Color-Word Stroop test performance across the adult life span

Self-Reported Executive Function in Hospitalized Cardiac Patients and Associations With Patient Characteristics and Cardiac Rehabilitation Attendance

PURPOSE

Executive function (ExF), the ability to do complex cognitive tasks like planning and refraining from impulsive behavior, is associated with compliance with medical recommendations. The present study identified associations between self-reported ExF and demographics of patients with cardiac disease as well as with cardiac rehabilitation (CR) attendance.

METHODS

Self-reported ExF impairment was measured using the Behavior Rating Inventory of Executive Function (BRIEF) on 316 individuals hospitalized for CR-qualifying cardiac events. Scores were calculated for a global measure (Global Executive Composite [GEC]) and the two BRIEF indices: Behavioral Regulation Index and Metacognition Index (MCI). Participants were followed up post-discharge to determine CR attendance. Univariate logistic regressions between ExF measures and demographic variables were conducted, as were multiple logistic regressions to identify significant, independent predictors. Analyses were conducted using clinical (T scores ≥ 65) and subclinical (T scores ≥ 60) criteria for significant ExF impairment as outcomes. One-way analyses of variance were performed between ExF impairment and CR attendance.

RESULTS

Self-reported ExF deficits were relatively rare; 8.9% had at least subclinical scores on the GEC. Using the subclinical criterion for the MCI, having diabetes mellitus (DM) and being male were significant, independent predictors of MCI impairment. No significant relationship was found between ExF and CR attendance.

CONCLUSION

Using the subclinical criterion only, individuals with DM and males were significantly more likely to have MCI impairment. No significant effect of ExF impairment on CR attendance was found, suggesting that self-reported ExF measured in the hospital may not be an appropriate measure for predicting behavioral outcomes.

The temporal dynamics of the Stroop effect from childhood to young and older adulthood

The processes involved in the Stroop task/effect are thought to involve conflict detection and resolution stages. Little is known about the evolution of these two components over the lifespan. It is well admitted that children and older adults tend to show longer response latencies than young adults. The present study aims at clarifying the rational of such changes from childhood to adulthood and in aging by comparing the impacted cognitive processes across age groups. More precisely, the aim was to clarify if all processes take more time to be executed, hence implying that longer latencies rely mainly on processing speed or if an additional process lengthens the resolution of the conflict in children and/or older adults. To this aim we recorded brain electrical activity using EEG in school-age children, young and older adults while they performed a classic verbal Stroop task. The signal was decomposed in microstate brain networks, and age groups and conditions were compared. Behavioral results evolved following an inverted U-shaped curve. In children, different brain states from the ones observed in adults were highlighted, both in the conflict detection and resolution time-windows. Longer latencies in the incongruent condition were mainly attributed to an overly increased duration of the microstates involved in the conflict resolution time window. In aging, the same microstate maps were reported for both young and older adult groups. The differences in performances between groups could be explained by a disproportionally long conflict detection phase, even compressing the latest stage of response articulation. These results tend to favor a specific immaturity of the brain networks involved coupled with a slowing of the processes in children, while cognitive decline could be mostly explained by a general slowing.

Gut microbiome-brain-cirrhosis axis

Cirrhosis is characterized by inflammation, degeneration, and fibrosis of liver tissue. Along with being the most common cause of liver failure and liver transplant, cirrhosis is a significant risk factor for several neuropsychiatric conditions. The most common of these is HE, which is characterized by cognitive and ataxic symptoms, resulting from the buildup of metabolic toxins with liver failure. However, cirrhosis patients also show a significantly increased risk for neurodegenerative diseases such as Alzheimer and Parkinson diseases, and for mood disorders such as anxiety and depression. In recent years, more attention has been played to communication between the ways the gut and liver communicate with each other and with the central nervous system, and the way these organs influence each other's function. This bidirectional communication has come to be known as the gut-liver-brain axis. The gut microbiome has emerged as a key mechanism affecting gut-liver, gut-brain, and brain-liver communication. Clinical studies and animal models have demonstrated the significant patterns of gut dysbiosis when cirrhosis is present, both with or without concomitant alcohol use disorder, and have provided compelling evidence that this dysbiosis also influences the cognitive and mood-related behaviors. In this review, we have summarized the pathophysiological and cognitive effects associated with cirrhosis, links to cirrhosis-associated disruption of the gut microbiome, and the current evidence from clinical and preclinical studies for the modulation of the gut microbiome as a treatment for cirrhosis and associated neuropsychiatric conditions.

A comparative study of the NAART and WRAT4 Word Reading subtest to estimate reading level

Patients are often asked to fill out paperwork in medical settings, but varying reading levels can affect the ability to self-report. By screening for reading level, clinicians can prevent potential patient confusion, frustration, and embarrassment. Clinicians can also avoid problems leading to misdiagnosis and providing materials that patients will not understand. The Wide Range Achievement Test - Fourth Edition (WRAT4) Word Reading (WR) subtest provides an estimation of word reading grade level as well as premorbid ability. The North American Adult Reading Test (NAART) only provides an estimation of premorbid abilities, but it is quick to administer and available in the public domain. By correlating these word reading measures (NAART & WRAT4 WR subtest), word reading level can be estimated by using the NAART alone. This project was a systematic replication of a study conducted by Jones et al. using a demographically-different sample of participants. Results indicate that NAART error scores and WRAT4 WR subtest raw scores were significantly correlated. Although the distributions of WRAT4 WR subtest raw scores from the Jones et al. study and the current study significantly differed, there was not a statistically significant difference between the proportion of predicted reading levels at/above or below fourth or fifth grade and actual reading levels at/above or below fourth or fifth grade. This finding suggests that the original regression equation created by Jones et al. can be applied to the current sample to accurately predict reading level classification.

Early time-restricted eating may favorably impact cognitive acuity in university students: a randomized pilot study

Cognitive acuity is important for academic success. The preliminary efficacy of early time-restricted eating (eTRE) on cognitive acuity was examined in a sample of university students attending a large southwestern university. It was hypothesized that adherence to eTRE would result in improved cognitive acuity as assessed by the Trail Making Tests (i.e., TMT-A and TMT-B) and the Stroop Color and Word Test. Participants were randomized to an intervention group (eTRE) with a daily 6-hour eating window or a control group (CON) with a daily 16-hour eating window; 24 participants initiated the study (13 eTRE and 11 CON). Blood ketones (i.e., β-hydroxybutyrate [BHB]) and brain-derived neurotrophic factor were also assessed. The 8-week intervention was forestalled by COVID-19 laboratory closures beginning in March 2020, and only data obtained at week 0 (baseline) and week 4 were viable for statistical analyses. Study attrition was high (50% for eTRE and 23% for CON). At week 4, there was a 27% and 6% decrease in TMT-B response time for the eTRE and CON groups, respectively (P = .02). TMT-B response time was inversely correlated to plasma BHB among participants (r = -0.633; P = .008). Considering the inverse relationship between TMT-B response time and plasma BHB, these preliminary data suggest that eTRE may improve some aspects of cognitive acuity in this population. Future investigations are needed to confirm these findings and should accommodate individual preferences regarding the initiation time of the eating window while also considering the impact on social influences and exercise engagement.

Improved Safety of Hybrid Electroconvulsive Therapy Compared With Standard Electroconvulsive Therapy in Patients With Major Depressive Disorder: A Randomized, Double-Blind, Parallel-Group Pilot Trial

Objectives

ECT is a rapid and effective treatment for depression. While efficacy is often remarkable over the initial 3-4 sessions, the efficacy of later sessions is less rapid, and the side-effects, especially cognitive impairment limit its use. To preliminarily compare the efficacy and acceptability of a novel hybrid-ECT (HECT) protocol for patients with major depressive disorder (MDD) with standard ECT, we conducted this pilot trial.

