Journal of the International Neuropsychological Society最新文献

Objective: Interoception is crucial for emotional processing. It relies on the bidirectional connections between the insula, a crucial structure in interoception, and the frontal lobe, which is implicated in emotional experiences. Acquired frontal brain injury often leads to emotional disorders. Our goal was to explore the interoceptive profiles of patients with frontal lesions with or without insular involvement.

Method: Given the neuroanatomical links between interoception and emotions, we conducted a systematic Preferred Reporting Items for Systematic Reviews and Meta-analyses guided review of studies assessing at least one dimension of interoception in adults with acquired frontal injuries, with or without associated insular lesions.

Results: Seven articles were included. The review indicated that interoceptive accuracy declines after frontal injuries. The two studies that investigated interoceptive sensitivity found lower scores in patient groups. Finally, inconsistent results were found for interoceptive metacognition after frontal damage.

Conclusions: This review is the first to explore interoceptive disorders after acquired frontal brain injury. The findings reveal deficits in cardiac interoceptive accuracy and interoceptive sensitivity following frontal damage. Inconsistent results were observed for interoceptive metacognition. Further research is needed to confirm the presence of interoceptive deficits following a frontal lesion. Additionally, the relationship between interoceptive deficits and emotional disorders, often reported after frontal brain injury, should be investigated.

Objective: Cognitive impairment is a common feature of multiple sclerosis (MS), and its severity may be influenced by several factors, such as biological sex and levels of cognitive reserve (CR). The relationship between sex, CR, and cognition has not yet been fully investigated. Therefore, the present study aimed to explore sex differences in CR building and the effect of sex and CR on cognitive performance in MS.

Method: 233 participants underwent the Brief Repeatable Battery of Neuropsychological Tests (BRB-N), the Stroop test, and the Cognitive Reserve Scale. The t-test was performed to compare sociodemographic variables, Italian adaptation of the Cognitive Reserve Scale, and cognitive test scores between sexes. To evaluate the effect of CR and sex and their interaction on cognitive performance several models of multivariate analyses of covariance were performed (dependent variables: all subtests of Brief Repeatable Battery of Neuropsychological Tests and Stroop scores; independent variables: sex and CR). Covariates included age, Expanded Disability Status Scale, and BDI-II scores.

Results: Women showed higher levels of CR, particularly in daily activities (t = -5.848, p<.001), hobbies (t = -2.591, p = .010), and social life (t = -2.362, p = .011). Sex differences were noted in verbal memory and fluency (with women outperforming men) and processing speed (with men performing better than women). Multivariate analyses revealed a nonsignificant interaction between CR and sex on cognition (Λ=.950, F_(10,260)=.813, p = .617, η_p² = .050).

Conclusions: CR and sex seemed to affect cognitive performance independently in pwMS. This highlights the importance of considering both factors in cognitive assessment, and that both sexes may benefit from specific psychoeducational training aimed at increasing CR levels.

Objective: Cognitive impairment is prevalent, disabling, and poorly managed in multiple sclerosis (MS). Physical activity, often expressed as steps/day, has been associated with cognitive function in this population. This brief report examined the possibility of a (1) steps/day threshold associated with absence of cognitive impairment or (2) dose-response relationship between steps/day and cognitive function in MS.

Method: The sample included 358 persons with MS who provided demographic (age, sex, race) and clinical (MS type, disease duration, disability status) information, and completed the Symbol Digit Modalities Test (SDMT) and California Verbal Learning Test-Second Edition (CVLT-II). Participants wore an ActiGraph GT3X+ accelerometer above the non-dominant hip during waking hours of the day over a 7-day period for measuring steps/day.

Results: The receiver operating characteristic (ROC) curve analysis did not identify a steps/day threshold associated with cognitive impairment on SDMT (area under the curve [AUC] ranged between 0.606 and 0.691). The ROC curve analysis further did not identify a threshold of steps/day associated with cognitive impairment based on CVLT-II (AUC range 0.606 to 0.691). The regression analysis indicated significant linear relationships between steps/day and SDMT (R² = .06; β=.251; p < .001) and CVLT-II (R² = .06; β=.247; p < .001) z-scores.

Conclusion: The observed linear relationship suggests that focusing on increasing steps/day across all levels of physical activity might have benefits for cognitive function in MS.

