Journal of Neuropsychology最新文献

We aimed at validating the Mini Social Cognition and Emotional Assessment (Mini-SEA) in a German cohort of mildly impaired behavioural-variant frontotemporal dementia (bvFTD) patients and healthy controls. The Mini-SEA comprises the Facial Emotion Recognition Test (FERT) and the Faux Pas Test (FPT) measuring Theory of Mind (ToM) abilities in social norm-related real-life stories. We examined the diagnostic performance of the Mini-SEA alongside other neuropsychological assessments and investigated its structural neural correlates. We included 32 bvFTD patients and 54 controls in logistic regression models with forward-stepwise selection containing demographics, standard neuropsychological battery (CERAD-NAB+) and the Mini-SEA scores to identify the most relevant variables. Demographic, neuropsychological and daily-life activity associations were explored. Voxel-based morphometry analysis was conducted in a subsample (14 bvFTD and 14 controls) on regions previously linked to emotion processing and ToM functions. The Mini-SEA yielded a very good performance, being in the best-fitting model with a high odds ratio alongside the executive-language and memory measures. Specifically, the FERT indicated the strongest effect in the group differentiation. Mini-SEA showed significant associations with executive-language tests and daily-life activities. In canonical emotion processing brain regions, we found associations of the Mini-SEA composite and the FERT with grey matter volumes in the left insula and lentiform nucleus of putamen. Within ToM regions, associations were found for the Mini-SEA composite and the FPT in cerebellar regions. The German Mini-SEA discriminates well between mildly impaired bvFTD patients and controls. We also demonstrated its significant value for neuropsychological assessment and neuro-behavioural associations in regions underlying emotion processing and ToM.

Harmonized neuropsychological assessment for neurocognitive disorders (NCDs) is an urgent priority in clinics. Neuropsychology assessments in NCDs seldom include tests exploring social cognitive skills. In 2022, we launched the SIGNATURE initiative to optimize socio-cognitive assessment in NCDs. Here, we report findings from the first initiative phase, including consortium creation and evaluation of the state of the art in socio-cognitive assessment in memory clinics. We developed an ad hoc online survey to explore practices and measures, relevance, and obstacles preventing the use of socio-cognitive testing in clinics. The survey was distributed within the SIGNATURE network. National coordinators were identified to disseminate the survey to local collaborators and scientific societies active in the field of dementia and/or neuropsychology. Data were analysed in aggregate form and stratified by geographical area and variables of interest. Four hundred and thirteen (413) responses from 10 European and Latin American geographical regions were recorded. Responders were balanced between physicians and psychologists. Seventy-eight (78) % of respondents reported no/limited experience with socio-cognitive measures; more than 85% agreed on their relevance in clinics. Ekman-60 faces was the most well-known and/or used task, followed by the Faux-Pas and Reading-the-Mind-in-the-Eyes tests. Lack of clinical measures, assessment time, guidelines, and education/training were reported as main obstacles. Real-life barriers prevent the adoption of socio-cognitive testing in clinics. Bidirectional collaboration between clinicians and researchers is required to address clinical needs and constraints and facilitate consistent socio-cognitive assessment.

Faced with increasing diversity in Europe, a large body of research in neuropsychology has emerged to develop tools for the reliable detection of cognitive disorders in diverse older adults. Following this perspective, few tools have been validated, particularly for assessing episodic memory, such as the Nine Images Test (TNI-93). The aim of the present study was to test the interest of adding a delayed recall to the classic TNI-93 procedure for the detection of clinical Alzheimer's disease (AD) in diverse populations. A French retrospective analysis was conducted based on the clinical and neuropsychological data of 281 patients (111 who received a clinical diagnosis of AD; 101 with a cognitive profile not suggestive of AD and 70 patients with a subjective cognitive decline). The sample was mostly composed of people with a low level of education and non-French speakers. The TNI-93 data from the neuropsychological assessment, including a free and a cued recall after a 20 min delay, were analysed. First, AD patients performed more poorly than both other groups on all scores. However, performance decreased more significantly after a 20 min delay in AD patients than in the other groups. Second, the Receiver-Operating-Characteristic analysis showed that the higher diagnostic accuracy for the detection of AD patients was obtained for the 20 min free recall. These results confirm the relevance of the TNI-93 for the clinical detection of AD in diverse populations. The added delayed recall condition seems relevant to highlight the accelerated forgetting of AD patients in a 20 min time window following learning.

