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Macoir J, Hudon C. Normative data for the verb fluency test in the adult French-Quebec population and validation study in mild cognitive impairment. APPLIED NEUROPSYCHOLOGY. ADULT 2025; 32:646-652. [PMID: 37084082 DOI: 10.1080/23279095.2023.2201448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
Verbal fluency tests are used to assess executive functions and language. The verb fluency test has proven successful in distinguishing healthy individuals (HCs) from participants with pathological conditions. However, few normative and psychometric studies have been published for the verb fluency test. The aim of Study 1 was to provide normative data in the adult population of French Québec for the verb fluency test. The aim of Study 2 was to determine its discriminant validity and test-retest reliability. The normative sample consisted of 424 HCs aged 50-92 years. Multiple linear regressions were used to generate equations for calculating Z-scores. To assess discriminant validity, the performance of 46 HCs was compared with that of 46 participants with mild cognitive impairment (MCI). To determine test-retest reliability, the test was administered twice, 3 months apart, to a group of 25 HCs. Age, sex, and education level were significantly related to performance on the test. The test distinguished the performance of HCs from that of participants with MCI. Test-retest analysis showed that scores had good stability over time. Norms and psychometric data for the verb fluency test will help clinicians and researchers better identify executive and language impairments associated with pathological conditions.
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Affiliation(s)
- Joël Macoir
- Faculté de médecine, Département de réadaptation, Université Laval, Quebec, Canada
- Centre de recherche CERVO - Brain Research Centre, Québec, Canada
| | - Carol Hudon
- Centre de recherche CERVO - Brain Research Centre, Québec, Canada
- Centre de recherche VITAM, Québec, Canada
- Faculté des sciences sociales, École de psychologie, Université Laval, Québec, Canada
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Ouerchefani R, Ouerchefani N, Rejeb MRB, Le Gall D. Relationship Between Cognitive Estimation, Executive Functions, and Theory of Mind in Patients With Prefrontal Cortex Damage. Arch Clin Neuropsychol 2024:acae109. [PMID: 39607752 DOI: 10.1093/arclin/acae109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 10/25/2024] [Accepted: 11/09/2024] [Indexed: 11/29/2024] Open
Abstract
OBJECTIVE Conflicting evidence has arisen from the few studies that have examined the role of the prefrontal cortex and executive control functions in theory of mind (ToM). Moreover, the involvement of other cognitive domains in the ability to infer mental states is still under debate. This study aims to examine, in addition to the potential contribution of executive functions, the role of cognitive estimation in ToM abilities, given that cognitive estimation processes are strongly associated with some aspects of executive control functions. METHOD The cognitive estimation task, along with a set of neuropsychological tasks assessing executive functions, was administered to 30 patients with prefrontal cortex damage and 30 control subjects matched by gender, age, and education level. RESULTS Patients with prefrontal cortex damage were impaired in all measures of executive functions, cognitive estimation, and theory of mind compared with control subjects. Regression analysis showed a significant interaction between executive measures and cognitive estimation in predicting ToM performance for patients with prefrontal cortex damage. Additionally, voxel-based lesion analysis identified a partially common bilaterally distributed prefrontal network involved in all three domains, centered within the ventral and dorsomedial areas with extension to the dorsolateral prefrontal cortex. CONCLUSION Our findings highlight that, apart from executive functions, cognitive estimation plays a crucial role in the ability to interpret others' cognitive and emotional states in both patients with prefrontal cortex damage and control subjects.
