A diffusion model analysis of episodic recognition in preclinical individuals with a family history for Alzheimer's disease: The adult children study

A Diffusion Model Account of Cognitive Variability in Healthy Aging and Mild Cognitive Impairment

Within-person variation in cognitive performance is linked to pathological aging. Cognitive fluctuations have not been analyzed using cognitive process models, such as the diffusion model, to characterize which cognitive processes contribute to variability in cognition. We collected 21 daily assessments of attention and personality in younger adults, healthy older adults, and those with mild cognitive impairment. We employed mixed-effects location scale models to analyze group differences on mean diffusion parameters and daily variability. Discussion focuses on how these methods extend our understanding of how cognitive deficits might appear in aging and disease and the moderating influence of daily personality.

The associations between attentional control, episodic memory, and Alzheimer's disease biomarkers of tau and neurodegeneration

BACKGROUND

While episodic memory decline is the most common cognitive symptom of Alzheimer's disease (AD), changes in attentional control have also been found to be sensitive to early AD pathology. The relations between longitudinal trajectories of these specific cognitive domains, especially attentional control, and biomarkers of tau and neurodegeneration have not been thoroughly examined.

OBJECTIVE

We examined whether baseline tau positron emission tomography (PET) and cortical thickness, relatively later markers within the AD cascade, predicted cross-sectional and longitudinal changes in episodic memory and attentional control.

METHODS

Cognitively normal individuals ([Clinical Dementia Rating CDR®] = 0; n = 249) at baseline completed a magnetic resonance imaging (MRI), tau PET, and multiple assessments of episodic memory and attentional control. Generalized additive mixed-effects models examined whether tau PET summary measure and cortical thickness signature predicted cross-sectional and longitudinal trajectories of attentional control and episodic memory.

RESULTS

Higher tau PET and lower MRI cortical thickness were generally associated with worse cross-sectional cognitive performance. Our exploratory analyses found cortex-wide associations between tau PET and episodic memory, with limited suggestions of region-specific associations with attentional control. On longitudinal follow-up, higher tau PET was associated with a greater decline in episodic memory.

CONCLUSIONS

These results indicate that tau PET is particularly sensitive to detecting longitudinal changes in episodic memory. This further informs relevant endpoints for clinical drug trials in cognitively normal individuals. Future studies might consider longer follow-ups and lag associations between changes in AD biomarkers and changes in cognition.

Differential responses of primary neuron-secreted MCP-1 and IL-9 to type 2 diabetes and Alzheimer's disease-associated metabolites

Type 2 diabetes (T2D) is implicated as a risk factor for Alzheimer's disease (AD), the most common form of dementia. In this work, we investigated neuroinflammatory responses of primary neurons to potentially circulating, blood-brain barrier (BBB) permeable metabolites associated with AD, T2D, or both. We identified nine metabolites associated with protective or detrimental properties of AD and T2D in literature (lauric acid, asparagine, fructose, arachidonic acid, aminoadipic acid, sorbitol, retinol, tryptophan, niacinamide) and stimulated primary mouse neuron cultures with each metabolite before quantifying cytokine secretion via Luminex. We employed unsupervised clustering, inferential statistics, and partial least squares discriminant analysis to identify relationships between cytokine concentration and disease-associations of metabolites. We identified MCP-1, a cytokine associated with monocyte recruitment, as differentially abundant between neurons stimulated by metabolites associated with protective and detrimental properties of AD and T2D. We also identified IL-9, a cytokine that promotes mast cell growth, to be differentially associated with T2D. Indeed, cytokines, such as MCP-1 and IL-9, released from neurons in response to BBB-permeable metabolites associated with T2D may contribute to AD development by downstream effects of neuroinflammation.

Cognitive Functioning of Unaffected First-degree Relatives of Individuals With Late-onset Alzheimer's Disease: A Systematic Literature Review and Meta-analysis

