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Determinants of Benton Facial Recognition Test performance in normal adults.

Clinical investigations have found that lesions of the right cerebral hemisphere can disrupt face perception. Much less is known about the determinants of facial discrimination in healthy adults, although age-related differences in many cognitive abilities have been shown to correlate with simple processing speed and variation in regional brain volumes. In this study, 174 healthy adults between the ages of 20 and 92 were asked to match pictures of unfamiliar faces. After their performance was regressed on age, sex, education, and perceptual comparison speed, adding terms for frontal lobe volume, nonfrontal volume, and ventricle-to-brain ratio (VBR) derived from magnetic resonance imaging improved the model and accounted for 35% of the variance in facial discrimination. VBR and processing speed alone accounted for nearly 34% of the variance. These findings suggest that both normal atrophic brain changes and decreases in processing speed contribute to individual differences in facial discrimination.

Adult↗

Speed of processing within semantic memory following severe closed head injury.

This study investigated the effects of severe closed head injury (CHI) on the speed of information processing within semantic categories. The question of whether subjects were able to benefit from priming was also investigated. Survivors of severe CHI who were less than 1 year postinjury and survivors who were greater than 1 year postinjury were compared with neurologically normal matched controls utilizing a category judgement task. The results demonstrated slower processing within semantic memory for both groups of CHI patients compared to normal controls. Furthermore, individuals with CHI were able to benefit from priming to the same relative degree as control subjects. Overall, the results suggested semantic organization remains intact after severe CHI, but accessing semantic information is slowed.

Adult↗

Ultra-high-field 7T MRI reveals neural abnormalities of attention networks in relation to cognitive impairment in hypertension.

Hypertension is a significant risk factor for cognitive impairment (CI), yet the corresponding neural network abnormalities remain underexplored. In this study, we examined the associations among global and domain-specific cognitive dysfunction, neuroimaging measures, and blood pressure in a subgroup of hypertensive patients with CI (N = 41) from a randomized controlled trial who underwent ultra-high-field 7 T MRI. Structural atrophy related to CI was localized to regions overlapping the attention networks. Both whole-brain and within-network dysfunction of the attention networks were associated with worse global cognitive performance. Notably, hyperconnectivity within key attention network hubs, including the right anterior insula and posterior intraparietal sulcus, was associated with declined processing speed in hypertensive patients, mediating the association between pulse pressure and processing speed. These findings provide new insights into the neural pathophysiology of hypertension-related CI and suggest potential network-based targets for intervention.

Magnetic Resonance Imaging↗

Issues concerning relative speed of processing hypotheses, schizophrenic performance deficits, and prefrontal function: comment on Schooler et al. (1997)

The authors have found the data presented in the C. Schooler, E. Neumann, L. J. Caplan, and B. R. Roberts (1997) article to be interesting and of potential value in constraining the further development of detailed theoretical models of Stroop performance. However, the authors have found that the relative speed of processing account of stimulus onset asynchrony (SOA) effects given by Schooler et al. in Experiment 1 fails to address several important and vexing issues faced by such accounts, which have been highlighted by existing formal models. The authors also have expressed concerns about Schooler et al.'s, interpretation of the reduction in Stroop interference observed among individuals with schizophrenia in Experiment 2. Whereas the authors have acknowledged that it is plausible to relate this to a dysfunction of prefrontal cortex, they have pointed to equally plausible alternative explanations, which are not addressed by the experiment or in the discussion in the Schooler et al. article.

Attention↗

The effects of aging in the medial geniculate nucleus: a comparison with the inferior colliculus and auditory cortex.

A common problem among the elderly is a difficulty in discriminating speech. One factor that may contribute to this is deterioration in the ability to process the dynamic components of speech such as formant transitions. The frequency-modulated (FM) sweep is a useful stimulus for investigating the neural basis of temporal processing speed since it has features in common with formant transitions. Previously, we showed that when cells in the auditory cortex of aged animals were presented with FM sweeps, they exhibited a decrease in temporal processing speed when compared to cells recorded from young animals. However, this was not the case for cells in the inferior colliculus (IC) where neural responses did not appear to be affected by aging. One question that remains is how the auditory thalamus is affected by aging: Is it similar to that of the auditory cortex or of the IC. To this end, single units were recorded from the ventral division of the medial geniculate nucleus (MGNv) of young and aged anaesthetized rats in response to FM sweeps. Results showed that there were no age-related differences in speed or direction selectivity of FM sweep responses in the MGNv. When compared with units recorded from the IC and AI, the responses of MGNv neurons were similar to those of the IC. This suggests that temporal processing speed is affected by aging in the cortex, but not in the auditory thalamus or midbrain.