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Affiliation(s)
- Riadh Ouerchefani
- Department of Psychology, University of Tunis El Manar, High Institute of Human Sciences, 26 Boulevard Darghouth Pacha, Tunis, Tunisia
- Univ Angers, Universite de Nantes, LPPL, SFR CONFLUENCES, 2 Boulevard Lavoisier, 49045 Angers Cedex 01, France
| | - Naoufel Ouerchefani
- Clinique de l'Essonne, 5 rue de la Clairiere, 91024 Evry COURCOURONNES, Paris, France
| | - Mohamed Riadh Ben Rejeb
- Department of Psychology, Faculty of Human and Social Science of Tunisia, University of Tunis I, Boulevard 9 Avril, CP, Tunis, Tunisia
| | - Didier Le Gall
- Univ Angers, Universite de Nantes, LPPL, SFR CONFLUENCES, 2 Boulevard Lavoisier, 49045 Angers Cedex 01, France
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Delfan M, Kordestani-Moghaddam P, Gholami M, Kazemi K, Mohammadi R. Evaluating the effects of Bacopa monnieri on cognitive performance and sleep quality of patients with mild cognitive impairment: A triple-blinded, randomized, placebo-controlled trial. Explore (NY) 2024; 20:102990. [PMID: 38538390 DOI: 10.1016/j.explore.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 02/19/2024] [Accepted: 02/28/2024] [Indexed: 07/08/2024]
Abstract
INTRODUCTION Mild cognitive impairment is the middle level of natural cognitive impairment during primary steps of dementia. There are a few studies about improving the cognitive performance and sleep quality in patients with a limited dementia. So, this study was conducted to evaluate the effects of Bacopa monnieri on cognitive performance and sleep quality of patients with mild cognitive impairment. MATERIALS AND METHODS In this study, 62 patients with mild cognitive impairment were categorized into two groups of control and intervention. The intervention group received one pill of 160 mg Bacopa monnieri extract in 2 months, and the control group received a pill containing starch powder. The cognitive impairment and sleep quality was assessed using a questionnaire containing demographic information, Montreal Cognitive Assessment, and the Pittsburg Sleep Quality Index in three time-points of before the study, one months after the intervention and 2 months after the intervention (the end of study). RESULTS The results showed no statistically significant difference between two groups in all three time-points in overall cognitive performance score and its 6 parameters (P > 0.05). While in the field of attention at the end of the first month (P = 0.033) and the end of the second month (P = 0.004), it was significant difference between the study groups. Also, in the field of verbal fluency at the end of the second month, this difference was significant (P = 0.003). The cognitive performance overall score showed no significant difference between two groups in first (P = 0.939) and second time-points (P = 0.661), although it was significant at third time-point (P = 0.029). There was no statistically significant difference between two groups in all time-points for sleep quality overall score (P > 0.05). CONCLUSION The results showed that Bacopa monnieri can improve the cognitive performance overall score and some of its parameters, but it had no effect on sleep quality.
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Affiliation(s)
- Maryam Delfan
- Master of Medical-Surgical Nursing, Student Research Committee, Medical-Surgical Nursing Department, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Parastou Kordestani-Moghaddam
- Assistant Professor of Cognitive Neuroscience, Social determinants of research health center, School of Nursing and midwifery, Emergency and Critical Care Nursing Depatrment, Lorestan University of Medical Sciences, Khorramabad, Iran.