First-degree relatives of individuals with late-onset Alzheimer's disease (LOAD) are at increased risk for developing dementia, yet the associations between family history of LOAD and cognitive dysfunction remain unclear. In this quantitative review, we provide the first meta-analysis on the cognitive profile of unaffected first-degree blood relatives of LOAD-affected individuals compared to controls without a family history of LOAD. A systematic literature search was conducted in PsycINFO, PubMed /MEDLINE, and Scopus. We fitted a three-level structural equation modeling meta-analysis to control for non-independent effect sizes. Heterogeneity and risk of publication bias were also investigated. Thirty-four studies enabled us to estimate 218 effect sizes across several cognitive domains. Overall, first-degree relatives (n = 4,086, mean age = 57.40, SD = 4.71) showed significantly inferior cognitive performance (Hedges' g = -0.16; 95% CI, -0.25 to -0.08; p < .001) compared to controls (n = 2,388, mean age = 58.43, SD = 5.69). Specifically, controls outperformed first-degree relatives in language, visuospatial and verbal long-term memory, executive functions, verbal short-term memory, and verbal IQ. Among the first-degree relatives, APOE ɛ4 carriership was associated with more significant dysfunction in cognition (g = -0.24; 95% CI, -0.38 to -0.11; p < .001) compared to non-carriers (g = -0.14; 95% CI, -0.28 to -0.01; p = .04). Cognitive test type was significantly associated with between-group differences, accounting for 65% (R23 = .6499) of the effect size heterogeneity in the fitted regression model. No evidence of publication bias was found. The current findings provide support for mild but robust cognitive dysfunction in first-degree relatives of LOAD-affected individuals that appears to be moderated by cognitive domain, cognitive test type, and APOE ɛ4.

Differential responses of primary neuron-secreted MCP-1 and IL-9 to type 2 diabetes and Alzheimer's disease-associated metabolites

Type 2 diabetes (T2D) is implicated as a risk factor for Alzheimer's disease (AD), the most common form of dementia. In this work, we investigated neuroinflammatory responses of primary neurons to potentially circulating, blood-brain barrier (BBB) permeable metabolites associated with AD, T2D, or both. We identified nine metabolites associated with protective or detrimental properties of AD and T2D in literature (lauric acid, asparagine, fructose, arachidonic acid, aminoadipic acid, sorbitol, retinol, tryptophan, niacinamide) and stimulated primary mouse neuron cultures with each metabolite before quantifying cytokine secretion via Luminex. We employed unsupervised clustering, inferential statistics, and partial least squares discriminant analysis to identify relationships between cytokine concentration and disease-associations of metabolites. We identified MCP-1, a cytokine associated with monocyte recruitment, as differentially abundant between neurons stimulated by metabolites associated with protective and detrimental properties of AD and T2D. We also identified IL-9, a cytokine that promotes mast cell growth, to be differentially associated with T2D. Indeed, cytokines, such as MCP-1 and IL-9, released from neurons in response to BBB-permeable metabolites associated with T2D may contribute to AD development by downstream effects of neuroinflammation.

Subclinical memory impairment in unaffected siblings of patients with dementia

Objective: Family history of dementia is a known risk factor for dementia. The cognitive performance of unaffected siblings of dementia patients has been poorly studied. We aimed to determine whether clinically unaffected siblings of dementia patients have significant cognitive impairment compared to individuals who do not have first-degree relatives with dementia. Methods: We compared the cognitive performance of 67 patients with dementia (24 males; mean age 69.5), 90 healthy siblings of those patients (34 males; mean age 61.56) and 92 healthy adults (35 males; mean age 60.96) who have no first-degree relatives with dementia. We assessed learning and memory (Rey Auditory Verbal Learning Test (RAVLT)), short-term/working memory (Digit Span) executive functions (Stroop Test) and general intelligence (Raven Progressive Matrices). Test scores were compared among three groups, with regression-based adjustments for age, sex, and education. Results: As expected, the patients with dementia were impaired in all cognitive domains. In the Sibling Group, RAVLT total learning was significantly lower compared to controls (B = -3.192, p = .005). In a subgroup analysis, compared to controls, RAVLT delayed recall was poorer in the siblings of patients with early-onset (<65 years) dementia. No significant differences were observed in other cognitive domains. Conclusion: Clinically unaffected siblings of dementia patients seem to have a selective subclinical impairment in memory encoding. This impairment seems to be more prominent in siblings of patients with early-onset dementia who also have deficits in delayed recall. Future studies are needed to determine if the observed cognitive impairment deteriorates to dementia.

