Source memory in normal aging and Parkinson's disease

Effectiveness of sorting tests for detecting cognitive decline in older adults with dementia and other common neurodegenerative disorders: A meta-analysis

The demand for simple, accurate and time-efficient screens to detect cognitive decline at point-of-care is increasing. Sorting tests are often used to detect the 'executive' deficits that are commonly associated with behavioural-variant frontotemporal dementia (bvFTD), but their potential for use as a cognitive screen with older adults is unclear. A comprehensive search of four databases identified 142 studies that compared the sorting test performance (e.g. WCST, DKEFS-ST) of adults with a common neurodegenerative disorder (e.g. Alzheimer's disease, vascular dementia, bvFTD, Parkinson's disease) and cognitively-healthy controls. Hedges' g effect sizes were used to compare the groups on five common test scores (Category, Total, Perseveration, Error, Description). The neurodegenerative disorders (combined) showed large deficits on all scores (g -1.0 to -1.3), with dementia (combined subtypes) performing more poorly (g -1.2 to -2.1), although bvFTD was not disproportionately worse than the other dementias. Overall, sorting tests detected the cognitive impairments caused by common neurodegenerative disorders, especially dementia, highlighting their potential suitability as a cognitive screen for older adults.

Alpha-synuclein differentially reduces surface expression of N-methyl-d-aspartate receptors in the aging human brain

The aging brain is associated with reduced cell surface expression of N-methyl-d-aspartate receptors (NMDARs), but the mechanism remains poorly understood. In the present study, we showed that in the striatum and hippocampus but not the cerebellum and parietal cortex, levels of α-synuclein monomers and oligomers increased with age, which correlated negatively with the expression of GluN1, and positively with the expression of total Rab5B. The oligomer-α-synuclein exhibited a stronger correlation with the expression of surface GluN1 and total Rab5B. In MES23.5 cells, the monomer- or oligomer-α-synuclein were shown to increase in a manner dependent on the concentrations of the added monomers and oligomers. Again, the oligomer-α-synuclein showed more potent effects than the monomer-α-synuclein on surface GluN1 and total Rab5B expression. Accordingly, the oligomer-treated cells showed a greater reduction in NMDA-evoked Ca²⁺ influx than the monomer-treated cells, which was largely inhibited by pistop2, a clathrin inhibitor. These results suggest that the age-dependent accumulation of α-synuclein monomers and oligomers differentially contributes to the reduction in surface NMDAR expression in selective brain regions.

Repetition-lag memory training is feasible in patients with chronic stroke, including those with memory problems

PRIMARY OBJECTIVE

Repetition-lag memory training was developed to increase individuals' use of recollection as opposed to familiarity in recognition memory. The goals of this study were to examine the feasibility of repetition-lag training in patients with chronic stroke and to explore whether the training might show suggestions of transfer to non-trained tasks.

RESEARCH DESIGN

Quasi-experimental.

METHODS AND PROCEDURES

Patients (n = 17) took part in six repetition-lag training sessions and their gains on the training and non-trained tasks were compared to those of age-matched healthy controls (n = 30).

MAIN OUTCOMES AND RESULTS

All but two patients completed the training, indicating that the method is feasible with a wide range of patients with stroke. The amount patients gained on the training task was similar to that of healthy controls (that is, the Group × Time interactions were by-and-large not significant), suggesting that patients with stroke might benefit to the same degree as healthy adults from this training. Both groups showed some indication of transfer to the non-trained backward digit span task and visuospatial memory.

CONCLUSIONS

These findings show that repetition-lag memory training is a possible approach with patients with stroke to enhance recollection. Further research on the method's efficacy and effectiveness is warranted.