| | - Mohammad Gholami
- Associate Professor, Social determinants of health reseachcenter, Medical Surgical Nursing Depatrment, School of Nursing and midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Khadije Kazemi
- MD, Neurologist, School of medicine, Shahid Rahimi Hospital, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Rasool Mohammadi
- Assistant Professor of Epidemiology, Department of Biostatistics and Epidemiology, School of Public Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
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Kemik K, Ada E, Çavuşoğlu B, Aykaç C, Savaş DDE, Yener G. Detecting language network alterations in mild cognitive impairment using task-based fMRI and resting-state fMRI: A comparative study. Brain Behav 2024; 14:e3518. [PMID: 38698619 PMCID: PMC11066416 DOI: 10.1002/brb3.3518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 04/06/2024] [Accepted: 04/13/2024] [Indexed: 05/05/2024] Open
Abstract
OBJECTIVE The objective of this study was to investigate the functional changes associated with mild cognitive impairment (MCI) using independent component analysis (ICA) with the word generation task functional magnetic resonance imaging (fMRI) and resting-state fMRI. METHODS In this study 17 patients with MCI and age and education-matched 17 healthy individuals as control group are investigated. All participants underwent resting-state fMRI and task-based fMRI while performing the word generation task. ICA was used to identify the appropriate independent components (ICs) and their associated networks. The Dice Coefficient method was used to determine the relevance of the ICs to the networks of interest. RESULTS IC-14 was found relevant to language network in both resting-state and task-based fMRI, IC-4 to visual, and IC-28 to dorsal attention network (DAN) in word generation task-based fMRI by Sorento-Dice Coefficient. ICA showed increased activation in language network, which had a larger voxel size in resting-state functional MRI than word generation task-based fMRI in the bilateral lingual gyrus. Right temporo-occipital fusiform cortex, right hippocampus, and right thalamus were also activated in the task-based fMRI. Decreased activation was found in DAN and visual network MCI patients in word generation task-based fMRI. CONCLUSION Task-based fMRI and ICA are more sophisticated and reliable tools in evaluation cognitive impairments in language processing. Our findings support the neural mechanisms of the cognitive impairments in MCI.
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Affiliation(s)
- Kerem Kemik
- Department of Neuroscience, Institute of Health SciencesDokuz Eylül UniversityIzmirTurkey
| | - Emel Ada
- Department of RadiologyDokuz Eylül University Medicine FacultyIzmirTurkey
| | - Berrin Çavuşoğlu
- Department of Medical Physics, Institute of Health SciencesDokuz Eylül UniversityIzmirTurkey
| | - Cansu Aykaç
- Department of Neuroscience, Institute of Health SciencesDokuz Eylül UniversityIzmirTurkey
| | | | - Görsev Yener
- Department of Neurology, Faculty of MedicineIzmir University of EconomicsİzmirTurkey
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Herrera E, Blanco C, Álvarez-Mundiñano B, González-Nosti M. Neuropsychological Rehabilitation Improves Memory and Action Naming in Patients With Post-COVID-19 Syndrome. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:791-799. [PMID: 38118457 DOI: 10.1044/2023_ajslp-23-00157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
PURPOSE Post-COVID-19 syndrome (PCS-19) is a condition characterized by both physical and cognitive alterations in patients who have overcome COVID-19. Despite the high incidence of this disorder and the inconveniences it produces to those affected, there are few studies investigating the efficacy of cognitive stimulation in these patients. The aim of this study was to compare two groups of patients with PCS-19. One of them was treated with neuropsychological intervention for 6 months, whereas the other did not receive treatment. Both groups shared similar clinical characteristics and cognitive profiles. METHOD The study included 15 participants. Eight (seven women and one man, with a mean age of 50.13 years) made up the experimental group and received neuropsychological rehabilitation sessions once a week with the aim of recovering or compensating for their impaired functions. The control group consisted of seven patients (six women and one man, with a mean age of 52.86 years) who did not undergo neuropsychological rehabilitation sessions. The neuropsychological assessment protocol included tests for all cognitive domains. RESULTS In comparison with the assessment prior to the neuropsychological intervention, significant differences were found in the experimental group both in verbal memory and in the action naming task. As for the control group, improvements in action fluency performance were observed. Neither group showed significant improvement in pre- versus posttest Stroop scores. However, the control group did perform higher than the treatment group in the final assessment. CONCLUSION Despite the small sample size, our results suggest that patients with PCS-19 may benefit from neuropsychological rehabilitation, as it may help them to improve several cognitive functions that do not recover spontaneously.