Parsing memory and nonmemory contributions to age-related declines in mnemonic discrimination performance: a hierarchical Bayesian diffusion decision modeling approach

The mnemonic discrimination task (MDT) is a widely used cognitive assessment tool. Performance in this task is believed to indicate an age-related deficit in episodic memory stemming from a decreased ability to pattern-separate among similar experiences. However, cognitive processes other than memory ability might impact task performance. In this study, we investigated whether nonmnemonic decision-making processes contribute to the age-related deficit in the MDT. We applied a hierarchical Bayesian version of the Ratcliff diffusion model to the MDT performance of 26 younger and 31 cognitively normal older adults. It allowed us to decompose decision behavior in the MDT into different underlying cognitive processes, represented by specific model parameters. Model parameters were compared between groups, and differences were evaluated using the Bayes factor. Our results suggest that the age-related decline in MDT performance indicates a predominantly mnemonic deficit rather than differences in nonmnemonic decision-making processes. In addition, this mnemonic deficit might also involve a slowing in processes related to encoding and retrieval strategies, which are relevant for successful memory as well. These findings help to better understand what cognitive processes contribute to the age-related decline in MDT performance and may help to improve the diagnostic value of this popular task.

Exploratory Longitudinal Study of Ocular Structural and Visual Functional Changes in Subjects at High Genetic Risk of Developing Alzheimer's Disease

This study aimed to analyze the evolution of visual changes in cognitively healthy individuals at risk for Alzheimer's disease (AD). Participants with a first-degree family history of AD (FH+) and carrying the Ε4+ allele for the ApoE gene (ApoE ε4+) underwent retinal thickness analysis using optical coherence tomography (OCT) and visual function assessments, including visual acuity (VA), contrast sensitivity (CS), color perception, perception digital tests, and visual field analysis. Structural analysis divided participants into FH+ ApoE ε4+ and FH- ApoE ε4- groups, while functional analysis further categorized them by age (40-60 years and over 60 years). Over the 27-month follow-up, the FH+ ApoE ε4+ group exhibited thickness changes in all inner retinal layers. Comparing this group to the FH- ApoE ε4- group at 27 months revealed progressing changes in the inner nuclear layer. In the FH+ ApoE ε4+ 40-60 years group, no progression of visual function changes was observed, but an increase in VA and CS was maintained at 3 and 12 cycles per degree, respectively, compared to the group without AD risk at 27 months. In conclusion, cognitively healthy individuals at risk for AD demonstrated progressive retinal structural changes over the 27-month follow-up, while functional changes remained stable.

Trends in Alzheimer Disease Mortality Among American Indian and Alaska Native People Between 2011 and 2019

PURPOSE

The number of American Indian and Alaska Native (AI/AN) people living with dementia is expected to increase 5-fold by 2060. Social determinants of health may explain disparities in the incidence of Alzheimer disease (AD) but remain largely overlooked.

METHODS

We examined the time trend of AD mortality rates and associations of the percentage of AI/ANs, density of primary care physicians and neurologists, area deprivation index, rurality, and Indian Health Service region with AD mortality in 646 purchased/referred care delivery area counties.

RESULTS

AD mortality rates significantly increased over time. Counties with higher concentrations of AI/AN people had lower AD mortality. More deprived counties had 34% higher AD mortality compared with less deprived counties. AD mortality was 20% lower in nonmetro counties than in metro counties.

CONCLUSIONS

Findings have implications for prioritizing areas where more resources for AD care, education, or outreach are needed.

Utility of Diffusion Modeling of Cogstate Brief Battery Test Performance in Detecting Mild Cognitive Impairment

Cognitive testing data are essential to the diagnosis of mild cognitive impairment (MCI), and computerized cognitive testing, such as the Cogstate Brief Battery, has proven helpful in efficiently identifying harbingers of dementia. This study provides a side-by-side comparison of traditional Cogstate outcomes and diffusion modeling of these outcomes in predicting MCI diagnosis. Participants included 257 older adults (160 = normal cognition; 97 = MCI). Results showed that both traditional Cogstate and diffusion modeling analyses predicted MCI diagnosis with acceptable accuracy. Cogstate measures of recognition learning and working memory accuracy and diffusion modeling variable of decision-making efficiency (drift rate) and nondecisional time were most predictive of MCI. While participants with normal cognition demonstrated a change in response caution (boundary separation) when transitioning tasks, participants with MCI did not evidence this change.

Antisaccadic eye movements in middle-aged individuals with a family history of Alzheimer's disease

Background

Antisaccade is closely associated with cognitive ability in Alzheimer's disease (AD). However, studies regarding antisaccade in the early stages of AD are scarce. Considering that first-degree family history is a well-established risk factor for AD, we explored the influence of family history on the performance of antisaccade tasks in individuals with normal cognition.

Methods

In total, 44 participants (aged 50-66 years) with a family history of AD (FH+) and 44 age-, gender-, and educational level-matched controls (FH-) were enrolled in our study. After cognitive assessment using the Montreal Cognitive Assessment and Mini-mental State Examination, participants underwent antisaccade trials, and all parameters were recorded using an eye tracker.