Methods

Thirty patients were randomly assigned to ECT or HECT. Both arms received three ECT sessions (phase 1) but, in phase 2, the HECT arm received low-charge electrotherapy instead of ECT. The primary outcome was the change in 24-item Hamilton depression rating scale (HAMD-24) scores between baseline and the end of treatment. Cognitive function was assessed by repeatable battery for the assessment of neuropsychological status (RBANS), Stroop color word, and orientation recovery tests (ORT). Safety was measured by the drop-out rate and adverse events (AEs). Four visits were conducted at baseline, post-phase 1, post-phase 2, and at 1-month follow-up. Trial registration: Chinese Clinical Trial Registry (http://www.chictr.org.cn/), identifier: ChiCTR1900027701.

Results

Patients in both arms showed significant within-group improvements in HAMD-24, but the between-group differences were non-significant. Participants in the HECT arm outperformed ECT patients for most cognitive tests at the end of treatment or at follow-up. There was a significantly lower AE rate and shorter ORT in phase 2 of the HECT ar.

Conclusion

In this pilot trial, HECT was associated with fewer AEs and better cognitive function including executive and memory function, but its possible similar antidepressive efficacy needs to be further investigated in future.

Effects of Repetitive Transcranial Magnetic Stimulation on Cognitive Function in Patients With Stress-Related Depression: A Randomized Double-Blind fMRI and 1H-MRS Study

Objectives

To reveal the effects of repetitive transcranial magnetic stimulation (rTMS) on the improvement of cognitive function in patients with stress-related depression, and to enrich the neural mechanism(s) underlying rTMS so as to improve cognitive function in patients with stress-related depression.

Methods

We conducted a randomized, double-blind, placebo-controlled study of rTMS in patients with stress-related depression who were 18–40 years of age. Patients were randomly allocated to either a sham or experimental group in a 1:1 ratio. A 10-session rTMS protocol was used with 10-Hz stimulation over the left dorsolateral prefrontal cortex (DLPFC). Clinical assessments (HAMD, HAMA, DASS, MoCA), neuropsychologic (Stroop, WCST), and resting state fMRI and ¹H-MRS assessments were executed at two time points—baseline and after the 10th rTMS session.

Results

rTMS relieved the mental symptoms of patients in both groups. The MoCA score of patients in the experimental group increased; the number of correct answers increased significantly in Stroop testing, and the number of errors and omissions decreased significantly; the number of persistent errors decreased significantly; and the time used to complete the test decreased to an even greater extent in the WCST experimental group. The ReHo value in the lingual gyrus of the right hemisphere and the cuneus of the left and right hemispheres in the experimental group decreased after treatment. The DC value in the left and right hemispheric cuneus and postcentral gyrus of the left hemisphere in the experimental group diminished after treatment. The functional connections of these brain regions also changed as the Cho and NAA/Cr of the left DLPFC changed, with alterations related to the improvement in cognitive function. The level of choline (Cho) in the left DLPFC of the experimental group was significantly lower than that of the control group, and the level of N-acetylaspartate/creatine (NAA/Cr) in the left DLPFC of the control group was significantly higher than that of the experimental group. These changes were related to the overall improvement in cognitive function.

Conclusions

Ten-Hz rTMS over the left DLPFC improved the cognitive function of patients with stress-related depression. The governing mechanism for this phenomenon may be via rTMS effects on multiple visual-related brain regions and their functional connections, and on the somatosensory cortex and its functional connection with visual and auditory cortex, reducing the level of Cho and stabilizing the level of NAA/Cr in the left DLPFC.

Evidence that ageing yields improvements as well as declines across attention and executive functions

Many but not all cognitive abilities decline during ageing. Some even improve due to lifelong experience. The critical capacities of attention and executive functions have been widely posited to decline. However, these capacities are composed of multiple components, so multifaceted ageing outcomes might be expected. Indeed, prior findings suggest that whereas certain attention/executive functions clearly decline, others do not, with hints that some might even improve. We tested ageing effects on the alerting, orienting and executive (inhibitory) networks posited by Posner and Petersen's influential theory of attention, in a cross-sectional study of a large sample (N = 702) of participants aged 58-98. Linear and nonlinear analyses revealed that whereas the efficiency of the alerting network decreased with age, orienting and executive inhibitory efficiency increased, at least until the mid-to-late 70s. Sensitivity analyses indicated that the patterns were robust. The results suggest variability in age-related changes across attention/executive functions, with some declining while others improve.

A Comparison of the Performance between the 60- and 120-Second Conditions of the Korean-Color Word Stroop Test: Color Reading (K-CWST: CR)

Background and Purpose

The Korean-Color Word Stroop Test: Color Reading (K-CWST: CR) included in the Seoul Neuropsychological Screening Battery, 2nd Edition (SNSB-II) examines inhibitory control deficit. It provides normative data for both 60- and 120-second conditions, but the validity of the 60-second condition has not yet been proven. This study examined the validity of the 60-second condition by observing concordance between the performances in cognitively normal, MCI, and mild dementia groups.

Methods

There were 1,336 patients performed the SNSB-II, including the K-CWST: CR. Based on the cognitive test results, activities of daily living, and clinical interview, the patients were assigned to normal cognition (n=104), MCI (n=884), or mild dementia (n=348) groups. Abnormal performance on the K-CWST: CR was operationally defined as 1SD below the normative mean. The receiver operating characteristic curve analyses were conducted to compare the discriminability between the 60- and 120-second conditions.

Results

The percentages of abnormal performance in the MCI group were 41.5% and 42.3%, and those in the mild dementia group were 82.7% and 82.4% for the 60- and 120-second conditions, respectively. The areas under the curve for the 60- and 120-seconds were as follows; 0.80 and 0.81 in differentiating normal from MCI; 0.95 and 0.96 in normal from mild dementia; and 0.77 and 0.77 in MCI from mild dementia.

Conclusions

The 60-second condition of the K-CWST showed very similar results, not statistically different from the 120-second condition. Therefore, the 60-second condition could be used interchangeably with the 120-second condition in a clinical setting.

When I'm 64: Age-related variability in over 40,000 online cognitive test takers

Objectives

Age-related differences in cognition are typically assessed by comparing groups of older to younger participants, but little is known about the continuous trajectory of cognitive changes across age, or when a shift to older adulthood occurs. We examined the pattern of mean age differences and variability on episodic memory and executive function measures over the adult life span, in a more fine-grained way than past group or life-span comparisons.

Method

We used a sample of over 40,000 people aged 18–90 who completed psychometrically validated online tests measuring episodic memory and executive functions (the Cogniciti Brain Health Assessment).

Results

Cognitive performance declined gradually over adulthood, and rapidly later in life on spatial working memory, processing speed, facilitation (but not interference), associative recognition, and set shifting. Both polynomial and segmented regression fit the data well, indicating a nonlinear pattern. Segmented regression revealed a shift from gradual to rapid decline that occurred in the early 60s. Variability between people (interindividual variability or diversity) and variability within a person across tasks (intraindividual variability or dispersion) also increased gradually until the 60s, and rapidly after. Confirmatory factor analysis revealed a single general factor (of variance shared between tasks) offered a good fit for performance across tasks.