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Affiliation(s)
- Elena Herrera
- Departament of Psychology, University of Oviedo, Spain
| | - Claudia Blanco
- Departament of Psychology, University of Oviedo, Spain
- Loquium, Clinic of Psychology and Neuropsychology, Oviedo, Spain
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Li C, Solinsky J, Cohen T, Pakhomov S. A curious case of retrogenesis in language: Automated analysis of language patterns observed in dementia patients and young children. NEUROSCIENCE INFORMATICS 2024; 4:100155. [PMID: 38433986 PMCID: PMC10907010 DOI: 10.1016/j.neuri.2023.100155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Introduction While linguistic retrogenesis has been extensively investigated in the neuroscientific and behavioral literature, there has been little work on retrogenesis using computerized approaches to language analysis. Methods We bridge this gap by introducing a method based on comparing output of a pre-trained neural language model (NLM) with an artificially degraded version of itself to examine the transcripts of speech produced by seniors with and without dementia and healthy children during spontaneous language tasks. We compare a range of linguistic characteristics including language model perplexity, syntactic complexity, lexical frequency and part-of-speech use across these groups. Results Our results indicate that healthy seniors and children older than 8 years share similar linguistic characteristics, as do dementia patients and children who are younger than 8 years. Discussion Our study aligns with the growing evidence that language deterioration in dementia mirrors language acquisition in development using computational linguistic methods based on NLMs. This insight underscores the importance of further research to refine its application in guiding developmentally appropriate patient care, particularly in early stages.
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Affiliation(s)
- Changye Li
- Institute of Health Informatics, University of Minnesota, Minneapolis, 55455, MN, USA
| | - Jacob Solinsky
- College of Pharmacy, University of Minnesota, Minneapolis, 55455, MN, USA
| | - Trevor Cohen
- Division of Biomedical Informatics and Medical Education, University of Washington, Seattle, 98195, WA, USA
| | - Serguei Pakhomov
- College of Pharmacy, University of Minnesota, Minneapolis, 55455, MN, USA
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Reekes TH, Higginson CI, Sigvardt KA, King DS, Levine D, Wheelock VL, Disbrow EA. Sex differences in Parkinson disease-associated episodic memory and processing speed deficits. J Int Neuropsychol Soc 2023; 29:813-820. [PMID: 36971238 DOI: 10.1017/s1355617723000097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
OBJECTIVES This study aims to address a gap in the data on cognitive sex differences in persons living with Parkinson disease (PD). There is some evidence that cognitive dysfunction is more severe in male PD, however data on episodic memory and processing speed is incomplete. METHODS One hundred and sixty-seven individuals with a diagnosis of PD were included in this study. Fifty-six of those individuals identified as female. The California Verbal Learning Test 1st edition and the Wechsler Memory Scale 3rd edition were used to evaluate verbal and visuospatial episodic memory and the Wechsler Adult Intelligence Scale 3rd edition was used to evaluate processing speed. Multivariate analysis of covariance was used to identify sex-specific differences across groups. RESULTS Our results show that males with PD performed significantly worse than females in verbal and visuospatial recall as well as a trend for the processing speed task of coding. CONCLUSIONS Our finding of superior performance among females with PD in verbal episodic memory is consistent with reports in both healthy and PD individuals; however, females outperforming males in measures of visuospatial episodic memory is unique to PD. Cognitive deficits preferentially affecting males appear to be associated with frontal lobe-related function. Therefore, males may represent a disease subgroup more susceptible to disease mechanisms affecting frontal lobe deterioration and cognitive disturbances in PD.