Results

While the average velocity was relatively lower in FH+ individuals than in FH- individuals (107.9 ± 14.3°/s vs. 132.9 ± 23.7°/s, p < 0.001), FH+ individuals surprisingly showed relatively fewer uninhibited reflexive saccades (44.7 ± 26.0% vs. 56.2 ± 24.7%, p = 0.037) than the control group. They also required a relatively shorter time to detect and correct false saccades (121.6 ± 40.7 ms vs. 143.9 ± 37.0 ms, p = 0.023).

Conclusions

This study showed that family history is associated with alterations in antisaccadic parameters, suggesting that eye tracking can be used to assess oculomotor control and executive function in individuals at risk of developing dementia.

The Effect of Ingroup vs. Outgroup Members' Behavior on Charity Preference: A Drift-Diffusion Model Approach

Providing potential donors with information about the behavior of others (i.e., social information) is an increasingly used strategy to nudge prosocial decision-making. In the present study, we investigated the effect of ingroup vs. outgroup information on participants' charity preferences by applying a Drift Diffusion Model (DDM) approach. In a joint evaluation scenario, we manipulated different levels of ingroup/outgroup preference ratios for two charities within subjects. Every subject was presented with three stimulus types (i.e., high, medium, and low ingroup ratio) randomized in 294 trials divided into six blocks. We expected that for stimuli with a high ingroup/outgroup ratio, participants should more often and faster decide for the ingroup's most favored charity. We expected that the speed of evidence accumulation will be higher the larger the ingroup/outgroup ratio. Additionally, we investigated whether variations in model parameters can explain individual differences in participants' behaviors. Our results showed that people generally followed ingroup members' preferences when deciding for a charity. However, on finding an unexpected pattern in our results, we conducted post-hoc analyses which revealed two different behavioral strategies used by participants. Based on participants' decisions, we classified them into “equality driven” individuals who preferred stimuli with the least difference between ingroup and outgroup percentages or “ingroup driven” individuals who favored stimuli with the highest ingroup/outgroup ratio. Results are discussed in line with relevant literature, and implications for practitioners are given.

Age differences in diffusion model parameters: a meta-analysis

Older adults typically show slower response times in basic cognitive tasks than younger adults. A diffusion model analysis allows the clarification of why older adults react more slowly by estimating parameters that map distinct cognitive components of decision making. The main components of the diffusion model are the speed of information uptake (drift rate), the degree of conservatism regarding the decision criterion (boundary separation), and the time taken up by non-decisional processes (i.e., encoding and motoric response execution; non-decision time). While the literature shows consistent results regarding higher boundary separation and longer non-decision time for older adults, results are more complex when it comes to age differences in drift rates. We conducted a multi-level meta-analysis to identify possible sources of this variance. As possible moderators, we included task difficulty and task type. We found that age differences in drift rate are moderated both by task type and task difficulty. Older adults were inferior in drift rate in perceptual and memory tasks, but information accumulation was even increased in lexical decision tasks for the older participants. Additionally, in perceptual and lexical decision tasks, older individuals benefitted from high task difficulty. In the memory tasks, task difficulty did not moderate the negative impact of age on drift. The finding of higher boundary separation and longer non-decision time in older than younger adults generalized over task type and task difficulty. The results of our meta-analysis are consistent with recent findings of a more pronounced age-related decline in memory than in vocabulary performance.

A diffusion model analysis of belief bias: Different cognitive mechanisms explain how cognitive abilities and thinking styles contribute to conflict resolution in reasoning

Recent results have challenged the widespread assumption of dual process models of belief bias that sound reasoning relies on slow, careful reflection, whereas biased reasoning is based on fast intuition. Instead, parallel process models of reasoning suggest that rule- and belief-based problem features are processed in parallel and that reasoning problems that elicit a conflict between rule- and belief-based problem features may also elicit more than one Type 1 response. This has important implications for individual-differences research on reasoning, because rule-based responses by certain individuals may reflect that these individuals were either more likely to give a rule-based default response or that they successfully inhibited and overrode a belief-based default response. In two studies, we used the diffusion model to describe decision making in a transitive reasoning task. In Study 1, 41 participants were asked to evaluate conclusions based on their validity. In Study 2, 133 participants evaluated conclusions based on their validity or believability. We tested which diffusion model parameters reflected conflict resolution and related those model parameters to individual differences in cognitive abilities and thinking styles. Individual differences in need for cognition predicted successful conflict resolution under logic instruction, which suggests that a disposition to engage in reflective thinking facilitates the inhibition and override of Type 1 responses. Intelligence, however, was negatively related to successful conflict resolution under belief instruction, which suggests that individuals with high cognitive abilities quickly generated a higher-level logical response that interfered with their ability to evaluate lower-level intrinsic problem features. Taken together, this double dissociation indicates that cognitive abilities and thinking styles affect the processing of conflict information through different mechanisms and at different stages: Greater cognitive abilities facilitate the efficient creation of decoupled problem representations, whereas a greater disposition to engage in critical thinking facilitates the detection and override of Type 1 responses.