Discussion

Life-span cognitive performance shows a nonlinear pattern, with gradual decline over early and mid-adulthood, followed by a transition in the 60s to notably accelerated, but more variable, decline. Some people show less decline than others, and some cognitive abilities show less within-person decline than others.

eStroop: Implementation, Standardization, and Systematic Comparison of a New Voice-Key Version of the Traditional Stroop Task

The Stroop effect is a well-documented phenomenon, demonstrating both interference and facilitation effects. Many versions of the Stroop task were created, according to the purposes of its applications, varying in numerous aspects. While many versions are developed to investigate the mechanisms of the effect itself, the Stroop effect is also considered a general measure of attention, inhibitory control, and executive functions. In this paper, we implement "eStroop": a new digital version based on verbal responses, measuring the main processes involved in the traditional effect. eStroop features four categories of stimuli in four different colors: (1) geometrical shapes, (2) neutral words, (3) congruent words, and (4) incongruent words. The results of the administration to 307 University students confirm the Stroop effect and offer baseline data for future research and clinical testing. Direct comparisons with other recent versions of the task are discussed, offering insights into differences and similarities between different task variables.

Stroop color and word test (SCWT): Normative data for the Lebanese adult population

The Stroop Color and Word Test (SCWT) is one of the most commonly used measures to assess multiple cognitive functions. Several studies have shown that SCWT performance is influenced by different demographic factors and have recommended the necessity of generating normative data in different cultures. The present study aims to explore the effect of gender, age, and education on SCWT scores and to generate normative data for the Lebanese healthy adults. A sample of 321 healthy participants aged 18 and above was recruited from different Lebanese regions. The SCWT was administered to the participants. A regression-based strategy was applied to generate normative data. The results showed a statistically significant effect of age and education on the SCWT scores whereas no significant effect for gender was found. An interactive calculator was created to calculate estimated Z-scores based on corresponding predictions of the linear regression model. The calculator also provides percentile ranks. The present study is the first to generate normative data for the SCWT test in Lebanon. Neuropsychologists in Lebanon will benefit from this outcome to improve the accurate detection of executive function deficits in clinical settings for the Lebanese adult population.

Age-related effects on a novel dual-task Stroop paradigm

The Stroop task is a traditional measure of cognitive control processes, yet results remain mixed when it comes to assessing age-related differences perhaps in part due to strategies participants use to reduce inhibitory control demands required for success on the task. Thirty-three older adults and 34 younger adults completed a Baseline (traditional, single-task) version of Stroop, followed by two, novel dual-task Stroop variants: Color-Dual (maintain secondary count of prespecified font color regardless the lexical content) and Lexical-Dual (maintain secondary count of prespecified word regardless the font color). With regard to Baseline performance, we predicted an Age x Trial Type interaction in which older adults would be selectively impaired on Incongruent trials compared to younger adults, and this prediction was supported. When we added secondary task demands, we predicted a Trial Type x Dual-Task Type interaction in which performance in the Lexical-Dual condition would be worse than performance in the Color-Dual condition. This prediction was also supported, suggesting that having a secondary task that activated the irrelevant stream of information required more inhibitory control. Finally, we also predicted that Age would interact with Trial Type and Dual-Task Type, which was partially supported in response latencies and more definitively supported in error rates. Overall, our results indicate that Stroop performance is differentially influenced by additional dual-task demands that potentially minimize strategy usage, which has implications for both young and older adult Stroop performance.

Effects of a multimodal exercise intervention on physical and cognitive functions in patients with chronic low back pain (MultiMove): study protocol for a randomized controlled trial

BACKGROUND

Chronic low back pain (CLBP) is a common medical condition in adults over the age of 50. It is associated with severe disability, ranging from physical impairments to psychosocial distress. Since current treatments provide only small to moderate short-term effects, alternative interventions are required, whereby guidelines recommended multimodal approaches. Dancing can be considered as an inherently multimodal approach, as it requires a combination of physical and cognitive functions. Furthermore, it has already been applied effectively in neurorehabilitation. Therefore, it seems promising to merge a dance-therapeutic component together with motor-cognitive, strength and flexibility exercises in a novel multimodal treatment (MultiMove) to target the impaired everyday mobility and cognition of CLBP patients. The aim of this study is to analyse specific physical, cognitive and psychosocial effects of MultiMove in CLBP patients.

METHODS

A prospective, two-arm, single-blinded, randomized controlled trial will be conducted with an estimated sample size of 100 CLBP patients, assigned to either the MultiMove group or a control group. The intervention group will receive MultiMove twice a week for 60 min each over a period of 12 weeks. The primary outcome will be the mobility and function of the lower extremities assessed by the Timed Up-and-Go Test. Secondary outcomes comprise further physical and physiological functions (e.g. gait variability and haemodynamic response in the prefrontal cortex during motor-cognitive dual tasks), subjective health state (e.g. disability in daily life), executive functions (e.g. cognitive flexibility) and psychosocial aspects (e.g. kinesiophobia). Measures will be taken at baseline, after the intervention and at a 12-week follow-up. It is assumed that MultiMove improves the mentioned outcome parameters.

DISCUSSION

The combined assessment of changes in physical and cognitive functions as well as neuropsychological aspects in response to MultiMove will allow a better understanding of the motor-cognitive adaptations induced by multimodal exercises in CLBP patients. The specific conclusions will lead to recommendations for the conservative treatment approach in this clinically relevant patient group.

TRIAL REGISTRATION

German Clinical Trial Register (ID: DRKS00021696 / 10.07.2020), https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00021696.

Signatures of white-matter microstructure degradation during aging and its association with cognitive status

Previous studies have shown an association between cognitive decline and white matter integrity in aging. This led to the formulation of a "disconnection hypothesis" in the aging-brain, which states that the disruption in cortical network communication may explain the cognitive decline during aging. Although some longitudinal studies have already investigated the changes occurring in white matter microstructure, most focused on specific white matter tracts. Our study aims to characterize the longitudinal whole-brain signatures of white matter microstructural change during aging. Furthermore, we assessed the relationship between distinct longitudinal alterations in white matter integrity and cognition. White matter microstructural properties were estimated from diffusion magnetic resonance imaging, and cognitive status characterized from extensive neurocognitive testing. The same individuals were evaluated at two timepoints, with a mean interval time of 52.8 months (SD = 7.24) between first and last assessment. Our results show that age is associated with a decline in cognitive performance and a degradation in white matter integrity. Additionally, significant associations were found between diffusion measures and different cognitive dimensions (memory, executive function and general cognition). Overall, these results suggest that age-related cognitive decline is related to white matter alterations, and thus give support to the "disconnected hypothesis" of the aging brain.

Accrual of functional redundancy along the lifespan and its effects on cognition

Despite the necessity to understand how the brain endures the initial stages of age-associated cognitive decline, no brain mechanism has been quantitatively specified to date. The brain may withstand the effects of cognitive aging through redundancy, a design feature in engineered and biological systems, which entails the presence of substitute elements to protect it against failure. Here, we investigated the relationship between functional network redundancy and age over the human lifespan and their interaction with cognition, analyzing resting-state functional MRI images and cognitive measures from 579 subjects. Network-wide redundancy was significantly associated with age, showing a stronger link with age than other major topological measures, presenting a pattern of accumulation followed by old-age decline. Critically, redundancy significantly mediated the association between age and executive function, with lower anti-correlation between age and cognition in subjects with high redundancy. The results suggest that functional redundancy accrues throughout the lifespan, mitigating the effects of age on cognition.

Neuroanatomical changes in early Parkinson's disease with mild cognitive impairment: a VBM study; the Parkinson's Disease Cognitive Impairment Study (PaCoS)

INTRODUCTION

Mild cognitive impairment (MCI) is common in Parkinson's disease (PD), but the underlying pathological mechanism has not been fully understood. Voxel-based morphometry could be used to evaluate regional atrophy and its relationship with cognitive performances in early PD-MCI.

