Journal of Clinical and Experimental Neuropsychology

Publisher: Taylor & Francis


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    Journal of clinical and experimental neuropsychology (Online)
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Publications in this journal

  • Journal of Clinical and Experimental Neuropsychology 01/2015;
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    ABSTRACT: Background: The apolipoprotein E (APOE) ε4 genotype is associated with an increased risk of Alzheimer's disease. In community surveys, older adults with this genotype have been found to have lower scores on neuropsychological tests than those who do not. It is possible that this is the consequence of subclinical changes in cognition in those persons who later develop dementia. The aim of this research was to determine whether the effect of APOE genotype on cognition would remain if those who subsequently became demented were retrospectively removed from the analysis of the baseline test data from a sample of healthy adults. Method: A sample of 241 nondemented persons over the age of 65 for whom APOE genotyping was available were administered a range of neuropsychological tests at baseline and were followed up 10 years later. Results: Significant differences between the ε4-present and ε4-absent groups were found for the delayed recall trial of the Rey Auditory Verbal Learning Test and the Trail Making Test. When those participants known to have developed dementia during the follow-up period were excluded from the analysis of the baseline data these differences disappeared. A total of 113 nondemented survivors from the original sample were retested, and no difference was found in the rate of decline on any measure between the ε4-present and ε4-absent groups. Conclusions: It is likely that the reported effect of the ε4 APOE genotype on cognition is the consequence of the ε4-present group containing persons whose cognition is subtly affected by the early stages of a dementing process. It is also unlikely that the presence of the ε4 allele by itself leads to a significantly accelerated rate of cognitive decline in the nondemented elderly.
    Journal of Clinical and Experimental Neuropsychology 07/2014;
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    ABSTRACT: Objective: Self-perceived mental fatigue is a common presenting symptom in many neurological diseases. Discriminating objective fatigability from self-perceived mental fatigue might facilitate neuropsychological diagnosis and treatment programs. However clinically valid neuropsychological instruments suitable for assessment of fatigability are still lacking. The prime aim of the study was to investigate aspects of cognitive fatigability and to identify properties of neuropsychological tests suitable to assess fatigability in patients with persistent cognitive complaints after mild brain injury. Another aim was to investigate whether cognitive fatigability captured by neuropsychological measures is influenced by depression or sleep disturbances. Method: Twenty-four patients with persistent cognitive symptoms after mild traumatic brain injury (mTBI), (aged 18-51 years) and 31 healthy controls (aged 20-49 years) underwent neuropsychological testing measuring three cognitive fatigability domains: Attention fatigability was assessed using the Ruff 2 & 7 Selective Attention Test, executive fatigability using the Color Word Test (Stroop), and psychomotor fatigability using the Digit Symbol Substitution Test from the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III). Subjective fatigue was measured using the Fatigue Severity Scale and a questionnaire of everyday consequences of fatigue. Depression was screened using the Hospital Anxiety and Depression Scale and sleep disturbances using the Pittsburgh Sleep Quality Index. Results: The patients reported significantly more mental fatigue and performed worse on tests of psychomotor and executive fatigability than the healthy controls. Furthermore, the cognitive fatigability measures were not influenced by depression or sleep disturbances, as was the case in self-reported fatigue. Conclusion: Tests demanding executive or simultaneous processing of several neuropsychological functions seem most sensitive in order to capture cognitive fatigability. Clinical tests that can capture fatigability enable a deeper understanding of how fatigability might contribute to cognitive complaints and problems in maintaining daily activities.