Association of the CD2AP locus with cognitive functioning among middle-aged individuals with a family history of Alzheimer's disease

First-degree family history is an established risk factor for Alzheimer's disease (AD). We investigated the association of late-onset AD risk loci with cognitive functioning among 315 offspring of AD patients. Participants were cognitively normal Jewish individuals, aged 40-65 years, from the Israel Registry for Alzheimer's Prevention (IRAP) study. Twenty-two single-nucleotide polymorphisms (SNPs) within these loci and the APOE E4 allele were included in the final analyses, and a polygenic risk score was also calculated. Using linear regression (assuming an additive genetic model), we found a significant association only for SNP rs9473117, located near the CD2-associated protein (CD2AP) gene, with global cognition. Controlling for demographic variables (age, sex, years of education, and ancestry), the late-onset AD risk allele C was associated with lower global cognitive functioning (p = 0.0005), and withstood correction for multiple testing. After adjusting for additional characteristics (APOE E4 status and then also for cardiovascular factors), the results remained essentially unchanged (p = 0.0003 and p = 0.0005, respectively). In secondary analyses examining specific cognitive domains, rs9473117 was similarly associated with episodic memory (p = 0.005), language (p = 0.009), and working memory/attention (p = 0.018) but not with executive functions (p = 0.27). Again, the results were similar after adjusting for APOE E4 status and cardiovascular factors. The polygenic risk score was not associated with global cognitive functioning or with any of the 4 domains. In conclusion, our findings suggest a contribution of the CD2AP locus to cognitive functioning in middle-aged individuals with a parental history of AD. Further validations, including in longitudinal studies, are required.

Comparing Eight Parameter Estimation Methods for the Ratcliff Diffusion Model Using Free Software

The Ratcliff Diffusion Model has become an important and widely used tool for the evaluation of psychological experiments. Concurrently, numerous programs and routines have appeared to estimate the model's parameters. The present study aims at comparing some of the most widely used tools with special focus on freely available routines (i.e., open source). Our simulations show that (1) starting point and non-decision time were recovered better than drift rate, (2) the Bayesian approach outperformed all other approaches when the number of trials was low, (3) the Kolmogorov-Smirnov and χ² approaches revealed more bias than Bayesian or Maximum Likelihood based routines, and (4) EZ produced substantially biased estimates of threshold separation, non-decision time and drift rate when starting point z ≠ a/2. We discuss the implications for the choice of parameter estimation approaches for real data and suggest that if biased starting point cannot be excluded, EZ will produce deviant estimates and should be used with great care.

Genetic risk of dementia modifies obesity effects on white matter myelin in cognitively healthy adults

APOE-ε4 is a major genetic risk factor for late-onset Alzheimer's disease that interacts with other risk factors, but the nature of such combined effects remains poorly understood. We quantified the impact of APOE-ε4, family history (FH) of dementia, and obesity on white matter (WM) microstructure in 165 asymptomatic adults (38-71 years old) using quantitative magnetization transfer and neurite orientation dispersion and density imaging. Microstructural properties of the fornix, parahippocampal cingulum, and uncinate fasciculus were compared with those in motor and whole-brain WM regions. Widespread interaction effects between APOE, FH, and waist-hip ratio were found in the myelin-sensitive macromolecular proton fraction from quantitative magnetization transfer. Among individuals with the highest genetic risk (FH+ and APOE-ε4), obesity was associated with reduced macromolecular proton fraction in the right parahippocampal cingulum, whereas no effects were present for those without FH. Risk effects on apparent myelin were moderated by hypertension and inflammation-related markers. These findings suggest that genetic risk modifies the impact of obesity on WM myelin consistent with neuroglia models of aging and late-onset Alzheimer's disease.