Source Memory Rehabilitation: A Review Toward Recommendations for Setting Up a Strategy Training Aimed at the "What, Where, and When" of Episodic Retrieval

Source memory is a core component of episodic recall as it allows for the reconstruction of contextual details characterizing the acquisition of episodic events. Unlike episodic memory, little is known about source memory rehabilitation. Our review addresses this issue by emphasizing several strategies as useful tools in source memory rehabilitation programs. Four main strategies are likely to improve source recall in amnesic patients-namely, (a) contextual cueing, (b) unitization, (c) errorless learning, and (d) executive function programs. The rationale behind our suggestion is that: (a) reinstating contextual cues during retrieval can serve as retrieval cues and enhance source memory; (b) unitization as an encoding process allows for the integration of several pieces of contextual information into a new single entity; (c) errorless learning may prevent patients from making errors during source learning; and (d) as source memory deteriorations have been classically attributed to executive dysfunction, the rehabilitation of the latter ability is likely to maintain the former ability. Besides these four strategies, our review suggests several additional rehabilitation techniques such as the vanishing cues and spaced retrieval methods. Another additional strategy is the use of electronic devices. By gathering these strategies, our review provides a helpful guideline for clinicians dealing with source memory impairments. Our review further highlights the lack of randomized and controlled studies in the field of source memory rehabilitation.

Training recollection in healthy older adults: clear improvements on the training task, but little evidence of transfer

Normal aging holds negative consequences for memory, in particular for the ability to recollect the precise details of an experience. With this in mind, Jennings and Jacoby (2003) developed a recollection training method using a single-probe recognition memory paradigm in which new items (i.e., foils) were repeated during the test phase at increasingly long intervals. In previous reports, this method has appeared to improve older adults’ performance on several non-trained cognitive tasks. We aimed to further examine potential transfer effects of this training paradigm and to determine which cognitive functions might predict training gains. Fifty-one older adults were assigned to either recollection training (n = 30) or an active control condition (n = 21) for six sessions over 2 weeks. Afterward, the recollection training group showed a greatly enhanced ability to reject the repeated foils. Surprisingly, however, the training and the control groups improved to the same degree in recognition accuracy (d′) on their respective training tasks. Further, despite the recollection group’s significant improvement in rejecting the repeated foils, we observed little evidence of transfer to non-trained tasks (including a temporal source memory test). Younger age and higher baseline scores on a measure of global cognitive function (as measured by the Montreal Cognitive Assessment tool) and working memory (as measured by Digit Span Backward) predicted gains made by the recollection training group members.

Genetic impact on cognition and brain function in newly diagnosed Parkinson's disease: ICICLE-PD study

Parkinson's disease is associated with multiple cognitive impairments and increased risk of dementia, but the extent of these deficits varies widely among patients. The ICICLE-PD study was established to define the characteristics and prevalence of cognitive change soon after diagnosis, in a representative cohort of patients, using a multimodal approach. Specifically, we tested the 'Dual Syndrome' hypothesis for cognitive impairment in Parkinson's disease, which distinguishes an executive syndrome (affecting the frontostriatal regions due to dopaminergic deficits) from a posterior cortical syndrome (affecting visuospatial, mnemonic and semantic functions related to Lewy body pathology and secondary cholinergic loss). An incident Parkinson's disease cohort (n = 168, median 8 months from diagnosis to participation) and matched control group (n = 85) were recruited to a neuroimaging study at two sites in the UK. All participants underwent clinical, neuropsychological and functional magnetic resonance imaging assessments. The three neuroimaging tasks (Tower of London, Spatial Rotations and Memory Encoding Tasks) were designed to probe executive, visuospatial and memory encoding domains, respectively. Patients were also genotyped for three polymorphisms associated with cognitive change in Parkinson's disease and related disorders: (i) rs4680 for COMT Val158Met polymorphism; (ii) rs9468 for MAPT H1 versus H2 haplotype; and (iii) rs429358 for APOE-ε2, 3, 4. We identified performance deficits in all three cognitive domains, which were associated with regionally specific changes in cortical activation. Task-specific regional activations in Parkinson's disease were linked with genetic variation: the rs4680 polymorphism modulated the effect of levodopa therapy on planning-related activations in the frontoparietal network; the MAPT haplotype modulated parietal activations associated with spatial rotations; and APOE allelic variation influenced the magnitude of activation associated with memory encoding. This study demonstrates that neurocognitive deficits are common even in recently diagnosed patients with Parkinson's disease, and that the associated regional brain activations are influenced by genotype. These data further support the dual syndrome hypothesis of cognitive change in Parkinson's disease. Longitudinal data will confirm the extent to which these early neurocognitive changes, and their genetic factors, influence the long-term risk of dementia in Parkinson's disease. The combination of genetics and functional neuroimaging provides a potentially useful method for stratification and identification of candidate markers, in future clinical trials against cognitive decline in Parkinson's disease.