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Cognitive markers of early Alzheimer's disease (AD) should be sensitive and specific to memory impairments that are not associated with healthy cognitive aging. In the present study, we investigated the effect of healthy cognitive aging on two proposed cognitive markers of AD: the Free and Cued Selective Reminding Task with Immediate Recall (FCSRT-IR) and a temporary visual memory binding (TMB) task.
Free recall and the cost of holding bound information in visual memory were compared between 24 younger and 24 older participants in a mixed, fully counterbalanced experiment.
A significant effect of age was observed on free recall in the FCSRT-IR only and not on the cost of binding in the TMB task.
Of these two cognitive markers, the TMB task is more likely to be specific to memory impairments that are independent of age.
Objectives: Anosognosia for motor impairment is a complex syndrome that can manifest itself under different forms, guiding patients’ behavior and task decisions. However, current diagnostic tools tend to evaluate only more explicit aspects of anosognosia (asking the patients about their motor abilities) and fail to address more subtle features of awareness. We have developed a new assessment measure, the ECT (Errand Choice Test), where patients are asked to judge task difficulty rather than estimate their own impairment. Methods: We assessed awareness in a group of 73 unilateral left- and right-brain damaged (30 LBD and 43 RBD, respectively) patients by means of the VATAm, which explicitly requires them to evaluate their own motor abilities, and the ECT. A control group of 65 healthy volunteers was asked to perform the ECT under two conditions: Current condition (i.e., using both hands) and Simulated conditions (i.e., simulating hemiplegia). Results: A total of 27% of the patients showed different performance on the VATAm and ECT, 21% of the patients showing lack of awareness only on VATAm and 6% only on ECT. Moreover, despite the ECT identified a higher frequency of anosognosia after RBD (33.3%) than LBD (27.6%), this hemispheric asymmetry was not significant. Remarkably, anosognosic patients performed very similarly to controls in the “current condition”, suggesting that anosognosic patients’ ability to perceive the complexity of each task per se is not altered. Conclusion: Different methods may be able to tackle different aspects of awareness and the ECT proved to be able to detect less evident forms of awareness. (JINS, 2018, 24, 45–56)
This study explored Closing-in behavior (CIB), the tendency in figure copying to draw very close to or on top of the model, in mild cognitive impairment (MCI). The files of 154 people diagnosed with MCI were reviewed and CIB was identified in 21% of cases. Two approaches were used to explore CIB. First, we capitalized on the diverse cognitive profiles within MCI, subdividing the overall sample into people with and without memory deficits. The frequency of CIB was significantly higher in multidomain non-amnestic MCI than in multidomain amnestic MCI, suggesting that CIB is not associated with specific memory impairment. Second, we assessed the cognitive correlates of CIB, by selecting patients with MCI who completed a battery of executive, visuo-constructional and memory tasks. Sub-groups of patients with and without CIB showed a similar overall severity of cognitive decline and comparable performance in visuo-constructional and memory tasks, but those with CIB were slightly but significantly more impaired on executive function tasks. The study provides evidence against memory-based accounts of CIB, and supports recent suggestions that executive impairments are the dominant cognitive correlate of this clinical sign. (JINS, 2012, 18, 269–276)
Previous dual task studies have demonstrated that patients with sporadic Alzheimer's disease (AD) are impaired in their ability to perform two tasks simultaneously compared with healthy controls, despite being able to successfully perform the tasks alone relatively well. Yet, it remains unclear what the earliest clinical manifestation of this dual task coordination deficit is. This study examined dual task abilities in individuals who are at risk of early-onset familial AD due to an E280A presenilin-1 mutation. Thirty-nine carriers of the gene mutation who did not meet the criteria for AD and 29 non-carrier healthy controls were asked to perform digit recall accompanied by a secondary tracking task. Individuals who were carriers of the genetic mutation demonstrated significantly higher dual task costs than healthy non-carriers. Dual task performance was found to be more sensitive to this very early stage of FAD than episodic memory measures. The findings support the notion that a deficit in the coordination mechanism of the central executive may be a pre-clinical marker for the early detection of AD due to the E280A presenilin-1 gene mutation. (JINS, 2012, 18, 234–241)
The Paradoxical Brain focuses on a range of phenomena in clinical and cognitive neuroscience that are counterintuitive and go against the grain of established thinking. The book covers a wide range of topics by leading researchers, including:Superior performance after brain lesions or sensory lossReturn to normal function after a second brain lesion in neurological conditionsParadoxical phenomena associated with human developmentExamples where having one disease appears to prevent the occurrence of another diseaseSituations where drugs with adverse effects on brain functioning may have beneficial effects in certain situationsA better understanding of these interactions will lead to a better understanding of brain function and to the introduction of new therapeutic strategies. The book will be of interest to those working at the interface of brain and behaviour, including neuropsychologists, neurologists, psychiatrists and neuroscientists.
