Archives of Clinical Neuropsychology最新文献

Objective: The COVID-19 pandemic highlighted the need to build an evidence base to support teletesting as an equivalent modality for standardized neuropsychological assessment. As such, the purpose of this study was twofold. First, this study evaluated teletesting equivalency of standardized reading achievement measures during COVID-19 in children ages 6-16. Further, to examine the impact of COVID-19 on reading, achievement scores were compared in two samples of children assessed before and during COVID-19.

Methods: Participants were referred for testing at an outpatient neuropsychology clinic at an urban, academic medical center. Aim one compared assessments administered in-person (n = 1039) versus teletesting (n = 283). A two one-sided test (TOST) was used to determine equivalency. Aim two compared children seen pre-COVID-19 (n = 2125) and during COVID-19 (n = 1322) including a subsample of elementary school-aged children. One-way analyses of covariance were employed, with insurance type and Wechsler Intelligence Scale for Children, Fifth Edition Matrix Reasoning (as a proxy for nonverbal IQ) included as covariates.

Results: Results showed equivalence in reading achievement scores administered via teletesting compared to in-person during COVID-19. For aim two, Nonsense Word Decoding scores were significantly higher for the COVID-19 group compared to the pre-COVID-19 group (p = 0.03). No other significant differences in reading scores were found between groups, including no differences among a subsample of elementary school-aged children (ages 6-10; all ps > 0.05).

Conclusions: This provides additional support for teletesting equivalency and suggests the negative impact of COVID-19 on foundational reading skills is less than predicted in a clinically referred sample.

Objective: This study aims to establish normative data for the modified Location Learning Test (m-LLT), considering sociodemographic characteristics such as age, sex, and educational level.

Materials and methods: One hundred eighty-nine middle-aged and elderly people aged 50 years and older were recruited from the French-speaking population in Quebec (Canada). The m-LLT procedure described by Kessels et al. (2006) was used. Percentiles were derived for performance scores (Trial 1, Total Displacement Score, Learning Index, Delayed Recall Displacements), stratified by sociodemographic characteristics where appropriate.

Results: Regarding the sex variable, the number of displacements in Trial 1 and for the Total Displacement Score were higher in men than in women. Age was positively associated with the Total Displacement Score and Delayed Recall Displacements and negatively associated with the Learning Index. Education was positively associated with the Learning Index and Delayed Recall Displacements. Two-thirds of the normative sample achieved a perfect score on the fifth and final learning trial.

Conclusions: Learning was better in women than in men, which may be explained by the use of verbal and nonverbal strategies and environmental awareness favoring women. The decline in learning and retrieval with age can be explained, among other reasons, by a less strategic approach during the encoding phase, a decline in other cognitive domains, or poorer imagery-based representations of the stimuli. The associations between education, strategic retrieval, and cognitive reserve are discussed. Overall, these normative data will enhance the detection of cognitive decline in geriatric clinical or research settings.

Objective: The relationship between perseveration and switching in semantic verbal fluency tasks and the possible role of self-generated interference one must overcome before switching back to a previously visited subcategory has not been explored.

Participants & method: We studied the performance on semantic verbal fluency in 60 cognitively unimpaired subjects, 30 patients with amnestic mild cognitive impairment (aMCI) and 30 patients with Alzheimer's Clinical Syndrome-dementia (ACS-Dementia). Our primary analysis focused on the association of switching and switchback with the first perseverative error.

Results: Perseveration was significantly associated with switchback in all three groups (χ2 = 24.88, p < .001). Within-cluster perseverations were few. The number of switchbacks was the only significant variable to predict perseverative responses (p < .01). Moving from cognitively unimpaired to aMCI to ACS-Dementia, progressively fewer switches and switchbacks were needed to trigger perseveration. In over half of the perseverations after a switchback in the cognitively unimpaired and aMCI groups and in over a third in the ACS-Dementia group, the subjects had already activated a new word in the switched back subcategory.

Conclusion: Switching between subcategories and subsequent switchback play an important role in triggering perseverations in semantic verbal fluency tasks in the cognitively unimpaired as well as in aMCI and ACS-Dementia. Self-generated interference caused by repeated switching may overwhelm the working memory capacity enough to reactivate a previously suppressed response when revisiting an earlier subcategory. Our findings may facilitate a deeper understanding of the cognitive mechanisms underlying perseveration in semantic fluency tests.

Objective: Context-dependent effect (CDE) is a process by which reinstating at test the original learning context enhances the recall ability of the material being studied. Although recognition by people with traumatic brain injury (TBI) is poorer than that of healthy controls, both groups show CDE equally. In the current study, we seek to test the effect of body emotional expressions as contextual information, on facial recognition, and eye movements.