Objective: Post-traumatic stress disorder (PTSD) and hypertension are highly prevalent among Veterans. Cognitive dispersion, indicating within-person variability across neuropsychological measures at one time point, is associated with increased risk of dementia. We examined interactive effects of PTSD symptom severity and hypertension on cognitive dispersion among older Veterans.

Methods: We included 128 Vietnam-era Veterans from the Department of Defense-Alzheimer's Disease Neuroimaging Initiative (DoD-ADNI) with a history of PTSD. Regression models examined interactions between PTSD symptom severity and hypertension on cognitive dispersion (defined as the intraindividual standard deviation across eight cognitive measures) adjusting for demographics and comorbid vascular risk factors.

Results: There was an interaction between PTSD symptom severity and hypertension on cognitive dispersion (p = .026) but not on mean cognitive performance (p = .543). Greater PTSD symptom severity was associated with higher cognitive dispersion among those with hypertension (p = .002), but not among those without hypertension (p = .531). Results remained similar after adjusting for mean cognitive performance.

Conclusions: Findings suggest, among older Veterans with PTSD, those with both hypertension and more severe PTSD symptoms may be at greater risk for cognitive difficulties. Further, cognitive dispersion may be a useful marker of subtle cognitive difficulties. Future research should examine these associations longitudinally and in a diverse sample.

Objective: The entorhinal cortex (EC) is the first cortical region affected by tau pathology in Alzheimer's disease (AD), but its functions remain unclear. The EC is thought to support memory binding, which can be tested using the Visual Short-Term Memory Binding Test (VSTMBT). We aimed to test whether VSTMBT performance can identify individuals with preclinical AD before noticeable episodic memory impairment and whether these performances are related to amyloid (Aβ) pathology and/or EC tau burden.

Methods: Ninety-four participants underwent the VSTMBT (including a shape-only condition (SOC) and a shape-color binding condition (SCBC)), standard neuropsychological assessment including the Preclinical Alzheimer Cognitive Composite (PACC5), an Aβ status examination, a 3D-T1 MRI and a [¹⁸F]-MK-6240 tau-PET scan. Participants were classified as follows: 54 Aβ-negative cognitively normal (Aβ - CN), 22 Aβ-positive CN (Aβ + CN, preclinical AD), and 18 Aβ + individuals with Mild Cognitive Impairment (Aβ + MCI, prodromal AD).

Results: Aβ + CN individuals performed worse than Aβ-CN participants in the SCBC while the SOC only distinguished Aβ - CN from MCI participants. The SCBC performance was predicted by tau burden in the EC after adjusting for Aβ, white matter hypointensities, inferior temporal cortex (ITC) tau burden, age, sex, and education. The SCBC was more sensitive than the PACC5 in identifying CN individuals with a positive tau-PET scan.

Conclusion: Impaired visual short-term memory binding performance was evident from the preclinical stage of sporadic AD and related to tau pathology in the EC, suggesting that SCBC performance could detect early tau pathology in the EC among CN individuals.

Objective: Significant gaps remain in our knowledge of cognitive aging in Hispanic adults, the largest and fastest-growing minority group in the United States (U.S.). Episodic autobiographical memory (EAM), which has well documented age-related differences, has not been directly examined in older U.S. Hispanic adults - a population that is commonly bilingual. This study aimed to examine the effects of Spanish-English bilingualism and aging on EAM among Hispanic adults.

Methods: In the present study 100 young and middle-aged/older Hispanic adults (50 English-Spanish bilingual Hispanic participants and 50 monolingual English-speaking Hispanic participants) narrated EAMs in a structured interview. We assessed these narratives for episodic and non-episodic details using an established scoring protocol.

Results: We replicated the commonly observed age-related decrease in episodic detail generation among Hispanic participants, with non-episodic detail not significantly differing between young and older Hispanic participants. Among young Hispanic participants, bilingualism was associated with higher episodic, but not non-episodic, detail generation. This bilingualism advantage for episodic detail, however, was not evident among older Hispanic participants.

Conclusions: These results underscore the complex interplay between bilingualism and age in autobiographical memory for events among Hispanic adults. Our study highlights the importance of including diverse racial/ethnic and linguistic samples in cognitive aging research to better understand how bilingualism and cultural factors influence memory across the lifespan.