The ‘KeyStrokes’ test (KS) was created as an online and computerized neuropsychological assessment to assess simple attention, processing speed, and executive function. This pilot study aims to show proof of concept of the KS test as a computerized assessment. Building on a previous feasibility study, we assessed the KS test's internal consistency and correlations to other neurocognitive assessments. Participants were recruited from a clinical sample of patients referred for standard neuropsychological evaluation and were asked to perform several standard neurocognitive tests and six subtests of the KS: two response time trials (arrows, words), three inhibition trials (arrows, words, arrows/words) and one inhibition/switching trial (arrows/words). We assessed internal consistency; conducted correlation analyses between each KS subtest, standard neuropsychological tests, and demographic characteristics (age, education, ethnicity, and gender); and conducted multiple regression analyses to assess the relationship between test performance and age and education. We assessed 87 individuals with a mean age of 54.09 years. Correlations between KS subtests were positive and strong (all above ρ > .72, p < .001). Subtests were generally positively correlated with select WAIS-IV and Reynolds Interference Task subtests, and negatively correlated with trail making tests, the grooved pegboard test, and age. Age significantly predicted performance (p < .001), whereas education did not. Ethnicity appeared to correlate with certain subtests, whereas gender did not. Analysis of correlations between the KS subtests and multiple well-established neuropsychological tests showed the possible viability of the KS as a new neurocognitive measure assessing areas of attention, processing speed, and executive function. Additional study of the KS can provide more evidence for its use as a new computerized, and possible online neuropsychological assessment.

Patients with dural arteriovenous fistulas (DAVF) suffer from cognitive impairments that go often unrecognized. This study aimed to explore the severity of cognitive impairment as well as specific cognitive domains affected in DAVF patients and to track its evolution over long-term follow-up after embolization. Consecutive DAVF patients (and an equal number of healthy controls) were prospectively enrolled and underwent a comprehensive baseline neuropsychological (NP) assessment. These patients were re-evaluated postembolization at a short-term follow-up of 1 month and long-term follow-up of 8–12 months. Thirty-one patients were included, with a male-to-female ratio of 5.2:1 and an average age of 45.1 years. NP assessments revealed significantly impaired cognitive scores across all domains (Addenbrooke's Cognitive Examination [m-ACE], the Rey Auditory Verbal Learning Test [RAVLT], the Wechsler Memory Scale, digit span forward and backward tests, and the Trail Making Test Parts A and B) in the DAVF group compared to healthy controls (p < .001). Post embolization, the m-ACE (p < .001), RAVLT (p = .04), WMS-verbal delay (p = .002) and Trail making test B (p = .019) scores showed statistically significant improvement compared to healthy controls at 1 month. However, the cognitive scores did not fully recover to the level of healthy controls at long-term follow-up. Though treatment leads to significant cognitive recovery, lasting residual cognitive deficits are persistent in DAVF patients compared to healthy controls. Inclusion of comprehensive NP evaluation in work up can unmask subtle cognitive deficits that may guide in therapeutic decision making especially in ‘benign’ DAVFs.

Transient global amnesia (TGA), a transient memory disorder in clinical neurology, is a unique clinical model for the study of hippocampal dysfunction and its implications for memory processes. While data are rather unequivocal concerning the relevance of the hippocampus for episodic memory, there is considerable dispute about its role for semantic memory. This study aimed at exploring how hippocampal impairment, which underlies the clinical presentation of TGA, affects semantic memory retrieval, particularly with regard to different retrieval strategies. Data from the acute and post-acute phase of 17 TGA patients and 17 healthy controls matched on socio-demographic factors were collected. Categorical word fluency tasks were differentiated into three retrieval strategies: first, with activation of episodic-spatial memory content; second, with novel and flexible linking of semantic memory content and third, with activation of overlearned semantic memory content. We find that hippocampal impairment during TGA significantly restricts semantic word fluency performance, with the degree of impairment depending on the retrieval strategy used and most pronounced when flexible relinking of semantic content is required. Our results suggest an important hippocampal contribution to semantic retrieval, especially in connection with novel and flexible linking of semantic content. They may furthermore be practically relevant for the early differential diagnosis and therapy of memory disorders.