PATIENTS AND METHODS

One hundred and six patients with PD were recruited from a larger cohort of patients, the Parkinson's Disease Cognitive Impairment Study (PaCoS). Subject underwent a T1-3D MRI and a complete clinical and neuropsychological evaluation. Patients were divided into PD with normal cognition (PD-NC) and PD-MCI according to the MDS level II criteria-modified for PD-MCI. A subgroup of early patients with short disease duration (≤ 2 years) was also identified. VBM analysis between PD-NC and PD-MCI and between early PD-NC and PD-MCI was performed using two-sample t tests with whole-brain statistical threshold of p < 0.001 uncorrected in the entire PD group and p < 0.05 FWE inside ROIs, in the early PD.

RESULTS

Forty patients were diagnosed with MCI and 66 were PD-NC. PD-MCI patients showed significant gray matter (GM) reduction in several brain regions, including frontal gyrus, precuneus, angular gyrus, temporal lobe, and cerebellum. Early PD-MCI showed reduction in GM density in superior frontal gyrus and cerebellum. Moreover, correlation analysis between neuropsychological performances and GM volume of early PD-MCI patients showed associations between performances of Raven and superior frontal gyrus volume, Stroop time and inferior frontal gyrus volume, accuracy of Barrage and volume of precuneus.

CONCLUSION

The detection of frontal and cerebellar atrophy, even at an early stage, could be used as an early marker of PD-related cognitive impairment.

Smartphone-Based Measurement of Executive Function in Older Adults with and without HIV

OBJECTIVE

To examine feasibility, convergent validity and biases associated with a mobile color-word interference test (mCWIT) among older persons living with HIV (PLHIV).

METHOD

Over a 14-day period, 58 PLHIV and 32 HIV-uninfected individuals (aged 50-74) completed the mCWIT on smartphones once per day in real-world settings. Participants also completed a comprehensive laboratory-based neuropsychological evaluation.

RESULTS

A high rate of compliance was observed (86%) in the repeated administration of the mCWIT. A practice effect was observed in the overall sample concerning mCWIT subscores, and these learning effects were greater for PLHIV. Stabilization of performance was observed after 6 (HIV+) and 7 days (HIV-) for completion time and after 2 (HIV-) and 3 days (HIV+) for mCWIT errors. A minor fatigue effect was observed in the overall sample which was unassociated with group status. Moderate to strong correlations were found between mCWIT completion time and mCWIT errors with global neurocognition and with all of the individual neurocognitive domains. The strongest associations were with mCWIT completion time and laboratory-based global neurocognition, executive function, and working memory scores.

CONCLUSIONS

Cognitive testing administered within the context of a person's daily life provides qualitatively different data than neuropsychological testing completed in clinical settings, and it may constitute a more ecologically valid indicator of cognitive performance than traditional methods. Mobile cognitive testing has potential to help characterize real-time cognitive performance and serve as a complementary assessment tool to traditional methods.

iNPH with parkinsonism: response to lumbar CSF drainage and ventriculoperitoneal shunting

OBJECTIVES

To evaluate clinical response after external lumbar drainage (ELD) and ventriculoperitoneal shunting (VPS) in a cohort of patients with idiopathic normal pressure hydrocephalus associated with parkinsonism (iNPH-P), considering parkinsonism as clinical primary outcome.

METHODS

Patients underwent long-term 72-h intracranial pressure-controlled CSF ELD. Clinical motor response before and after ELD was evaluated using changes in UPDRS-ME as outcome measure. A standardized cognitive assessment was also performed. iNPH-P patients who underwent VPS were clinically followed-up after surgery.

RESULTS

Fourteen iNPH-P patients (age: 69.3 ± 11.6 years) were studied. The time of evaluation after ELD removal was 3.5 ± 1.8 days. We observed a significant motor improvement after the drainage in eight (57.1%) patients. Percent clinical motor response was 18.4 ± 6.7%. Twelve (85.7%) patients underwent VPS. Nine patients were examined after surgery at 31.6 ± 7 months. Four (44.4%) patients presented a clinically detectable improvement in motor response after VPS. No significant changes in cognitive performances were detected.

CONCLUSIONS

A clinically detectable motor response on parkinsonian signs was observed in a consistent part of iNPH-P patients few days after ELD as well as over two and half years after VPS. Parkinsonism should be considered as outcome measure for the clinical management of patients with iNPH-P.

Modulatory role of background music on cognitive interference task in young people

BACKGROUND

The Stroop Colour and Word Test (SCWT) is the most extensively used neuropsychological test in humans to evaluate the ability to inhibit cognitive interference. Any music played while the listener's primary attention is focused on another activity is known as background music and its effects on SCWT have not been studied well.

OBJECTIVE

The current study was designed to evaluate the influence of different background music (classical and heavy metal) on inhibiting cognitive interference in young adults by using the Stroop Colour and Word Test.

METHODS

Eighty student volunteers were invited for the study after obtaining their informed consent. They were first tested for colour blindness using Ishihara's colour test, and once passed, they were recruited to perform a computerised Stroop colour-word interference test. Each participant was requested to take part in four reading exercises: monochrome words, rectangle colours, coloured words and colour naming, respectively. These exercises were performed under three different conditions such as silence (absence of background music), presence of heavy metal and classical music, respectively. The participants' reaction time, errors made and heart rate were recorded and compared.

RESULTS

The participants' reaction time was found to be significantly decreased with classical and heavy metal background music compared with the silence condition. The heart rate and errors made by the participants did not significantly change during any of the study conditions.

CONCLUSIONS

Results of this study indicate the positive impact of background music on a cognitive interference task. Further studies are warranted to elucidate the underlying neural mechanisms.

Cognitive flexibility and persistent post-surgical pain: the FLEXCAPP prospective observational study

BACKGROUND

Impaired performance on tasks assessing executive function has been linked to chronic pain. We hypothesised that poor performance on tests assessing the ability to adjust thinking in response to changing environmental stimuli (cognitive flexibility) would be associated with persistent post-surgical pain.

METHODS

We conducted a single-centre prospective observational study in two perioperative cohorts: patients undergoing total knee arthroplasty or noncardiac chest surgical procedures. The co-primary outcome measures compared preoperative performance on the Trail Making Test and the colour-word matching Stroop test between patients who developed persistent post-surgical pain and those who did not. Secondary outcome measures included the associations between these test scores and pain severity at 6 months.

RESULTS

Of 300 participants enrolled, 198 provided 6 month follow-up data. There were no significant differences in preoperative Trail Making Test B minus A times (33 vs 34 s; P=0.59) or Stroop interference T-scores (47th vs 48th percentile; P=0.50) between patients with and without persistent post-surgical pain (primary outcome). Of those who reported persistent post-surgical pain, poorer baseline performance on the colour-word matching Stroop test was associated with higher pain scores at 6 months in both knee arthroplasty (r=-0.32; P=0.04) and chest (r=-0.44; P=0.02) surgeries (secondary outcome).

CONCLUSIONS

Preoperative cognitive flexibility test performance was not predictive of overall persistent post-surgical pain incidence 6 months after surgery. However, poor performance on the colour-word matching Stroop test was independently associated with more severe persistent post-surgical pain in both cohorts.

CLINICAL TRIAL REGISTRATION

NCT02579538.

Effect of repetitive transcranial magnetic stimulation (rTMS) treatment of major depressive disorder (MDD) on cognitive control

BACKGROUND

Major Depressive Disorder (MDD) is commonly accompanied by cognitive control dysfunction that may persist after remission of clinical symptoms with antidepressant medication treatment. Repetitive Transcranial Magnetic Stimulation (rTMS) is an effective treatment alternative for medication-resistant MDD. In this study, we investigated whether rTMS treatment had a beneficial effect not only on depressive symptoms, but on also cognitive control dysfunction.

METHODS

77 subjects with MDD received a 30-session treatment course of 10 Hz rTMS administered at the left dorsolateral prefrontal cortex (DLPFC). Treatment efficacy was assessed using the Inventory of Depressive Symptomatology Self-Rated (IDS-SR) before and after treatment, with clinical response defined as 50% or greater decrease in the IDS-SR score at treatment 30. Cognitive control function was assessed before and after treatment using the Stroop word-color interference task. We examined changes in Stroop accuracy and reaction time for congruent and incongruent trials, as well as in relation to changes in depressive symptoms.