    Journal of Clinical and Experimental Neuropsychology 06/2014;
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    ABSTRACT: The "z-drugs" zopiclone, zolpidem, eszopiclone, and zaleplon were introduced in the 1980s for the treatment of insomnia, as it was observed that the side effect profile associated with these medications were more benign than those related to the benzodiazepines. This meta-analysis set out to ascertain which domains of cognitive function, if any, were affected by the ingestion of these medications. A total of 20 studies met the study inclusion criteria. Results revealed medium effect sizes for zopiclone and zolpidem on measures of verbal memory. An additional medium effect size was observed for zolpidem on attention. Finally, smaller effect sizes were observed for zolpidem speed of processing and for zopiclone on working memory. It is clear from these data that the use of a single dose of the z-drugs in healthy adults as measured in the morning following the exposure does produce a specific rather than a generalized negative effect on cognitive function. However, there were only enough studies to evaluate the individual cognitive effects of the zolpidem and zopiclone medications; the specific effects of zaleplon and eszopiclone cannot be ascertained because only one study met the inclusion and exclusion criteria for the review.
    Journal of Clinical and Experimental Neuropsychology 06/2014;
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    ABSTRACT: In the present study, we explored the contribution of different cortical areas in processing different semantic violations in action representation-that is, instrumental or functional violations. The cortical contribution in object-related action comprehension was verified by measuring changes in event-related potential (N400 effect), error rates (ERs), and response times (RTs), by applying an inhibitory transcranial direct current stimulation (tDCS) on the dorsolateral prefrontal cortex (DLPFC). Thirty-three subjects performed the detection task (action frames ending with a congruous vs. incongruous action). The tDCS effect was analyzed by comparing the N400, ERs, and RTs before and after stimulation. A significant reduction of the N400 and increased RTs were observed for incongruous stimuli in the case of inhibitory stimulation of the DLPFC. These results highlighted that DLPFC inhibition may limit the ability to analyze a semantically incongruous action, with a reduced N400 ERP effect and increased "cognitive costs" (higher RTs). Moreover, functional violation showed also the contribution of the temporoparietal areas to modulate the N400 amplitude. Therefore the existence of different cortical generators was supposed for the instrumental (more frontal) and the functional (more frontal and temporoparietal) semantic anomaly processing.
    Journal of Clinical and Experimental Neuropsychology 06/2014;
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    ABSTRACT: Using a Bayesian latent group analysis in a simulation design, we recently showed a high diagnostic accuracy when assessing effort in the context of malingered memory deficits. We here further evaluate our Bayesian model in a sample of cognitively impaired patients. The main analysis showed both high sensitivity and specificity, thus corroborating a high diagnostic accuracy of the model. Additional analysis showed variations on effort estimates after changes in malingering base rates. Variations affected sensitivity, but not specificity, which is in line with typical findings in malingering research. These data suggest that Bayesian analyses may complement and improve existing effort measures.
    Journal of Clinical and Experimental Neuropsychology 06/2014;
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    ABSTRACT: Objective: Attention-deficit/hyperactivity disorder (ADHD) in childhood is associated with poor academic functioning. Deficits in academic functioning have proven to be less responsive to intervention than behavioral deficits in this population, yet the causes of this academic underperformance are not well understood. The purpose of this study is to examine the relationship between ADHD and academic performance in elementary-aged children in a developmental context. To do this, we study important cognitive variables and academic achievement over a three-year timeframe. Method: Based on teacher ratings of ADHD, children were divided into a high symptom group (n = 17) and a low symptom group (n = 34). A thorough battery of cognitive and academic tests was administered at Time 1 and again 2 years later. Cognitive measures focused specifically on working memory and response inhibition. Results: Results indicate that children who have high levels of ADHD signs differ from their low-sign peers in academic achievement and in several cognitive domains. Differences in cognitive functioning show a developmental trend consistent with earlier developmental delays in response inhibition and later delays in working memory. Working memory appears to be particularly important in several academic domains. Importantly, in a longitudinal model, working memory was more predictive of math achievement for students demonstrating signs of ADHD than for those who did not. Conclusion: The relationship between these cognitive variables and academic functioning are explicated in the domains of reading, math, and problem solving.