Model-based assessment and neural correlates of spatial memory deficits in mild cognitive impairment

Mild cognitive impairment (MCI) is characterized by subjective and objective memory impairments within the context of generally intact everyday functioning. Such memory deficits are typically thought to arise from medial temporal lobe dysfunction; however, differences in memory task performance can arise from a variety of altered processes (e.g., strategy adjustments) rather than, or in addition to, "pure" memory deficits. To address this problem, we applied the linear ballistic accumulator (LBA: Brown and Heathcote, 2008) model to data from individuals with MCI (n = 18) and healthy older adults (HOA; n = 16) who performed an object-location association memory retrieval task during functional magnetic resonance imaging (fMRI). The primary goals were to 1) assess between-group differences in model parameters indexing processes of interest (memory sensitivity, accumulation speed, caution and time spent on peripheral perceptual and motor processes) and 2) determine whether differences in model-based metrics were consistent with fMRI data. The LBA provided evidence that, relative to the HOA group, those with MCI displayed lower sensitivity (i.e., difficulty discriminating targets from lures), suggestive of memory impairment, and displayed higher evidence accumulation speed and greater caution, suggestive of increased arousal and strategic changes in this group, although these changes had little impact on MCI-related accuracy differences. Consistent with these findings, fMRI revealed reduced activation in brain regions previously linked to evidence accumulation and to the implementation of caution reductions in the MCI group. Findings suggest that multiple cognitive mechanisms differ during memory retrieval in MCI, and that these mechanisms may explain neuroimaging alterations outside of the medial temporal lobes.

Item-specific processing reduces false recognition in older and younger adults: Separating encoding and retrieval using signal detection and the diffusion model

Our study examined processing effects in improving memory accuracy in older and younger adults. Specifically, we evaluated the effectiveness of item-specific and relational processing instructions relative to a read-only control task on correct and false recognition in younger and older adults using a categorized-list paradigm. In both age groups, item-specific and relational processing improved correct recognition versus a read-only control task, and item-specific encoding decreased false recognition relative to both the relational and read-only groups. This pattern was found in older adults despite overall elevated rates of false recognition. We then applied signal-detection and diffusion-modeling analyses, which separately utilized recognition responses and the latencies to those responses to estimate contributions of encoding and monitoring processes on recognition decisions. Converging evidence from both analyses demonstrated that item-specific processing benefits to memory accuracy were due to improvements of both encoding (estimates of d' and drift rate) and monitoring (estimates of lambda and boundary separation) processes, and, importantly, occurred similarly in both younger and older adults. Thus, older and younger adults showed similar encoding-based and test-based benefits of item-specific processing to enhance memory accuracy.

Family history of Alzheimer's disease alters cognition and is modified by medical and genetic factors

In humans, a first-degree family history of dementia (FH) is a well-documented risk factor for Alzheimer’s disease (AD); however, the influence of FH on cognition across the lifespan is poorly understood. To address this issue, we developed an internet-based paired-associates learning (PAL) task and tested 59,571 participants between the ages of 18–85. FH was associated with lower PAL performance in both sexes under 65 years old. Modifiers of this effect of FH on PAL performance included age, sex, education, and diabetes. The Apolipoprotein E ε4 allele was also associated with lower PAL scores in FH positive individuals. Here we show, FH is associated with reduced PAL performance four decades before the typical onset of AD; additionally, several heritable and non-heritable modifiers of this effect were identified.

Gene-environment interactions in Alzheimer's disease: A potential path to precision medicine

Alzheimer's disease (AD) is the leading cause of dementia in the United States and afflicts >5.7 million Americans in 2018. Therapeutic options remain extremely limited to those that are symptom targeting, while no drugs have been approved for the modification or reversal of the disease itself. Risk factors for AD including aging, the female sex, as well as carrying an APOE4 genotype. These risk factors have been extensively examined in the literature, while less attention has been paid to modifiable risk factors, including lifestyle, and environmental risk factors such as exposures to air pollution and pesticides. This review highlights the most recent data on risk factors in AD and identifies gene by environment interactions that have been investigated. It also provides a suggested framework for a personalized therapeutic approach to AD, by combining genetic, environmental and lifestyle risk factors. Understanding modifiable risk factors and their interaction with non-modifiable factors (age, susceptibility alleles, and sex) is paramount for designing personalized therapeutic interventions.