RESULTS

Performance accuracy improved particularly for the rTMS responders in the incongruent condition, with older subjects benefitting most from the rTMS treatment. Improvement in reaction times was positively associated with clinical improvement, especially in the incongruent condition.

LIMITATIONS

We used a single cognitive task in a naturalistic setting without control for individual rTMS treatment parameters or concomitant medication.

CONCLUSIONS

Overall, these results indicate that rTMS treatment for MDD has beneficial effects on psychomotor speed and cognitive control. Future studies should extend these findings to larger patient populations and other cognitive domains.

Beta Neurofeedback Training Improves Attentional Control in the Elderly

One of the well-documented behavioral changes that occur with advancing age is a decline in executive functioning, for example, attentional control. Age-related executive deficits are said to be associated with a deterioration of the frontal lobes. Neurofeedback is a training method which aims at acquiring self-control over certain brain activity patterns. It is considered as an effective approach to help improve attentional and self-management capabilities. However, studies evaluating the efficacy of neurofeedback training to boost executive functioning in an elderly population are still relatively rare and controversial. The aim of our study was to contribute to the assessment of the efficacy of neurofeedback as a method for enhancing executive functioning in the elderly. We provided a group of seniors with beta up-training (12-22 Hz), consisting of 20 sessions (30 minutes each), on the Cz site and tested its possible beneficiary influence on attentional control assessed by means of the Stroop and Simon tasks. The analysis of the subjects' mean reaction times during consecutive tasks in the test and the retest, after implementation of neurofeedback training, showed a significant improvement. In contrast, the difference in reaction times between the test and the retest in the control group who had not been submitted to neurofeedback training was not significant.

Incidence of Mild Cognitive Impairment and Dementia in Parkinson's Disease: The Parkinson's Disease Cognitive Impairment Study

Background: Cognitive impairment in Parkinson’s disease (PD) includes a spectrum varying from Mild Cognitive Impairment (PD-MCI) to PD Dementia (PDD). The main aim of the present study is to evaluate the incidence of PD-MCI, its rate of progression to dementia, and to identify demographic and clinical characteristics which predict cognitive impairment in PD patients.

Methods: PD patients from a large hospital-based cohort who underwent at least two comprehensive neuropsychological evaluations were retrospectively enrolled in the study. PD-MCI and PDD were diagnosed according to the Movement Disorder Society criteria. Incidence rates of PD-MCI and PDD were estimated. Clinical and demographic factors predicting PD-MCI and dementia were evaluated using Cox proportional hazard model.

Results: Out of 139 enrolled PD patients, 84 were classified with normal cognition (PD-NC), while 55 (39.6%) fulfilled the diagnosis of PD-MCI at baseline. At follow-up (mean follow-up 23.5 ± 10.3 months) 28 (33.3%) of the 84 PD-NC at baseline developed MCI and 4 (4.8%) converted to PDD. The incidence rate of PD-MCI was 184.0/1000 pyar (95% CI 124.7–262.3). At multivariate analysis a negative association between education and MCI development at follow-up was observed (HR 0.37, 95% CI 0.15–0.89; p = 0.03). The incidence rate of dementia was 24.3/1000 pyar (95% CI 7.7–58.5). Out of 55 PD-MCI patients at baseline, 14 (25.4%) converted to PDD, giving an incidence rate of 123.5/1000 pyar (95% CI 70.3–202.2). A five time increased risk of PDD was found in PD patients with MCI at baseline (RR 5.09, 95% CI 1.60–21.4).

Conclusion: Our study supports the relevant role of PD-MCI in predicting PDD and underlines the importance of education in reducing the risk of cognitive impairment.

Gait Stability and Its Influencing Factors in Older Adults

A stable gait pattern is a prerequisite to successfully master various activities of daily living. Furthermore, reduced gait stability is associated with a higher risk of falling. To provide specific intervention strategies to improve gait stability, gaining detailed knowledge of the underlying mechanism and influencing factors is of utmost importance. The effects of relevant influencing factors on gait stability are poorly examined, yet. Therefore, the aim of the current study was to quantify the effects of various influencing factors on gait stability. In a cross-sectional study, we assessed dynamic gait stability and relevant influencing factors in 102 older adults (age >65 years). In addition to dynamic gait stability (largest Lyapunov exponent [LLE] and gait variability measures) during normal over-ground (single-task: ST) and dual-task (DT) walking, we registered the following influencing factors: health status (SF12), pain status (painDETECT, SES), fear of falling (falls efficacy scale), depression (CES-D), cognition performance (Stroop test), physical activity (Freiburger Fragebogen zur körperlichen Aktivität), proprioception (joint position sense), peripheral sensation (mechanical and vibration detection threshold), balance performance (static balance on force plate) and muscular fitness (instrumented sit-to-stand test). We used a principal components regression to link the identified principal components with the gait stability and gait variability responses. The four principal components “strength and gender” (e.g., p = 0.001 for LLE during ST), “physical activity” (e.g., p = 0.006 for LLE during ST), “pain” (e.g., p = 0.030 for LLE during DT) and “peripheral sensation” (e.g., p = 0.002 for LLE during ST) were each significantly associated with at least two of the analyzed gait stability/variability measures. The dimension “balance” was a significant predictor in only one gait measure. While “proprioception” tends to correlate with a gait variability measure, we did not find a dependency of mental health on any gait measure. In conclusion, the participants' ability to recover from small perturbations (as measured with the largest Lyapunov exponent) seems to be related to gender and strength, the amount of physical activity the participants spent every week, peripheral sensation and pain status. Since the explained variance is still rather low, there could be more relevant factors that were not addressed, yet.

A functional MRI investigation of crossmodal interference in an audiovisual Stroop task

The visual color-word Stroop task is widely used in clinical and research settings as a measure of cognitive control. Numerous neuroimaging studies have used color-word Stroop tasks to investigate the neural resources supporting cognitive control, but to our knowledge all have used unimodal (typically visual) Stroop paradigms. Thus, it is possible that this classic measure of cognitive control is not capturing the resources involved in multisensory cognitive control. The audiovisual integration and crossmodal correspondence literatures identify regions sensitive to congruency of auditory and visual stimuli, but it is unclear how these regions relate to the unimodal cognitive control literature. In this study we aimed to identify brain regions engaged by crossmodal cognitive control during an audiovisual color-word Stroop task, and how they relate to previous unimodal Stroop and audiovisual integration findings. First, we replicated previous behavioral audiovisual Stroop findings in an fMRI-adapted audiovisual Stroop paradigm: incongruent visual information increased reaction time towards an auditory stimulus and congruent visual information decreased reaction time. Second, we investigated the brain regions supporting cognitive control during an audiovisual color-word Stroop task using fMRI. Similar to unimodal cognitive control tasks, a left superior parietal region exhibited an interference effect of visual information on the auditory stimulus. This superior parietal region was also identified using a standard audiovisual integration localizing procedure, indicating that audiovisual integration resources are sensitive to cognitive control demands. Facilitation of the auditory stimulus by congruent visual information was found in posterior superior temporal cortex, including in the posterior STS which has been found to support audiovisual integration. The dorsal anterior cingulate cortex, often implicated in unimodal Stroop tasks, was not modulated by the audiovisual Stroop task. Overall the findings indicate that an audiovisual color-word Stroop task engages overlapping resources with audiovisual integration and overlapping but distinct resources compared to unimodal Stroop tasks.