    Journal of Clinical and Experimental Neuropsychology 06/2014;
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    ABSTRACT: Patterns of smoking behavior vary between the sexes. There is evidence that decision making, which is one of the key "executive functions" necessary for making life-style modifications such as smoking cessation, is relatively lateralized to the right hemisphere in males and left hemisphere in females. In the current study, we examined whether the side of brain lesion has a differential effect on smoking behavior between the sexes. We hypothesized sex differences in smoking cessation based on lesion side. Participants were 49 males and 50 females who were smoking at the time of lesion onset. The outcome variable was abstinence from smoking (quit rate) at least one year post lesion. We found that in patients with left-hemisphere damage, quit rates were significantly higher in males than in females; however, in patients with right-hemisphere damage, quit rates were not statistically different. The findings support previous cognitive neuroscience literature showing that components of behavior responsible for maintaining addiction tend to be more strongly lateralized in males, whereas in females there is a more bilateral distribution. Our study provides further evidence for differences in lateralization of complex behavior between the sexes, which has significant implications for differences in treatment strategies between the sexes.
    Journal of Clinical and Experimental Neuropsychology 06/2014; 36(5):551-8.
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    ABSTRACT: Aim: This study tested the mediating role of probabilistic reasoning ability in the relationship between fluid intelligence and advantageous decision making among adolescents in explicit situations of risk-that is, in contexts in which information on the choice options (gains, losses, and probabilities) were explicitly presented at the beginning of the task. Method: Participants were 282 adolescents attending high school (77% males, mean age = 17.3 years). We first measured fluid intelligence and probabilistic reasoning ability. Then, to measure decision making under explicit conditions of risk, participants performed the Game of Dice Task, in which they have to decide among different alternatives that are explicitly linked to a specific amount of gain or loss and have obvious winning probabilities that are stable over time. Results: Analyses showed a significant positive indirect effect of fluid intelligence on advantageous decision making through probabilistic reasoning ability that acted as a mediator. Specifically, fluid intelligence may enhance ability to reason in probabilistic terms, which in turn increases the likelihood of advantageous choices when adolescents are confronted with an explicit decisional context. Conclusions: Findings show that in experimental paradigm settings, adolescents are able to make advantageous decisions using cognitive abilities when faced with decisions under explicit risky conditions. This study suggests that interventions designed to promote probabilistic reasoning, for example by incrementing the mathematical prerequisites necessary to reason in probabilistic terms, may have a positive effect on adolescents' decision-making abilities.
    Journal of Clinical and Experimental Neuropsychology 05/2014;
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    ABSTRACT: Memory for unfamiliar faces has received little attention in the effort to identify neuropsychological measures that could differentiate mild cognitive impairment (MCI) from normal aging and/or predict conversion from MCI to dementia. We used the Wechsler Memory Scale-III Faces test to investigate facial memory in normal aging (n = 58), MCI (n = 74), and mild Alzheimer's disease (n = 22). After adjustment for age, gender, and years of education, MCI patients demonstrated significantly poorer memory for unfamiliar faces than their healthy peers. Lower scores were also associated with worsening cognition and functional abilities but not an increased risk of dementia.
    Journal of Clinical and Experimental Neuropsychology 05/2014;
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    ABSTRACT: Objectives: Verbal memory assessment metrics are an essential component of cognitive screening tools. We compared the relative utilities of word list and story recall metrics in predicting cognitive functioning in nondemented and demented nursing home patients. We selected memory metrics from the Brief Cognitive Assessment Tool (BCAT) and the Brief Interview for Mental Status (BIMS). The BCAT incorporates both word lists and story recall metrics, while the BIMS only has a word list feature. Method: Two hundred and thirty-nine individuals residing in a Maryland skilled nursing facility were referred for neurocognitive evaluation over a one-year period. These residents met inclusion criteria for retrospective data analysis by completing the BCAT and BIMS and were aged 60 or older. Results: For the entire sample and for demented individuals, all four verbal memory metrics significantly predicted cognitive diagnosis. For nondemented individuals, only the BCAT delayed word list significantly predicted cognitive diagnosis. There appears to be enhanced utility in using both verbal memory metric types, as the inclusion of word list and story recall was a stronger predictor of cognitive diagnosis than any individual verbal memory metric. Conclusion: This study highlights the importance of using cognitive screening tools that contain both story recall and word list metrics. This is particularly true in long-term care settings where the base rate of cognitive impairment is high.