Method: Twenty-four healthy individuals and 27 patients with moderate-to-severe TBI participated in the study. Participants were exposed to photos of people with neutral facial and body expressions and were asked to remember the people for a subsequent memory test. In the testing session, they were asked to determine whether the person presented to them had appeared before, under two conditions: (1) where the context remains constant (facial and body expressions remained neutral-Repeat condition) and (2) where the context changes (facial expression remained neutral but the body expression changed to angry or happy-Re-pair condition).

Results: While the memory of the individuals with TBI was poorer than that of the controls, both groups exhibited equal CDE. We found that both groups, controls more than TBI, spent most of their time looking at the head. Furthermore, longer dwell time was associated with better recognition in the study phase.

Conclusions: These findings are consistent with previous studies showing that despite impaired memory following TBI compared to a control group, CDE was preserved. The current study extends the context effect to body postures that express emotion.

Objective: Cognitive complaints are commonplace among women living with endometriosis-associated chronic pelvic pain (CPP); yet, surprisingly few studies have assessed their cognitive functioning. As an initial step to address the resulting knowledge gap, this review aimed to synthesize the current literature reporting on cognition in females with endometriosis-associated CPP, and due to the poverty of endometriosis studies, to draw on data from female cohorts with other chronic pain conditions to gain potentially relevant insights.

Methods: Three database searches were conducted (Scopus, PubMed, and PsycINFO). Eighteen studies met the inclusion criteria (n = 8 regarding endometriosis, n = 10 regarding other chronic pain conditions).

Results: Six of the seven studies employing objective cognitive measures in females with other chronic pain reported significant cognitive deficits. Associated changes in neural circuitry thought to underpin these deficits align with neural patterns reported in females with endometriosis-associated CPP. While two studies reported a high prevalence (≥60%) of self-reported cognitive impairment in endometriosis-associated CPP, objective performance deficits have not been reported. Nonetheless, self-reported accounts of cognitive impairment suggest females with endometriosis-associated CPP may experience difficulties with inhibition, attention, and memory. Most studies did not control for potential moderating factors and comorbidities that prevail among endometriosis populations.

Conclusion: The field is in desperate need of research assessing cognitive performance in females with endometriosis-associated CPP, to objectively determine any cognitive difficulties. Attention should be paid to likely moderators, pain-related mechanisms, and whether findings extend to endometriosis without CPP.

Objective: Conflicting evidence has arisen from the few studies that have examined the role of the prefrontal cortex and executive control functions in theory of mind (ToM). Moreover, the involvement of other cognitive domains in the ability to infer mental states is still under debate. This study aims to examine, in addition to the potential contribution of executive functions, the role of cognitive estimation in ToM abilities, given that cognitive estimation processes are strongly associated with some aspects of executive control functions.

Method: The cognitive estimation task, along with a set of neuropsychological tasks assessing executive functions, was administered to 30 patients with prefrontal cortex damage and 30 control subjects matched by gender, age, and education level.

Results: Patients with prefrontal cortex damage were impaired in all measures of executive functions, cognitive estimation, and theory of mind compared with control subjects. Regression analysis showed a significant interaction between executive measures and cognitive estimation in predicting ToM performance for patients with prefrontal cortex damage. Additionally, voxel-based lesion analysis identified a partially common bilaterally distributed prefrontal network involved in all three domains, centered within the ventral and dorsomedial areas with extension to the dorsolateral prefrontal cortex.

Conclusion: Our findings highlight that, apart from executive functions, cognitive estimation plays a crucial role in the ability to interpret others' cognitive and emotional states in both patients with prefrontal cortex damage and control subjects.

Objective: Although inattention, impulsivity, and impairments to vigilance are most associated with attention-deficit/hyperactivity disorder (ADHD), transdiagnostic attentional deficits are prevalent across all psychiatric disorders. To further elucidate this relationship, the present study investigated parent-reported neuropsychiatric symptom correlates of attention deficits using the factor structure of the Conners' Continuous Performance Test (CPT-II), a neuropsychological test of attention.

Method: Two-hundred and eighteen children and adolescents (7-21 years old) completed the CPT-II as part of standard clinical protocol during outpatient pediatric neuropsychology visits. The factor structure of the CPT-II was determined with a principal component analysis (PCA) using Promax rotation. Pearson correlation analyses and regression models examined the relationship between the generated factor structure, parent-reported clinical symptoms, and pre-determined clinical diagnoses.