Updated criteria pertaining to the diagnosis of Alzheimer's disease (AD) have sparked debate over the reliance on biomarkers—particularly amyloid-β and phosphorylated tau. While biomarkers promise earlier detection and standardized criteria, the potential extension and interpretation of their use in asymptomatic individuals remains controversial. Many individuals with abnormal biomarker profiles never experience cognitive decline, raising concerns about overdiagnosis, unintended negative psychosocial consequences and the blurring line between risk and definitive diagnosis. We, and others, argue that biomarker positivity should be reframed not as a definitive diagnosis but rather as an indicator of elevated risk, particularly in the absence of cognitive symptoms. Doing so better aligns with current evidence, preserves clarity in diagnosis, and avoids unintended psychosocial consequences. Crucially, the role of cognitive reserve—influenced by education, other life experiences and structural inequities—must be considered, particularly among racially and ethnically diverse populations historically underrepresented in AD research. Biomarker thresholds (as well as neuropsychological tools) derived from predominantly non-Hispanic white cohorts may not generalize across groups, risking misclassification and inequity. As the field moves towards precision medicine and AI-driven risk models, inclusive data and culturally valid frameworks are essential. Ultimately, embracing a risk-based, multifactorial approach respects the complexity of AD and promotes equitable care. This perspective calls for interdisciplinary collaboration to refine diagnostic strategies that are scientifically grounded, socially conscious and responsive to the lived realities of diverse populations. Only then can we responsibly integrate biomarkers into practice without sacrificing nuance.

We introduce a special issue of the Journal of Neuropsychology dedicated to a recent paradigm shift in Alzheimer's disease diagnosis. Joint workgroups from the (US) National Institute on Aging and the Alzheimer's Association (NIA-AA) recently issued policy guidelines reclassifying Alzheimer's disease as a biological entity. These guidelines shift the onus of diagnosis in favour of protein biomarkers, relegating cognitive symptoms (e.g. subjective memory and language disorders) as supportive rather than core features. We invited experts in the study of Alzheimer's disease and Related Disorders (ADRDs) to express their views on this paradigmatic shift in dementia management. In this editorial, we synthesize some of the main points advanced in the commentaries. Contributors identified the promise of blood-based biomarker testing for improving equitable detection of dementia in large swathes of the world population. This enthusiasm was tempered by concerns about the biomarker-only diagnostic approach, including the potential for significant harm (e.g. stigma, depression, suicide) caused by labelling asymptomatic older adults who might otherwise never behaviourally express the underlying disease pathology.

This study used fMRI to examine the effect that the abstract-concrete dimension may have on the thematic-taxonomic distinction. The dual hub theory (DHT) posits that left angular gyrus supports thematic relationships and left temporal pole supports taxonomic relationships; however, the DHT is largely based on evidence from concrete words. It is important that theories of semantic organization include abstract words as they are ubiquitous in everyday discourse (Lupyan & Winter, Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences, 2018, 373, 20170137). Additionally, there is reason to believe that there may bean interaction between the abstract-concrete dimension and the thematic-taxonomic distinction, based on the different representational frameworks (DRF) hypothesis, which posits that abstract concepts are primarily organized by association/theme, and that concrete concepts are primarily organized by similarity/taxonomy. However, there appears to be a mismatch among the DHT, predictions of the DRF hypothesis for brain activation, and existing neuroimaging data for the concreteness effect. Thus, we sought to include abstract words in a test of the DHT and determine whether any interactions exist between the abstract-concrete dimension and the thematic-taxonomic distinction. While we replicated the localization of abstract and concrete word processing, we did not extend the DHT to include abstract words, nor did we find an interaction that would support the DRF hypothesis. Rather, our results align more closely with the hub-and-spoke model (Patterson et al., Nature Reviews Neuroscience, 2007, 8, 976).

Transcranial electrical stimulation (tES) holds promise for neuropsychological rehabilitation by leveraging the brain's inherent plasticity to enhance cognitive and motor functions. However, early results have been variable due to oversimplified approaches. This manuscript explores the potential and complexities of tES, particularly focusing on a protocol defined transcranial direct current stimulation as a reference model for all tES protocols, emphasising the need for precision in tailoring stimulation parameters to individual characteristics. By integrating intrinsic (i.e. the neuro-physiological system state) and extrinsic factors (i.e. experimental set up), highlighting the critical role of state-dependent effects and the synergy with cognitive tasks, we aim to refine tES protocols. This approach not only addresses the complexity of the brain system (as defined by its current state) but also highlights the importance of collaborative research and data sharing to understand the underlying mechanisms of tES-induced changes and optimising therapeutic efficacy. Emphasising the integration of tES with targeted tasks and clearer hypotheses, this work underscores the potential for more effective neurorehabilitation strategies.