Acoustic Stimulation↗

Neurocognitive correlates of the COMT Val(158)Met polymorphism in chronic schizophrenia.

BACKGROUND: Neurocognitive deficits are recognized as a cardinal feature of schizophrenia, but the determinants of these deficits remain unknown. Recent reports have suggested that a functional polymorphism, Val(158)Met in exon III of the catechol-O-methyltransferase gene, shares approximately 4% variance with performance on the Wisconsin Card Sorting Test. These findings led to suggestions that the catechol-O-methyltransferase polymorphism may exert its effects by modulating prefrontal dopamine function, but few other neurocognitive measures have been examined, leaving open questions about phenotypic specificity. METHODS: We examined the effects of the catechol-O-methyltransferase Val(158)Met polymorphism in 58 individuals with chronic schizophrenia who completed a battery of 15 neurocognitive tests, which were reduced to four reliable neurocognitive domain scores. We examined the effects of genotype on these four domains and on global neurocognitive ability. RESULTS: The Met allele was associated with better performance in the Processing Speed and Attention domain, but not with other domain scores measuring executive and visuoperceptual functions, declarative verbal learning and memory, simple motor ability, or global neurocognitive function. Genotype shared approximately 11% of variance with Processing Speed and Attention scores, and approximately 2% of variance with Wisconsin Card Sorting Test scores. CONCLUSIONS: The findings provide independent support for the hypothesis that the catechol-O-methyltransferase Val(158)Met polymorphism influences neurocognitive function in schizophrenia, and suggest that the functional effects may be expressed on measures of Processing Speed and Attention. This information may prompt reconsideration of the "prefrontal dopamine" hypothesis and invites examination of a broader range of effects in efforts to refine the neurocognitive phenotype that is most relevant to variation in catechol-O-methyltransferase expression.

Adult↗

Aging, cognitive resources, and declarative learning.

A battery of cognitive tasks designed to assess information-processing speed, working memory capability, and declarative learning was administered to a cross-sectional sample of 477 adults ranging in age from 17 to 86 years. Results showed significant age-related decrements in all three constructs. A variety of structural equation models was fit to the results. The preferred model on empirical and conceptual grounds was one that showed (a) working memory capability as the most important mediator of age effects in declarative learning; (b) working memory capability as the mediator for the effects of general processing speed on declarative learning; and (c) differentiation among verbal, numeric, and spatial processing speed and between verbal and spatial working memory capability.

Adolescent↗

Age-related slowing of digit symbol substitution revisited: what do longitudinal age changes reflect?

A previous investigation reported that cross-sectional age differences in Digit Symbol Substitution (DSS) test performance reflect declines in perceptual processing speed. Support for the tenability of the processing speed hypothesis requires examining whether longitudinal age-related change in DSS performance is largely mediated by changes in speed. The present study used data from the Victoria Longitudinal Study to examine patterns and predictors of longitudinal change in DSS for 512 older adults (M(age) = 68.37 years, SD = 7.43). On the basis of multilevel modeling, baseline DSS performance was poorer for older participants and men, with longitudinal declines more pronounced with increasing age and decreasing speed. In contrast to the present cross-sectional findings, statistical control of change trajectories in perceptual speed using the same data did not substantially attenuate age changes. These discrepancies suggest different sources of variance may underlie cross-sectional age differences and longitudinal age changes for DSS.

Aged↗

Improvement in specific aspects of neurocognitive performance in children after renal transplantation.