Impaired conflict monitoring in cognitive decline

Resolving conflicts is an important cognitive ability of executive function, and it may decrease with cognitive decline. The flanker task is a practical test used to assess the ability to suppress responses that are inappropriate in a particular context. The aims of the present study were to investigate conflict monitoring of cognitive control in subjects with different levels of cognitive impairment, and clarify the usefulness of the flanker task in screening cognitive decline. We recruited 50 subjects with mild cognitive impairment (MCI) and 34 patients with Alzheimer's disease (AD), and 44 mentally healthy elderly subjects as a control group. To evaluate cognitive performance, each participant underwent a neuropsychological assessment using the Cognitive Abilities Screening Instrument and a modified flanker task. Compared with the normal controls and those with MCI, the patients with AD had a significantly lower accuracy rate and longer reaction time in both congruent and incongruent trials. The diagnosis of AD predicted significantly poorer performances on the flanker tasks. Furthermore, behavioral data of the patients with AD were significantly correlated with the results of neuropsychological tests. Our results indicated that executive cognitive deficits in conflict monitoring as detected by the flanker task were significantly impaired in the patients with AD. The flanker task could be a quick and easier alternative tool for screening AD among elderly people with suspicious cognitive impairment.

Two processes are not necessary to understand memory deficits

Bastin et al. propose a dual-process model to understand memory deficits. However, results from state-trace analysis have suggested a single underlying variable in behavioral and neural data. We advocate the usage of unidimensional models that are supported by data and have been successful in understanding memory deficits and in linking to neural data.

Modelling reaction time distribution of fast decision tasks in schizophrenia: Evidence for novel candidate endophenotypes

Increased reaction time (RT) and variability of RT in fast decision tasks is observed in patients with schizophrenia and their first degree relatives. This study used modelling of the RT distribution with the aim of identifying novel candidate endophenotypes for schizophrenia. 20 patients with schizophrenia, 15 siblings of patients and 25 healthy controls performed an oddball task of varying working memory load. Increases in mean and standard deviation (SD) of RT were observed for both patients and siblings compared to controls and they were again independent of working memory load. Ex-Gaussian modelling of the RT distribution confirmed that parameters μ, σ and τ increased significantly in patients and siblings compared to controls. The Drift Diffusion Model was applied on RT distributions. A decrease in the diffusion drift rate (v) modeling the accumulation of evidence for reaching the decision to choose one stimulus over the other, was observed in patients and siblings compared to controls. The mean time of the non-decisional sensorimotor processes (t0) and it's variance (st0) was also increased in patients and siblings compared to controls. In conclusion modeling of the RT distribution revealed novel potential cognitive endophenotypes in the quest of heritable risk factors for schizophrenia.

A model-based quantification of action control deficits in Parkinson's disease

Basal ganglia dysfunction in Parkinson's disease (PD) is thought to generate deficits in action control, but the characterization of these deficits have been qualitative rather than quantitative. Patients with PD typically show prolonged response times on tasks that instantiate a conflict between goal-directed processing and automatic response tendencies. In the Simon task, for example, the irrelevant location of the stimulus automatically activates a corresponding lateralized response, generating a potential conflict with goal-directed choices. We applied a new computational model of conflict processing to two sets of behavioral data from the Simon task to quantify the effects of PD and dopaminergic (DA) medication on action control mechanisms. Compared to healthy controls (HC) matched in age gender and education, patients with PD showed a deficit in goal-directed processing, and the magnitude of this deficit positively correlated with cognitive symptoms. Analyses of the time-course of the location-based automatic activation yielded mixed findings. In both datasets, we found that the peak amplitude of the automatic activation was similar between PD and HC, demonstrating a similar degree of response capture. However, PD patients showed a prolonged automatic activation in only one dataset. This discrepancy was resolved by theoretical analyses of conflict resolution in the Simon task. The reduction of interference generated by the automatic activation appears to be driven by a mixture of passive decay and top-down inhibitory control, the contribution of each component being modulated by task demands. Our results suggest that PD selectively impairs the inhibitory control component, a deficit likely remediated by DA medication. This work advances our understanding of action control deficits in PD, and illustrates the benefit of using computational models to quantitatively measure cognitive processes in clinical populations.

