on clinical aims is crucial to ensure clinically meaningful decision-making.

Cognitive assessment and analysis of plasma biomarkers are lower-cost options for the early assessment of Alzheimer's disease (AD). In this study, we examined whether serial position markers in the Rey's AVLT were sensitive to plasma AD biomarkers in cognitively unimpaired older individuals. Participants (n = 327; mean age = 70.4, SD = 10.4) were free of dementia (MMSE = 24+) at baseline and recruited as part of the Memory Evaluation Research Initiative (MERI; Nathan Kline Institute, NY, USA). Data included plasma p-tau231, Aβ40 and Aβ42, AVLT scores and demographics. Bayesian linear and logistic regression analyses were carried out with plasma biomarkers as outcomes (including the Aβ42/40 ratio); memory scores, including traditional metrics and serial position scores, were predictors; and age, years of education, APOE ε4-status and reported gender were control variables. Results indicated that plasma p-tau231 was associated primarily with delayed primacy recall (first four words): the more primacy words were recalled, the lower the plasma p-tau231 levels were. This study confirms that serial position analysis of word-list recall data, and particularly delayed primacy, is a valuable tool for the identification of in vivo AD-related pathology in cognitively unimpaired individuals.

Depressive symptoms (DS) after stroke are associated with marked negative consequences for rehabilitation. Identifying determinants of DS is needed to enable prediction and develop psychological interventions. A promising candidate may be self-concept and changes thereof, so-called self-discrepancy. Consulting recent self-concept models, we investigated the role of self-concept subdomains and their individual importance. Within a prospective longitudinal study, 120 stroke survivors were interviewed via telephone 3 years post-ictus to assess present and past self-concept, self-discrepancy, self-concept subdomains and DS. The association of self-concept measures and DS was investigated using an ANCOVA. Controlling for established determinants (age, sex, history of depression, functional independence, social support), multiple regression analyses were used to examine the independent influence of self-concept measures and the role of subdomains and importance-weightings. Self-discrepancy showed a significant interaction with DS (F (1, 118) = 32.69, p < .001, η² = .22). DS showed a stronger association with present (r = -.72) than with past self-concept (r = -.34) and self-discrepancy (r = -.47; all p < .001). Age, history of depression, social support and present self-concept were independent predictors of DS while functional independence was not (∆F (1, 113) = 48.04, p < .001). Importance-weighting of subdomains did not affect explained variance, though the number of self-concept subdomains showing significant association with DS increased. Findings propose appraisals of self-concept as independent predictors of DS after stroke. Considering individual importance of subdomains reveals their differential influence. The results suggest investigating the use of general self-concept for prediction and considering the individual relevance of subdomains in psychological interventions after stroke.

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.

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.

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.

Involving people with lived experience in research (patient and public involvement or co-production) is one principle of open research (transparent research practices). Involvement of experts by experience helps ensure that clinical and health research is relevant, ethical and accessible. While public contributors are likely to view co-production as important, what do public contributors know and think about other open research practices (e.g., pre-registration, data sharing)? We carried out a mixed methods online survey investigating what public contributors already know and would like to know about different open research practices, working with public contributors to shape the study. The 64 participants had a range of lived experience, which they had contributed to research and were passionate about the benefits of co-production. Although many participants did not know the term 'open research', they rated specific practices as familiar and important, seeing the moral imperative. Participants described the balance of practical benefits (e.g., efficiency, transparency) and potential risks (e.g., data sharing, pre-prints). Some practices (e.g., pre-registration) were less well understood, and participants learnt more about open research from the survey. Most participants were interested to learn more, and over 70% indicated an interest in further training. Overall, there is a need and an opportunity to share accessible information and training about open research with those who contribute their lived experience to research. This has the potential to improve research involvement and co-production, as well as the quality and applicability of research more broadly.

Polymicrogyria is a congenital brain malformation characterized by an excessive number of small gyri formed in distinct areas of the cerebral cortex. The perisylvian variant, also known as congenital bilateral perisylvian syndrome (CBPS), is believed to occur in the context of post-migrational trauma during gestational development. Due to the heterogeneity and low prevalence of CBPS, few case studies have characterized its neuropsychological sequelae. We describe an illustrative case study of a 20-year-old young adult male with intellectual and expressive language impairments. Patient's history was notable for significantly delayed developmental milestones such that he was never able to speak beyond single words/syllables. He experienced his first seizure at the age of 6 and, at the time of the evaluation, he was experiencing breakthrough seizures despite being on anti-seizure medication. Given limited expressive language abilities, a bottom-up approach was utilized wherein abilities were assessed iteratively. Data were broadly consistent with moderate-to-severe intellectual disability with deficits in basic and higher-order language globally influencing domains such as spatial attention, working memory and visual learning/recall. He benefited from recognition cues. Motor testing revealed bilaterally impaired strength and fine motor speed/dexterity that were non-lateralized. Collateral report indicated that he required significant support in adaptive functioning and prompting to complete even basic Activities of Daily Living (ADLs). Although fairly brief, this evaluation largely utilized measures that did not require expressive language. This case further highlights the challenges in characterizing cognitive abilities in CBPS patients who fall on the severe end of the spectrum and also have a concomitant history of epilepsy.

We identified in two awake surgery cases a postoperative double dissociation between phonological and graphemic output buffer deficits. Using lesion-symptom mapping from ischaemic mini-strokes and preoperative tractography, we demonstrated that the phonological (resp. graphemic) disorder fitted with ventral (resp. dorsal) damage to the AF. Further studies are needed to confirm our hypothesis of a ventro-dorsal functional organization within the AF for phonological versus graphemic processing.