BACKGROUND: Chronic renal failure in childhood is considered to affect neurocognitive function adversely, and kidney transplantation may ameliorate the deficits. However, previous studies have suffered from the use of poorly matched control groups, comparison of transplant with uncorrected uremia, lack of standardization of dialysis, and insufficiently sensitive neuropsychological tests. METHODS: We studied nine medically stable children and adolescents age 14.2 +/- 3.5 years with end-stage renal disease prior to and again one year after successful renal transplant. At baseline, the Wechsler Intelligence Scale for Children-III (WISC-III) or the Wechsler Adult Intelligence Scale-Revised (WAIS-R) was performed. Repeatable tests used before and after transplant included the Paced Auditory Serial Addition Test (PASAT) or the Children's Paced Auditory Serial Addition Test (CHIPASAT), the Stroop Color-Word Naming Test, the Buschke Selective Reminding Test, the Meier Visual Discrimination Test, the Grooved Pegboard Test, the WISC-III or the WAIS-R Coding subtests and the Trailmaking Test. Computer-based measures of mental processing speed, reaction time, and discrimination sensitivity included the Cognitive Abilities Test (CAT) and the Connors Continuous Performance Test (CPT). Formal kinetic modeling of dialysis delivery ensured adequate renal replacement therapy. Transplant function was good on stable doses of immunosuppressives, without recent rejections at the time of testing. RESULTS: Within-subject comparison showed statistically significant improvement in mental processing speed by CAT, reaction time and discrimination sensitivity by CPT, and working memory by PASAT/CHIPASAT after renal transplant. Other measures were unchanged. CONCLUSION: Mental processing speed and sustained attention improved in children after renal transplantation in a carefully controlled prospective cross-over study.

Adolescent↗

Whole-brain N-acetylaspartate level and cognitive performance in HIV infection.

BACKGROUND AND PURPOSE: In the brain of HIV-infected patients, proton MR spectroscopic studies are typically used to examine small volumes of tissue with single-voxel methods. Since brain disease is diffuse in patients with HIV, such studies preclude assessment of the true extent of the metabolic burden. To assess this extent, the relationship between global neuronal integrity, reflected by the whole-brain N-acetylaspartate (WBNAA) concentration, was correlated with neuropsychological function and the AIDS dementia complex (ADC) stage score. METHODS: WBNAA levels were compared between 15 HIV-infected patients (seven symptomatic, eight asymptomatic) and 13 age- and sex-matched healthy subjects. The patients' WBNAA level was correlated with cognitive performance, as measured with a battery of eight tests (NPZ-8), including the ADC stage score and four total-memory, mood, motor, and processing speed subtests. RESULTS: WBNAA levels were significantly different between patients and healthy subjects (mean +/- sigma, 11.82 +/- 1.40 and 12.91 +/- 1.03 mmol/L, respectively; P =.032) after we adjusted for age and sex effects. Intermediate negative correlations were found between the WBNAA level, the processing speed subtest score (r = -0.50, P =.03), and the ADC stage score (r = -0.44, P =.05). CONCLUSION: The WBNAA concentration complements brain atrophy data with information about the quality of the remaining neuronal and axonal tissue in patients with HIV infection. In HIV-infected patients, its correlation with processing speed and the ADC score indicates that the latter reflects pathologic deficits, which are extensive throughout the brain.

AIDS Dementia Complex↗

Multivariate modeling of age and retest in longitudinal studies of cognitive abilities.

Longitudinal multivariate mixed models were used to examine the correlates of change between memory and processing speed and the contribution of age and retest to such change correlates. Various age- and occasion-mixed models were fitted to 2 longitudinal data sets of adult individuals (N>1,200). For both data sets, the results indicated that the correlation between the age slopes of memory and processing speed decreased when retest effects were included in the model. If retest effects existed in the data but were not modeled, the correlation between the age slopes was positively biased. The authors suggest that although the changes in memory and processing speed may be correlated over time, age alone does not capture such a covariation.

Age Factors↗

Predictors of web navigation performance in a life span sample of adults.

The influence of age, subject matter knowledge, working memory, reading abilities, spatial abilities, and processing speed on Web navigation was assessed in a sample of 41 participants between the ages of 19 and 83 years. Each participant navigated a stand-alone tourism Web site to find answers to 12 questions. Performance was measured using time per trial, number of pages per trial, and number of revisited pages per trial. Age did not influence the number of total pages or repeat pages visited, which were predicted by domain knowledge, working memory, and processing speed. Age was associated with slower times per trial, and the effect remained significant after controlling for working memory, processing speed, and spatial abilities. Only with the addition of subject matter knowledge and World Wide Web experience was the age effect eliminated. Actual or potential applications of this research include redesigning Web sites to minimize memory demands and enhance visual segmentation. The data also suggest that age differences in Web navigation can be offset partially by taking advantage of older adults' prior experiences in the domain.

Adult↗

Dimensions of intelligence in schizophrenia: evidence from patients with preserved, deteriorated and compromised intellect.