Objective: The aim of this study was to investigate sensorimotor functions that require cerebellar processing, and visuospatial perception and visuospatial abilities in adult patients with attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD).

Method: We included patients with unmedicated ADHD (n = 52), medicated ADHD (n = 39), ASD (n = 33), the combination of unmedicated ADHD and ASD (n = 31) and controls (n = 78). A multimodal set of neurocognitive tests and motor tasks were administrated to evaluate cognitive and motor skills.

Results: All patient groups exhibited significantly worse performances than controls in sensorimotor functions, visuospatial perception, and visuospatial abilities. We observed significant associations between sensorimotor functions and visuospatial perception and visuospatial abilities. We conducted a regression analysis to evaluate the impact of potential confounders on neurocognitive outcomes. The results indicated that age, level of education, and insomnia, but not anxiety or depression, affected the performance on some tests.

Conclusions: Our results reveal deficits in sensorimotor functions, visuospatial perception, and visuospatial abilities in patients with neuropsychiatric disorders. Clear deficits emerged, despite the majority of patients showing a mild degree of severity index of ADHD/ASD across all groups (61-84%). The results are consistent with the idea that these disorders are linked to cerebellar deficits. Our results suggest that these objective tests have the potential to enhance clinical evaluations.

Background: Deficits in Executive Function (EF) and Theory of Mind (ToM) are common and significant in attention deficit hyperactivity disorder (ADHD), impacting self-regulation and social interaction. The nature of ToM deficits is believed to be partially associated with preexisting deficits in other core cognitive domains of ADHD, such as EF, which are essential for making mental inferences, especially complex ones. Evaluating these associations at a meta-analytic level is relevant.

Objective: To conduct a systematic literature review followed by a meta-analysis to identify potential associations between EF and ToM among individuals with ADHD and their healthy counterparts, considering different developmental stages.

Method: A systematic review was conducted in seven different databases. The methodological quality of the studies was assessed using the Newcastle-Ottawa Scale. The meta-analytic measurement was estimated with the correlation coefficient as the outcome. Due to the presence of heterogeneity, a random-effects model was adopted. Independent meta-analyses were conducted for different EF subdomains and ADHD and healthy control groups. Subgroup analyses were performed to examine the influence of age on the outcome of interest.

Results: Fifteen studies were analyzed. Moderate associations were found when comparing EF and ToM between individuals with ADHD (0.20-0.38) and healthy subjects (0.02-0.40). No significant differences were found between child and adult samples (p > 0.20).

Conclusion: The association between EF and ToM was significant, with a moderate effect size, although no significant differences were found according to age, the presence of ADHD, or EF subdomains. Future research is suggested to expand the age groups and overcome the methodological limitations indicated in this review.

Objective: The National Institutes of Health (NIH) Executive Abilities: Measures and Instruments for Neurobehavioral Evaluation and Research (EXAMINER) is a validated laptop-based battery of executive functioning tests. A modified tablet version of the EXAMINER was developed on the UCSF Tablet-based Cognitive Assessment Tool (TabCAT-EXAMINER). Here we describe the battery and investigate the reliability and validity of a composite score.

Methods: A diagnostically heterogeneous sample of 2135 individuals (mean age = 65.58, SD = 16.07), including controls and participants with a variety of neurodegenerative syndromes, completed the TabCAT-EXAMINER. A composite score was developed using confirmatory factor analysis and item response theory. Validity was evaluated via linear regressions that tested associations with neuropsychological tests, demographics, clinical diagnosis, and disease severity. Replicability of cross-sectional results was tested in a separate sample of participants (n = 342) recruited from a frontotemporal dementia study. As this separate sample also collected longitudinal TabCAT-EXAMINER measures, we additionally assessed test-retest reliability and associations between baseline disease severity and changes in TabCAT-EXAMINER scores.

Results: The TabCAT-EXAMINER score was normally distributed, demonstrated high test-retest reliability, and was associated in the expected directions with independent tests of executive functioning, demographics, disease severity, and diagnosis. Greater baseline disease severity was associated with more rapid longitudinal TabCAT-EXAMINER decline.

Conclusions: The TabCAT-EXAMINER is a tablet-based executive functioning battery developed for observational research and clinical trials. Performance can be summarized as a single composite score, and results of this study support its reliability and validity in cognitive aging and neurodegenerative disease cohorts.