How many trials are required for parameter estimation in diffusion modeling? A comparison of different optimization criteria

Diffusion models (Ratcliff, 1978) make it possible to identify and separate different cognitive processes underlying responses in binary decision tasks (e.g., the speed of information accumulation vs. the degree of response conservatism). This becomes possible because of the high degree of information utilization involved. Not only mean response times or error rates are used for the parameter estimation, but also the response time distributions of both correct and error responses. In a series of simulation studies, the efficiency and robustness of parameter recovery were compared for models differing in complexity (i.e., in numbers of free parameters) and trial numbers (ranging from 24 to 5,000) using three different optimization criteria (maximum likelihood, Kolmogorov-Smirnov, and chi-square) that are all implemented in the latest version of fast-dm (Voss, Voss, & Lerche, 2015). The results revealed that maximum likelihood is superior for uncontaminated data, but in the presence of fast contaminants, Kolmogorov-Smirnov outperforms the other two methods. For most conditions, chi-square-based parameter estimations lead to less precise results than the other optimization criteria. The performance of the fast-dm methods was compared to the EZ approach (Wagenmakers, van der Maas, & Grasman, 2007) and to a Bayesian implementation (Wiecki, Sofer, & Frank, 2013). Recommendations for trial numbers are derived from the results for models of different complexities. Interestingly, under certain conditions even small numbers of trials (N < 100) are sufficient for robust parameter estimation.

Experimental validation of the diffusion model based on a slow response time paradigm

The diffusion model (Ratcliff, Psychol Rev 85(2):59-108, 1978) is a stochastic model that is applied to response time (RT) data from binary decision tasks. The model is often used to disentangle different cognitive processes. The validity of the diffusion model parameters has, however, rarely been examined. Only few experimental paradigms have been analyzed with those being restricted to fast response time paradigms. This is attributable to a recommendation stated repeatedly in the diffusion model literature to restrict applications to fast RT paradigms (more specifically, to tasks with mean RTs below 1.5 s per trial). We conducted experimental validation studies in which we challenged the necessity of this restriction. We used a binary task that features RTs of several seconds per trial and experimentally examined the convergent and discriminant validity of the four main diffusion model parameters. More precisely, in three experiments, we selectively manipulated these parameters, using a difficulty manipulation (drift rate), speed-accuracy instructions (threshold separation), a more complex motoric task (non-decision time), and an asymmetric payoff matrix (starting point). The results were similar to the findings from experimental validation studies based on fast RT paradigms. Thus, our experiments support the validity of the parameters of the diffusion model and speak in favor of an extension of the model to paradigms based on slower RTs.

The relationship between baseline EEG spectra power and memory performance in older African Americans endorsing cognitive concerns in a community setting

The finding that some older individuals report declines in aspects of cognitive functioning is becoming a frequently used criteria to identify elderly at risk for mild cognitive impairment (MCI) and dementia. Once concerns are identified in a community setting, however, effective means are necessary to pinpoint those individuals who should go on to more complex and costly diagnostic evaluations (e.g., functional imaging). We tested 44 African American volunteers endorsing cognitive concerns (37 females, 7 males) age≥65years with CogState battery subtests and recorded resting-state EEG, with eyes closed. After current source density (CSD) transformations of EEG recordings we obtained spectral power for delta, theta, alpha, and beta frequency bands. We characterized CogState One Card Back Learning (OCL, memory) with diffusion model parameters drift rate, boundary and non-decision time (NDT). Forward regression models showed that lower OCL drift rate, slower accumulation of information needed for decision making was linked to increased absolute and relative delta at occipital region. Lower drift rate was also linked to decrease in OCL theta power at parietal region, with no findings for ONB. Results show that cortical resting, eyes closed EEG rhythms are related to memory in African American seniors endorsing cognitive concerns. This study further supports the use of EEG as an easily accessible, cost-effective, culture-fair, and noninvasive clinical measurement that could provide potentially reliable diagnostic (and perhaps prognostic) information to differentiate at-risk from stable African American seniors.

Retest reliability of the parameters of the Ratcliff diffusion model

In the recent years, there is a growing interest to use the Ratcliff Diffusion Model (1978) for diagnostic purposes as the parameters of the model capture interindividual differences in specific cognitive processes. The parameters are estimated using reaction time data from binary classification tasks. For a potential diagnostic application of parameter values sufficient reliability is a necessary precondition. In two studies, each with two sessions separated by 1 week, the retest reliability of the diffusion model parameters was assessed. In Study 1, 105 participants completed a lexical decision task and a recognition memory task. In Study 2, 128 participants worked on an associative priming task. Results show that the reliability of the main parameters of the Ratcliff Diffusion Model (in particular of the speed of information accumulation and the threshold separation with rs > 0.70 for all three tasks) is satisfying. Besides, we analyzed the influence of the number of trials on the retest reliability using different estimation methods (Kolmogorov-Smirnov, Maximum Likelihood, Chi-square and EZ) and both empirical and simulated datasets.