There is a growing literature describing a subgroup of "high-functioning" people with schizophrenia who show preserved intellectual ability (IQ). A detailed characterisation of the cognitive abilities of this group may be important in targeting appropriate treatment, management and services for patients with schizophrenia. It is a widely held belief that variation in cognitive processing speed is the basis of individual differences in intelligence. The main objective of this study was to identify subgroups of schizophrenia patients with preserved (N=45), deteriorated (N=47) and compromised (N=17) intellect in order to study whether these subgroups differ in specific cognitive abilities (e.g. executive functions) or in general cognitive processing speed, as measured with an inspection time (IT) task. The patients who displayed an average estimated premorbid IQ, with no evidence of IQ decline (premorbid-current IQ difference <10 points), were found to show better performance on measures of executive function (continuous performance task, verbal fluency) compared with patients in the deteriorated and compromised subgroups. Nevertheless, this represented significantly impaired performance relative to healthy controls. In contrast, the average inspection times of patients with preserved IQ were as slow as those obtained in the deteriorated or compromised groups, indicating that high functioning patients are impaired in terms of cognitive processing speed. Furthermore, the average IT for all schizophrenia groups was significantly slower than that of healthy controls. These findings suggest that high functioning patients with schizophrenia exhibit enduring cognitive difficulties that may impact on their ability to benefit from rehabilitation interventions.

Adolescent↗

Stroke and apolipoprotein E epsilon4 are independent risk factors for cognitive decline: A population-based study.

BACKGROUND AND PURPOSE: Stroke and apolipoprotein E epsilon4 (ApoE epsilon4) are individually important risk factors for cognitive decline, including Alzheimer disease. It has been suggested that ApoE epsilon4 multiplies the risk for cognitive decline following stroke. In a population-based sample, using well-defined sensitive cognitive measures, this study investigates whether cognitive decline following stroke is worse for patients who carry the ApoE epsilon4 allele. METHODS: Subjects were participants in the Longitudinal Aging Study Amsterdam (LASA). The sample consisted of 1224 subjects, aged 62 to 85 years, who participated in the 3-year follow-up examination and for whom ApoE and stroke data were complete. We assessed cognitive decline using the Mini-Mental State Examination, the Auditory Verbal Learning Test (memory: immediate and delayed recall), and the Coding Task (information processing speed). The effects of stroke and ApoE epsilon4 on cognitive decline were evaluated with ANOVA and multiple logistic regression analysis, adjusted for age, sex, education, and baseline cognition. RESULTS: A synergistic effect modification for stroke and ApoE epsilon4 on cognitive decline was not observed. Unexpectedly, instead, stroke patients carrying the epsilon4 allele demonstrated a nonsignificantly lowered risk for Mini-Mental State Examination decline (OR=0.3; 95% CI 0.1 to 1.1). ApoE epsilon4 was associated with declines in information processing speed (OR=1.5; 95% CI 1.1 to 2.1) and small declines for immediate and delayed recall. CONCLUSIONS: Stroke and ApoE epsilon4 may impair cognition through distinct nonsynergistic mechanisms. The slowing of information processing speed for ApoE epsilon4 carriers was more evident than impairment in memory.

Aged↗

Estrogen replacement therapy and postural stability in the elderly.

Postural instability and falls in the elderly patient constitute a major health care problem. The etiology is often multifactorial, involving abnormal sensory input (visual, vestibular, and somatosensory), poor central processing, and suboptimal musculoskeletal biomechanics. Estrogen replacement therapy has been shown to prevent Alzheimer's disease and to improve cognitive performance in women with dementia. It was, therefore, postulated that estrogen replacement may improve central processing speed, which would result in improved postural stability. In this prospective, randomized, double-blinded study, 87 elderly female subjects (age > 69) were examined by repeated dynamic platform posturography, to measure the effect of estrogen therapy versus placebo upon postural stability. Results indicate that those receiving estrogen had no significant improvement in postural stability at 2 and 8 months of treatment relative to those receiving placebo. Trail Making B test was used as the psychometric test of central processing speed. There was no significant effect of estrogen on this measure over the 8 months of observations. It is concluded that 8 months of estrogen replacement therapy has no significant effect on central processing speed or postural stability in a healthy older female population.

Aged↗

Generalized atherosclerosis, cognitive decline, and depressive symptoms in old age.