Practice makes perfect: High performance gains in older adults engaged in selective attention within and across sensory modalities

Selective attention has been found to decline with aging, possibly depending on the sensory modality through which targets and distractors are presented. We investigated the capacity of older adults to improve performance on visual and auditory selective attention tasks. 31 younger (mean age = 22.8 years, SD = 2.1) and 29 older participants (mean age = 69.5 years, SD = 5.8) performed visual and auditory tasks with and without unimodal and cross-modal distraction across five practice sessions. Reaction time decreased with practice in both age groups. Strikingly, this performance improvement was similar across the age groups. Moreover, distractor modality did not affect performance gains in either age group. Older adults were disproportionally affected by cross-modal visual distraction, however, corroborating previous studies. This age-related effect was mitigated during the practice sessions. Finally, there was no transfer of practice to neuropsychological test performance. These results suggest a high capacity of older individuals to improve selective attention functions within and across sensory modalities.

Virtual apartment stroop task: Comparison with computerized and traditional stroop tasks

BACKGROUND

Measurement of supervisory attentional control is typically performed by placing task-relevant information in conflict with task-irrelevant information. A number of paper-and-pencil versions of the Stroop task have been developed to assess executive functioning and inhibitory control through the presentation of blocks of multiple Stroop stimuli on a card. While multi-item paper-and-pencil Stroop tasks are often used, there are instances when a single-item presentation of Stroop stimuli may be preferable. For example, there may be situations when neuropsychologists are interested in precise analysis of reaction times for individual stimuli. A limitation of these modalities is that they may not reflect the cognitive load found in everyday activities that are replete with distractors.

NEW METHOD

A potential answer to this issue is to embed Stroop stimuli into a virtual environment that includes distractors.

COMPARISON WITH EXISTING METHOD

We compared the performance of 91 healthy undergraduates on a virtual apartment-based Stroop with traditional (multi-item) and computerized (single item) modalities.

RESULTS

Results revealed that the classic "Stroop pattern" found in traditional modalities was observed in the Virtual Apartment Stroop task. Furthermore, participants performed more poorly on the Virtual Apartment Stroop task when distractors were present.

CONCLUSIONS

These results suggest the potential of the Virtual Apartment Stroop task to distinguish between prepotent response inhibition and resistance to distractor inhibition in young adults.

The long-term effects of cocaine use on cognitive functioning: A systematic critical review

BACKGROUND

The predominant view of chronic cocaine use maintains that it causes a broad range of cognitive deficits. However, concerns about the possibly deleterious impact of cocaine on cognitive functioning have yet to be thoroughly vetted. This review addresses the impact of cocaine use on such cognitive domains as executive function, memory, language, and psychomotor speed. Additionally, relevant neuroimaging data is considered to understand the neural basis underlying cocaine-related effects on cognitive functioning.

METHODS

We searched PubMed, Google Scholar, and Embase using the search terms "cocaine and cognition," "cocaine and cognitive functioning," and "cocaine and cognitive deficits or impairment." To meet inclusion criteria we evaluated only cognitive and neuroimaging studies describing the long-term effects of cocaine on cognitive functioning published from 1999 to 2016.

RESULTS

The majority of studies reported statistically significant differences between cocaine users and non-drug-using controls in brain structures, blood-oxygen-level dependent signals, and brain metabolism. However, differences in cognitive performance were observed on a minority of measures. Additionally, the majority of studies were not compared against normative data.

CONCLUSIONS

The current evidence does not support the view that chronic cocaine use is associated with broad cognitive deficits. The view that cocaine users have broad cognitive deficits is inaccurate based upon current evidence, and the perpetuation of this view may have negative implications for treatment programs and development of public policies.

Gender Differences in Cognitive Test Performance in Adults With Heart Failure

BACKGROUND

Cognitive deficits are found in up to 73% of persons with heart failure (HF) and are associated with increased mortality and other poor clinical outcomes. It is known that women have better memory test performance than men do in healthy samples, but gender differences in cognitive performance in the context of HF are not well understood and may have important clinical implications.

OBJECTIVE

The objective of this study was to examine possible gender differences in cognitive function in a sample of individuals with HF (98.9% New York Heart Association class II and III).

METHODS

A total of 183 adults with HF (116 men and 67 women) completed a neuropsychological test battery as part of a larger project. Measures were chosen to assess functioning in attention/executive function and memory.

RESULTS

After controlling for demographic and medical factors, multivariate analysis of covariance revealed that men and women differed on memory test performance (λ = 0.90, F4, 169 = 4.76, P = .001). Post hoc comparisons revealed that women performed better on California Verbal Learning Test Learning, Short Recall, and Delayed Recall. No differences emerged on tests of attention/executive function (λ = 0.97, F5, 168 = 0.96, P = .44).

CONCLUSIONS

In this sample of persons with HF, men exhibited poorer performance on memory measures than women did. Future studies are needed to determine the underlying mechanisms for this pattern and its possible influence on daily function.

White Matter Changes and Cognitive Decline in a Ten-Year Follow-Up Period: A Pilot Study on a Single-Center Cohort from the Leukoaraiosis and Disability Study

AIMS

To describe the contribution of white matter lesions to the long-term neuropsychological profiles of different groups of clinical diagnoses, and to identify neuropsychological predictors of cognitive impairment in a 10-year follow-up.

METHODS

The Lisbon subcohort of the Leukoaraiosis and Disability (LADIS) study was re-evaluated performing a clinical, functional and cognitive evaluation [including Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale - Cognition (ADAS-Cog) and ADAS-Cog with the extension for vascular impairment (VADAS-Cog), the 9-word version of the California Verbal Learning Test (CVLT-9), the Trail-Making test and the Stroop test] as well as an MRI scan. Using clinical diagnostic criteria, participants were identified as having no cognitive impairment (NI), cognitive impairment but no dementia (CIND) or dementia (DEM), and the effect of time on clinical diagnosis and neuropsychological profiles was analyzed.

RESULTS

From the initial group of 66 participants, 37 out of 41 survivors (90%) were re-evaluated (mean age 81.40 years, 57% women). Fifteen patients (41%) had DEM, 12 (32%) CIND and 10 (27%) NI. Over time, the three groups presented distinct profiles in the MMSE [F2, 62 = 15.85, p = 0.000], ADAS [F2, 62 = 15.85, p = 0.000] and VADAS [F2, 48 = 5.87, p = 0.008]. Logistic regression analysis identified higher scores on MMSE (β = 1.14, p = 0.03, OR = 3.13, 95% CI 1.09-8.97) as predictors of NI after 10 years of follow-up.

CONCLUSION

Higher scores on baseline MMSE were the only neuropsychological predictors of NI after 10 years.

A Randomized Control Trial: Supplementing Hearing Aid Use with Listening and Communication Enhancement (LACE) Auditory Training

OBJECTIVE

To examine the effectiveness of the Listening and Communication Enhancement (LACE) program as a supplement to standard-of-care hearing aid intervention in a Veteran population.

DESIGN

A multisite randomized controlled trial was conducted to compare outcomes following standard-of-care hearing aid intervention supplemented with (1) LACE training using the 10-session DVD format, (2) LACE training using the 20-session computer-based format, (3) placebo auditory training (AT) consisting of actively listening to 10 hr of digitized books on a computer, and (4) educational counseling-the control group. The study involved 3 VA sites and enrolled 279 veterans. Both new and experienced hearing aid users participated to determine if outcomes differed as a function of hearing aid user status. Data for five behavioral and two self-report measures were collected during three research visits: baseline, immediately following the intervention period, and at 6 months postintervention. The five behavioral measures were selected to determine whether the perceptual and cognitive skills targeted in LACE training generalized to untrained tasks that required similar underlying skills. The two self-report measures were completed to determine whether the training resulted in a lessening of activity limitations and participation restrictions. Outcomes were obtained from 263 participants immediately following the intervention period and from 243 participants 6 months postintervention. Analyses of covariance comparing performance on each outcome measure separately were conducted using intervention and hearing aid user status as between-subject factors, visit as a within-subject factor, and baseline performance as a covariate.