Results: Results from the PCA suggested a three-factor model best supported the structure of the CPT-II, and were subsequently defined as inattention, impulsivity, and vigilance. Performance-based inattention was significantly correlated with parent-reported hyperactivity, aggression, conduct problems, and depression. Parent-reported depressive symptoms and conduct problems were the strongest correlates of performance-based inattention, not hyperactivity or aggression. Performance-based inattention was significantly associated with an ADHD diagnosis but not a depression or anxiety diagnosis.

Conclusions: Findings suggest attentional deficits are not specific to any one disorder. To enhance the identification, classification, and treatment of neuropsychiatric disorders, both researchers and clinicians alike must diminish the importance of categorical approaches to child/adolescent psychopathology and continue to consider the dimensionality of transdiagnostic characteristics such as inattention.

Objective: Deficits in online self-awareness (SA) are common after acquired brain injury (ABI), leading to safety concerns and impacting daily activities and rehabilitation outcomes. Early identification is recommended as a critical first step in cognitive rehabilitation following ABI. The aim of this observational study was to examine differences in online SA and strategy use between individuals with ABI and healthy controls. It also investigated whether online SA moderates the relationship between strategy use and performance accuracy on a test designed to assess cognitive-functional deficits.

Method: 80 individuals with ABI and 76 controls completed the Spanish Weekly Calendar Planning Activity-10. Measures of online SA included strategy use and self-recognized errors assessed during task. An after-task interview assessed individuals' self-evaluation of task difficulty and accuracy of performance.

Results: Individuals with ABI performed worse than controls on most measures of online SA. They were less likely to self-recognize errors and use self-monitoring strategies. They also tended to overestimate their performance and showed greater discrepancy between self-rated and actual performance. Moderation analyses show that better performance was significantly associated with greater strategy use among ABI individuals who were aware of their performance.

Conclusions: Online SA appears to moderate the use of cognitive strategies during functional cognitive performance after ABI. Therefore, it is important to include assessments of online SA and strategy use for individuals with ABI. Furthermore, these findings highlight the importance of focusing on SA and self-generated strategies as key goals of cognitive rehabilitation aimed at improving daily functioning after ABI.

Background: End-stage chronic kidney disease (CKD) is a significant concern for older adults and is often associated with cognitive impairment (CI). The origin of this CI is multifactorial, involving vascular and metabolic factors. Additionally, renal treatments, including dialysis, may affect cognition. This study aimed to assess the neuropsychological profiles of these patients and understand the effects of dialysis treatment.

Methods: We conducted an observational retrospective study including older adults with end-stage CKD attending for kidney transplantation (KT). Comprehensive neuropsychological assessments were conducted. Composite cognitive scores were computed. Multivariate regression models were used to assess associations between cognition and dialysis status.

Results: We included 223 patients (151 treated with dialysis, 72 with conservative management), mean age of 73.5 ± 3.4. We observed a high prevalence of CI, around 30% for global cognition and affecting all neuropsychological domains. Patients treated with dialysis exhibited lower cognitive performance compared to those not undergoing dialysis, particularly in episodic (p = .031) and working memory (p = .024).

Conclusion: This study confirms the high prevalence of CI in end-stage CKD, with dialysis being associated with worse episodic and working memory compared to non-dialyzed participants. Future investigations are needed to track the long-term cognitive trajectory of patients on the KT waiting list and post-transplantation.

Trial registration: Retrospectively registered, no 22-808 on July 7th, 2022, CNIL register number 22-5808.

Objective: Cognitive dysfunction occurs in many neurological, psychiatric, and other health conditions. This review aimed to characterize the breadth and degree of cognitive morbidity associated with varied health conditions.

Method: We systematically reviewed Medline, EMBASE, and Cochrane databases for meta-analyses of cognitive dysfunction associated with any health condition. Meta-analyses were eligible if they reviewed studies that compared patients with health conditions to healthy controls on cognitive testing and provided effect sizes.

Results: We found 91 meta-analyses for 94 health conditions. Among >800,297 participants, healthy controls out-performed clinical participants in every condition on cognitive testing. Mean effect sizes ranged from -2.02 to -0.00 across conditions and were ≤ -0.5 on average, denoting moderate to very severe dysfunction for 41% of them.

Conclusions: Cognitive dysfunction is ubiquitous in medicine. Both primary care and specialist physicians likely treat patients with cognitive dysfunction. Depending on its severity, cognitive dysfunction can affect treatment adherence, everyday functioning, quality of life, and the capacity to provide informed consent for treatment. These findings highlight the transdiagnostic nature of cognitive symptoms and the potential value of establishing collaborations between physicians and clinical neuropsychologists to integrate cognitive assessment into patient care. Even brief assessments can identify cognitive deficits that likely affect treatment adherence and functional outcomes.