BACKGROUND: Atherosclerosis may be linked to cognitive decline and depression in old age. METHODS: The Leiden 85-Plus Study is a prospective population-based study of 599 subjects from age 85 onward. The generalized atherosclerotic burden was rated by the number of cardiovascular pathologies at baseline, as assessed by history taking from treating physicians and EKG. Cardiovascular pathologies included myocardial infarction, angina pectoris or myocardial ischemia, claudicatio intermittens, and arterial surgery. Global cognitive function (Mini-Mental State Examination), attention (Stroop Test), processing speed (Letter Digit Coding Test), immediate recall memory (Word Learning Test-Immediate Recall), delayed recall memory (Word Learning Test-Delayed Recall), and depressive symptoms (15-item Geriatric Depression Scale) were assessed each year from ages 85 through 90. The prospective associations between both the generalized atherosclerosis rating and stroke with cognitive function and depressive symptoms were analyzed by linear mixed models adjusted for sex and level of education. RESULTS: During follow-up, there was a significant cognitive decline and a significant increase of depressive symptoms. At baseline, a history of stroke was correlated with lower global cognitive function, slower processing speed, impaired immediate and delayed recall memory, and more depressive symptoms. In addition, a higher generalized atherosclerosis rating was correlated with impaired global cognitive function, lower attention, and a slower processing speed at baseline. During follow-up, a higher generalized atherosclerosis rating was associated with an accelerated decline of immediate recall memory and delayed recall memory. In contrast, there was no relation between the generalized atherosclerosis rating and depressive symptoms, either in the cross-sectional analysis or in the prospective analysis. CONCLUSION: In the population at large, generalized atherosclerosis contributes to cognitive decline in old age but not to depression.

Aged, 80 and over↗

Divided visual attention as a predictor of bumping while walking: the Salisbury Eye Evaluation.

PURPOSE: The purpose of this study was to determine the association between bumping while walking and divided visual attention, as measured by the useful field of view (UFOV). METHODS: The Salisbury Eye Evaluation is a population-based study of community-dwelling adults, aged 72 to 92 at the third round of data collection. Participants walked a circuitous 32.8-m course, seeded with obstacles, and the number of bumps made while traversing the course was counted. UFOV divided attention score was based on processing speed: the time taken to identify a central target, and the location of a peripheral target simultaneously. Association between number of bumps and UFOV score was assessed in a generalized linear model, with adjustment for vision and attention measures that might explain the UFOV score. RESULTS: Of the 1504 participants in this study, 10.1% did not attempt the mobility course. In a model adjusting for demographic, physical, cognitive and attention, and vision measures, a decrease of 50 ms in processing speed for the divided-attention task was associated with a 4.9% increase (P = 0.004) in number of bumps made over the course. Receiver operating characteristic curves were created for the UFOV and visual field tests, to determine accuracy in detecting those with a high number of bumps. The visual field test had slightly higher area under the curve, but positive predictive value for both tests was low. CONCLUSIONS: The UFOV test of divided attention, as measured by processing speed, independently predicted bumping while walking. These data suggest that poor visual attention is a significant risk factor for bumping while walking.

Aged↗

White matter hyperintensities are associated with impairment of memory, attention, and global cognitive performance in older stroke patients.

BACKGROUND: The importance of white matter hyperintensities (WMH) for cognitive performance in older stroke patients is largely unknown. We hypothesized that processing speed and executive dysfunction will be associated with frontal WMH whereas impaired memory will be associated with temporal WMH. METHODS: Neuropsychological assessments using the Cambridge Cognitive Examination (CAMCOG) and the Cognitive Drug Research (CDR) were completed for 96 stroke survivors aged older than 75 and 23 age-matched controls. Magnetic resonance imaging whole-brain axial FLAIR images were undertaken to visualize WMH and an automated threshold technique was used to determine their volume. RESULTS: In comparison to controls, the stroke patients had significantly greater volume of WMH in all key areas. Within the stroke group, a consistent pattern of significant association was identified between total and frontal WHM volumes and attention and processing speed tasks (eg, choice reaction time [right: R=0.24 P=0.02; left: R=0.26, P=0.01]), but not with executive function. There were significant associations between memory and temporal WMH volumes (right: R=0.27, P=0.008; left: R=0.20, P=0.047). CONCLUSIONS: In older stroke patients, cognitive processing speed and performance on measures of attention are significantly associated with WMH volume, particularly in the frontal lobe regions, whereas memory impairment is associated with the volume of temporal lobe WMH.

Aged↗