RESULTS

No statistically significant main effects or interactions were found for the use of LACE on any outcome measure.

CONCLUSIONS

Findings from this randomized controlled trial show that LACE training does not result in improved outcomes over standard-of-care hearing aid intervention alone. Potential benefits of AT may be different than those assessed by the performance and self-report measures utilized here. Individual differences not assessed in this study should be examined to evaluate whether AT with LACE has any benefits for particular individuals. Clinically, these findings suggest that audiologists may want to temper the expectations of their patients who embark on LACE training.

Metabolic alterations in the anterior cingulate cortex and related cognitive deficits in late adolescent methamphetamine users

The adolescent brain, with ongoing prefrontal maturation, may be more vulnerable to drug use-related neurotoxic changes as compared to the adult brain. We investigated whether the use of methamphetamine (MA), a highly addictive psychostimulant, during adolescence affect metabolic and cognitive functions of the anterior cingulate cortex (ACC). In adolescent MA users (n = 44) and healthy adolescents (n = 53), the levels of N-acetyl aspartate (NAA), a neuronal marker, were examined in the ACC using proton magnetic resonance spectroscopy. The Stroop color-word task was used to assess Stroop interference, which may reflect cognitive functions of behavior monitoring and response selection that are mediated by the ACC. Adolescent MA users had lower NAA levels in the ACC (t = -2.88, P = 0.005) and relatively higher interference scores (t = 2.03, P = 0.045) than healthy adolescents. Moreover, there were significant relationships between lower NAA levels in the ACC and worse interference scores in adolescent MA users (r = -0.61, P < 0.001). Interestingly, early onset of MA use, as compared to late onset, was related to both lower NAA levels in the ACC (t = -2.24, P = 0.03) as well as lower performance on interference measure of the Stroop color-word task (t = 2.25, P = 0.03). The current findings suggest that metabolic dysfunction in the ACC and its related cognitive impairment may play an important role in adolescent-onset addiction, particularly during early adolescence.

The Disconnected Brain and Executive Function Decline in Aging

Higher order speeded cognitive abilities depend on efficient coordination of activity across the brain, rendering them vulnerable to age reductions in structural and functional brain connectivity. The concept of "disconnected aging" has been invoked, suggesting that degeneration of connections between distant brain regions cause cognitive reductions. However, it has not been shown that changes in cognitive functions over time can be explained by simultaneous changes in brain connectivity. We followed 119 young and middle-aged (23-52 years) and older (63-86 years) adults for 3.3 years with repeated assessments of structural and functional brain connectivity and executive functions. We found unique age-related longitudinal reductions in executive function over and above changes in more basic cognitive processes. Intriguingly, 82.5% of the age-related decline in executive function could be explained by changes in connectivity over time. While both structural and functional connectivity changes were related to longitudinal reductions in executive function, only structural connectivity change could explain the age-specific decline. This suggests that the major part of the age-related reductions in executive function can be attributed to micro- and macrostructural alterations in brain connectivity. Although correlational in nature, we believe the present results constitute evidence for a "disconnected brain" view on cognitive aging.

Stress and its Impact on the Neurocognitive Performance of Australian Nurses

Nurses function inside a particularly stressful occupation that requires the provision of continuous care to individuals who are often in great need. Stress has been shown to impair performance and specifically shown to impair nursing quality. However, we do not yet know how stress influences the cognitive performance of nurses, and hence, the present study investigated the associations between stress and cognitive performance in nurses using electroencephalography and administered cognitive assessments. Thirty-six nurses (34 women) of mean age 37.77 ± 11.40 years were recruited. Stress was examined using the Lifestyle Appraisal Questionnaire. Broad spectrum electroencephalogram activity at positions Fp1, Fp2, C3 and C4 was recorded for a 5-min baseline and active phase to physiologically assess cognitive performance. Additionally, the Mini-Mental State Exam and Cognistat were also used to measure cognitive performance. Assessed cognitive performance was not associated to stress, however, lifestyle factors, as well as a number of the examined cognitive electroencephalographic variables including changes in theta, alpha activity and gamma reactivity were. Definitively determining how stress affects the cognitive performance of nurses requires additional research; the present study forms a foundation from which future research can further expand the examination of stress exposure in nurses. Copyright © 2016 John Wiley & Sons, Ltd.

Nutrition and Cognition in Older Adults With Heart Failure: A Systematic Review

Cognitive impairment is commonly observed in older adults with heart failure; nutrition is a possible contributing factor. The purpose of the current systematic review is to examine the relationship between nutrition and cognition in older adults with heart failure. A literature review was performed through August 2015 that examined published, peer-reviewed studies from PubMed, PsycINFO, CINAHL, and Web of Science. Four articles were selected for inclusion. Findings revealed that poorer nutritional habits were associated with poorer attention, executive functioning, and memory in older adults with heart failure. Nutritional biomarkers, including anemia, hyponatremia, hypokalemia, hyperglycemia, and hypoalbuminemia, were also associated with cognitive impairment. More research is needed to explore the relationship between nutrition and cognition in this population. Descriptive studies will inform scientists as they design and test nutritional interventions to optimize cognitive function in older adults with heart failure.

Performance-Based Contingency Management in Cognitive Remediation Training: A Pilot Study

Impairments in attention, working memory, and executive function are common among substance users and may adversely affect SUD treatment outcomes. The ability of cognitive remediation (CR) interventions to improve these deficits is hindered in part because levels of engagement in CR training may be inadequate to achieve benefit. This pilot study aimed to increase CR engagement and improve outcome by implementing contingency management (CM) procedures that reinforce performance improvements on CR tasks. Participants were forty individuals (50% male; 65% African American) in an outpatient substance use treatment facility with mild cognitive impairment who had ≥30-days of abstinence from alcohol and drugs. They were randomized to standard (CR-S; n=21) or CM-enhanced (CR-CM; n=19) cognitive remediation training. CR consisted of 1-hour sessions, three times per week for four weeks (12 sessions). A neuropsychological assessment battery was administered prior to and after the four-week intervention. Both groups had high rates of CR session attendance (mean CR-S=11.7, CR-CM=10.9 sessions). Performance on 8 of the 9 CR tasks significantly improved over time for both conditions, with the CR-CM condition demonstrating greater improvement on a CR Sequenced Recall task [F(1,37)=5.81, p<.05]. Significant improvement was also evident on 4 of 9 neuropsychological assessment measures, with the CR-CM condition showing differential improvement on the Trail Making Test - Part B [F (1,37)=5.34, p<.05]. These findings support the feasibility of using CM procedures to enhance substance users' engagement with CR training and suggest the potential value of more research in this area.

Normative data for the Stroop color word test for a North American population

BACKGROUND

Cognitive impairment in multiple sclerosis (MS) often involves attentional deficits. The Stroop colour word test, a measure of attention, lacks current normative data for an english-speaking North american MS population. Further some authors suggest the Stroop actually measures processing speed.

OBJECTIVE

To generate normative data for the Stroop colour word test that can be used for a Canadian or North american MS population and to examine the relationship between processing speed tests--the Paced auditory Serial addition Test (PASAT) and Symbol Digit Modalities Test (SDMT)--and the Stroop.