    Journal of Clinical and Experimental Neuropsychology 05/2014;
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    ABSTRACT: Purpose. We evaluated the internal consistency and construct and criterion validity of a 10-item revision of the Cognitive Estimation Task (CET-R) developed by Shallice and Evans to assess problem-solving hypothesis generation. Method. The CET-R was administered to 216 healthy adults from the Aging, Brain Imaging, and Cognition study and 57 adult outpatients with schizophrenia. Results. Exploratory and confirmatory factor analysis (EFA and CFA) of the healthy sample revealed that seven of the 10 CET-R items constitute a more internally consistent scale (CET-R-7). Though EFA indicated that two CET-R-7 dimensions might be present (length and speed/time estimation, respectively), CFA confirmed that a single factor best represents the seven items. The CET-R-7 was modeled best by crystallized intelligence, adequately by fluid intelligence, and inadequately by visuospatial problem solving. Performance on the CET-R-7 correlated significantly with the neuropsychological domains of speed and fluency, but not memory or executive function. Finally, CET-R performance differed by diagnosis, sex, and education, but not age. Conclusions. This study identified an internally consistent set of items that measures the construct of cognitive estimation. This construct relates to several important dimensions of psychological functioning, including crystallized and fluid intelligence, generativity, and self-monitoring. It also is sensitive to cognitive dysfunction in adults with schizophrenia.
    Journal of Clinical and Experimental Neuropsychology 05/2014;
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    ABSTRACT: Current literature on cognitive functioning in pregnancy and postpartum is mixed, with most research showing deficits in memory and attention during pregnancy or no difference between pregnant participants and controls with little emphasis on the postpartum period. In the current study, we used a longitudinal controlled design and 42 primarily not depressed participants to compare pregnant women in the third trimester and approximately three months postpartum with matched controls over the same time period on neuropsychological domains including memory, attention, learning, visuospatial, and executive functioning. We also evaluated the role of mood and quality of life as potential moderators of cognitive functioning in pregnancy/postpartum. Results indicated no differences between controls and pregnant/postpartum women on neuropsychological measures at any time points. Self-reported memory difficulties, however, were higher in the pregnant/postpartum women. Pregnant and postpartum women had worse self-reported mood and quality of life than controls. Mood and quality of life slightly moderated specific measures of attention and verbal fluency; however, neither mood nor quality of life moderated overall neuropsychological functioning in either group. Number of previous pregnancies had no effect on the study findings. Results suggest differences in subjective memory complaints, but no differences in objective neuropsychological test results between controls and pregnant/postpartum women who are primarily not diagnosed with depression.
    Journal of Clinical and Experimental Neuropsychology 05/2014;
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    ABSTRACT: Objective: We compared Alzheimer's disease (AD) patients' and elderly controls' abilities to select the best strategy on each item and determined whether AD patients tended to repeat the same strategy across consecutive items more often than controls. Method: A total of 60 participants (30 healthy older adults, HOA; 30 AD patients) were asked to select the best rounding strategy to estimate products of multiplication problems (e.g., estimating 42 × 76 by rounding operands down or up, like doing 40 × 70 = 2800 or 50 × 80 = 3200). We identified strategies used on each problem and measured solution latencies and percentage errors with each strategy as a function of problem characteristics. Results: Older adults and AD patients were able to use both available strategies. However, AD patients were less able to select the best strategy than HOA, especially on problems for which selecting the best strategy was most difficult. Moreover, AD patients significantly repeated the preceding strategies across successive problems more often than HOA. Conclusions: Our findings have important implications for further our understanding of dementia-related differences in strategic aspects of cognitive performance.
    Journal of Clinical and Experimental Neuropsychology 05/2014;