The frequency and characteristics of closing-in behavior (CIB) were examined in 797 patients with Alzheimer’s disease (AD), 132 of whom were followed up longitudinally. The frequency of CIB increased with the complexity of the graphic copying task and with the severity of Alzheimer’s disease. Regression analyses suggested that attentional deficits are critical factors for the appearance of CIB, but that visuospatial impairments also play an important role in the emergence of severe forms of CIB. (JINS, 2009, 15, 787–792.)
In this chapter we argue that visuospatial working memory offers a useful theoretical construct, possibly open to further fractionation, that can account for a variety of symptoms shown by neuropsychological patients as well as for some important aspects of visuospatial cognition in the healthy brain. We discuss evidence that draws on studies of a range of impairments of visuospatial cognition that arise following focal brain damage in human adults, and specifically the condition known as unilateral spatial neglect, together with investigations of mental discovery and of immediate visuospatial memory in healthy adults. This evidence is incompatible with common assumptions about working memory as a temporary buffer between sensory input and long-term memory. It is also not consistent with assumptions that mental visual imagery and the processes of visual perception share broadly overlapping cognitive functions and/or neuroanatomical networks. It is proposed that visuospatial working memory can be viewed as part of a mental workspace in which visually presented material can be made available in an interpreted form together with other information in working memory derived from other sensory input or from the long-term store of knowledge.
Working-memory retention as activated long-term memory fails to capture orchestrated processing and storage, the hallmark of the concept of working memory. The event-related potential (ERP) data are compatible with working memory as a mental workspace that holds and manipulates information on line, which is distinct from long-term memory, and deals with the products of activated traces from stored knowledge.
The aim of the study is to provide (i) a standardized procedure for a Cancellation Test of Digits, designed to assess in the visual modality selective attention deficits in patients with Alzheimer's disease, and (ii) a detailed analysis of how patients cope with it.
Age-, education-, and sex-adjusted normative scores earned by 352 healthy controls are set forth, as well as data yielded by the Digit Cancellation Test in 74 Alzheimer patients, in 26 patients with a CT-assessed frontal lobe lesion and in a group of 24 healthy subjects urged to perform the task with a shortened time-constraint. Findings include discriminant power of Alzheimer patients versus healthy controls, sensitivity to cognitive evolution of the dementing process and analysis of errors. Attention data failed to supply psychometric support for the posterior-to-anterior algorithm of progressive cortical encroachment of Alzheimer's disease suggested by PET-findings.
Emphasis is put on methodological aspects of neuropsychological research on Alzheimer patients and on the analysis of processing components of the tests employed. Results are discussed in the light of the relationships between psychometric assessments and related functions, and underlying neuronal degeneration.
A structured enquiry for assessing autobiographical memory is proposed. It is made up of three standardized time-cued sets of questions focusing on three life periods: adolescence, early and late adulthood, with five questions for each life period. Standardized testing procedure, checking for veracity and scoring methods are described. Normative data from 157 healthy individuals aged over 55 are converted into ‘equivalent scores’ for use with the enquiry and for diagnostic purposes. Education and ageing, but not sex, appear to be significant factors in the efficiency of retrieval from the autobiographic repertoire.
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