RESULTS

Data from 146 healthy subjects aged 18-56 was collected. age was significantly although weakly correlated with general intelligence (r=0.168, p=0.043) assessed with the North american adult Reading Test (NAART), and education (r=-0.313, p<0.001). No demographic variables were associated with SDMT or PASAT. age had a low-moderate negative correlation (r=-0.403, p<0.001) with Stroop scores. The mean (±standard deviation, SD) Stroop score was 45.4(10.4). The z-score can thus be calculated as [(X-45.4)/10.4]. if adjusted for age, Xadj = [X-(-0.47)(age-37.5)] and is substituted for X. in a comparison MS population consisting of 75 randomly selected patients from the MS Cognitive clinic, Stroop and PASAT performance were not related. a relationship existed between Stroop and SDMT scores but only 12.2% of the Stroop score variance was explained by the SDMT. Therefore, the Stroop measures selective attention independently of processing speed.

CONCLUSION

This data can be used to determine impaired attention in MS patients.

Données normatives pour le test mot-couleur de Stroop chez une population nord-américaine.

A novel Tactile Braille-Stroop test (TBSt)

Stroop interference effects occur when word reading and the target words’ print color naming are incongruent. This interference reflects reading proficiency while naming print color instead of reading color’s names. We devised a tactile version of the Stroop test in which the congruity between three target materials (paper, Braillon, and plastic) and the embossed materials’ names, in braille, was manipulated. The participants’ task was to palpate and name the target materials. The baseline condition was a board with 63 cells each containing one of the target materials. Three similarly constructed boards had (a) a single non-sensical triplet of braille letters embossed on all stimuli, and (b) the first three consonants of the material’s name, embossed in braille, congruently, or (c) incongruently. A total of 45 blind participants were tested: young adults, high school, and elementary school students (16, 10, and 3 mean years of braille reading, respectively). Older, more experienced braille readers showed the largest Stroop interference costs, in speed and accuracy, not only in the incongruent condition but also in the non-sense (non-word) condition compared to the congruent condition. Also, the adults committed more errors compared to high school students in the incongruent condition. However, the more experienced braille readers were faster in the congruent condition compared to the non-word condition. Elementary school children showed no relative gains in the congruent versus non-word condition, and only small incongruence (interference) costs in speed or accuracy. These findings indicate that braille reading competes with tactile material naming, as a function of reading proficiency, even for non-sensical letter strings, a Stroop effect.

Predisposition to and effects of methamphetamine use on the adolescent brain

Adolescence is a period of heightened vulnerability both to addictive behaviors and drug-induced brain damage. Yet, only limited information exists on the brain mechanisms underlying these adolescent-specific characteristics. Moreover, distinctions in brain correlates between predisposition to drug use and effects of drugs in adolescents are unclear. Using cortical thickness and diffusion tensor image analyses, we found greater and more widespread gray and white matter alterations, particularly affecting the frontostriatal system, in adolescent methamphetamine (MA) users compared with adult users. Among adolescent-specific gray matter alterations related to MA use, smaller cortical thickness in the orbitofrontal cortex was associated with family history of drug use. Our findings highlight that the adolescent brain, which undergoes active myelination and maturation, is more vulnerable to MA-related alterations than the adult brain. Furthermore, MA-use-related executive dysfunction was greater in adolescent MA users than in adult users. These findings may provide explanation for the severe behavioral complications and relapses that are common in adolescent-onset drug addiction. Additionally, these results may provide insights into distinguishing the neural mechanisms that underlie the predisposition to drug addiction from effects of drugs in adolescents.

An updated Italian normative dataset for the Stroop color word test (SCWT)

The Stroop color and word test (SCWT) is widely used to evaluate attention, information processing speed, selective attention, and cognitive flexibility. Normative values for the Italian population are available only for selected age groups, or for the short version of the test. The aim of this study was to provide updated normal values for the full version, balancing groups across gender, age decades, and education. Two kinds of indexes were derived from the performance of 192 normal subjects, divided by decade (from 20 to 90) and level of education (4 levels: 3-5; 6-8; 9-13; >13 years). They were (i) the correct answers achieved for each table in the first 30 s (word items, WI; color items, CI; color word items, CWI) and (ii) the total time required for reading the three tables (word time, WT; color time, CT; color word time, CWT). For each index, the regression model was evaluated using age, education, and gender as independent variables. The normative data were then computed following the equivalent scores method. In the regression model, age and education significantly influenced the performance in each of the 6 indexes, whereas gender had no significant effect. This study confirms the effect of age and education on the main indexes of the Stroop test and provides updated normative data for an Italian healthy population, well balanced across age, education, and gender. It will be useful to Italian researchers studying attentional functions in health and disease.

Clinical Spanish norms of the Stroop test for traumatic brain injury and schizophrenia

The Stroop Color-Word Test is a useful tool to evaluate executive attention and speed of processing. Recent studies have provided norms for different populations of healthy individuals to avoid misinterpretation of scores due to demographic and cultural differences. In addition, clinical norms may improve the assessment of cognitive dysfunction severity and its clinical course. Spanish normative data are provided for 158 closed traumatic brain injury (TBI) and 149 first-episode schizophrenia spectrum disorder (SCH) patients. A group of 285 Spanish healthy individuals (HC) was also considered for comparison purposes. Differences between groups were found in all Stroop scores with HC outperforming both clinical groups (p .3 in all cases). TBI patients scored lower than SCH patients in word-reading (p < .001 and d = .6), and color-naming conditions (p < .001 and d = .4), but not in the color-word condition (p = .34 and d = .03). However, SCH patients exhibited a higher interference effect as compared to TBI (p < .002 and d = .5). Three sets of norms stratified by age and education (HC), and by education (TBI and SCH) are presented for clinical use.

Whole body vibration improves cognition in healthy young adults

This study investigated the acute effects of passive whole body vibration (WBV) on executive functions in healthy young adults. Participants (112 females, 21 males; age: 20.5±2.2 years) underwent six passive WBV sessions (frequency 30 Hz, amplitude approximately 0.5 mm) and six non-vibration control sessions of two minutes each while sitting on a chair mounted on a vibrating platform. A passive WBV session was alternated with a control session. Directly after each session, performance on the Stroop Color-Block Test (CBT), Stroop Color-Word Interference Test (CWIT), Stroop Difference Score (SDS) and Digit Span Backward task (DSBT) was measured. In half of the passive WBV and control sessions the test order was CBT-CWIT-DSBT, and DSBT-CBT-CWIT in the other half. Passive WBV improved CWIT (p = 0.009; effect size r = 0.20) and SDS (p = 0.034; r = 0.16) performance, but only when the CBT and CWIT preceded the DSBT. CBT and DSBT performance did not change. This study shows that two minutes passive WBV has positive acute effects on attention and inhibition in young adults, notwithstanding their high cognitive functioning which could have hampered improvement. This finding indicates the potential of passive WBV as a cognition-enhancing therapy worth further evaluation, especially in persons unable to perform active forms of exercise.

Cognitive impairment in native Chinese with spinocerebellar ataxia type 3

BACKGROUND

Previous studies have shown cognitive impairment in patients with spinocerebellar ataxia type 3 (SCA3). However, there is a lack of data on Chinese patients with SCA3.

METHOD

We investigated 22 native Chinese with SCA3 and 18 controls matched for age, education as well as mental status. Cognitive assessments were carefully carried out to measure verbal fluency, memory, attention, executive function, visuospatial and visuoconstructive functions.

RESULTS

The most common impairments of cognition in native Chinese with SCA3 were disruption of phonemic verbal fluency and frontal executive dysfunction. Deficits in semantic fluency were detected in about 31.8% patients. Impaired visuospatial function and verbal memory were also found in native Chinese with SCA3. The degree of ataxia, CAG repeat length and education were found to correlate with cognitive performance. Multivariate binary logistic regression suggested that an oculomotor disorder and depression are predictors of cognitive impairment.

CONCLUSION

Native Chinese with SCA3 had cognitive impairment of frontal executive function, temporal and parietal functions. An oculomotor disorder might be an index of cognitive dysfunction.