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Affiliation(s)
- Tyler H Reekes
- Department of Pharmacology, Toxicology, and Neuroscience, Louisiana State University Health Sciences Center, Shreveport, LA, USA
- LSU Health Shreveport Center for Brain Health, Shreveport, LA, USA
| | | | - Karen A Sigvardt
- Department of Neurology, University of California Davis, Davis, CA, USA
| | - David S King
- Clinical Functional Neuroscience Department, Kaiser Permanente Northern California, Sacramento, CA, USA
| | - Dawn Levine
- Clinical Functional Neuroscience Department, Kaiser Permanente Northern California, Sacramento, CA, USA
| | - Vicki L Wheelock
- Department of Neurology, University of California Davis, Davis, CA, USA
- Clinical Functional Neuroscience Department, Kaiser Permanente Northern California, Sacramento, CA, USA
| | - Elizabeth A Disbrow
- Department of Pharmacology, Toxicology, and Neuroscience, Louisiana State University Health Sciences Center, Shreveport, LA, USA
- LSU Health Shreveport Center for Brain Health, Shreveport, LA, USA
- Department of Neurology, Louisiana State University Health Sciences Center, Shreveport, LA, USA
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Fisher MN, Casenhiser DM, Paek EJ. Objective and Subjective Clustering Methods for Verb Fluency Responses From Individuals With Alzheimer's Dementia and Cognitively Healthy Older Adults. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:2589-2601. [PMID: 37722380 PMCID: PMC10721246 DOI: 10.1044/2023_ajslp-22-00290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 03/13/2023] [Accepted: 06/27/2023] [Indexed: 09/20/2023]
Abstract
PURPOSE The verb fluency task has been researched using a variety of analysis methods and shown its sensitivity to declines in executive functioning and lexical retrieval abilities in various neurogenic populations. Few studies to date, however, have analyzed clusters and switches in the task, and there is a lack of robust analysis methods that preclude subjectivity and potential rater bias. The purpose of this study was to investigate the reliability when using subjective clustering methods and to determine the feasibility of using an objective clustering method to determine verb fluency performance in individuals with Alzheimer's dementia (IwDs) and cognitively healthy older adults (CHOAs). METHOD Responses from a verb fluency task were obtained from IwDs and CHOAs. Group differences were examined using an objective clustering method for multiple variables regarding clustering and switching. We also calculated the intrarater, interrater, and intermethod reliability using intraclass coefficients. RESULTS Significant group differences were found when utilizing the objective clustering method in all variables except the average cluster size, with IwDs performing poorer than CHOAs. Intrarater reliability was excellent. Interrater reliability between two authors and intermethod reliability between the objective and subjective methods were variable ranging from moderate to good. CONCLUSIONS The results from using the objective clustering method in this study are consistent with the previous literature, making it a viable option for clustering analyses on the verb fluency task, which naturally minimizes subjectivity and rater bias. Alternatively, employing a thoroughly validated and reliable subjective approach can also mitigate potential rater bias and improve replicability across studies. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24061017.
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Affiliation(s)
- Madison N. Fisher
- Department of Audiology and Speech Pathology, College of Health Professions, The University of Tennessee Health Science Center, Knoxville
| | - Devin M. Casenhiser
- Department of Audiology and Speech Pathology, College of Health Professions, The University of Tennessee Health Science Center, Knoxville
| | - Eun Jin Paek
- Department of Audiology and Speech Pathology, College of Health Professions, The University of Tennessee Health Science Center, Knoxville
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Ponomareva NV, Andreeva TV, Protasova MS, Kunizheva SS, Kuznetsova IL, Kolesnikova EP, Malina DD, Mitrofanov AA, Fokin VF, Illarioshkin SN, Rogaev EI. Neuronal Hyperactivation in EEG Data during Cognitive Tasks Is Related to the Apolipoprotein J/Clusterin Genotype in Nondemented Adults. Int J Mol Sci 2023; 24:6790. [PMID: 37047762 PMCID: PMC10095572 DOI: 10.3390/ijms24076790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 03/24/2023] [Accepted: 03/30/2023] [Indexed: 04/08/2023] Open
Abstract
The clusterin (CLU) rs11136000 CC genotype is a probable risk factor for Alzheimer's disease (AD). CLU, also known as the apolipoprotein J gene, shares certain properties with the apolipoprotein E (APOE) gene with a well-established relationship with AD. This study aimed to determine whether the electrophysiological patterns of brain activation during the letter fluency task (LFT) depend on CLU genotypes in adults without dementia. Previous studies have shown that LFT performance involves activation of the frontal cortex. We examined EEG alpha1 and alpha2 band desynchronization in the frontal regions during the LFT in 94 nondemented individuals stratified by CLU (rs11136000) genotype. Starting at 30 years of age, CLU CC carriers exhibited more pronounced task-related alpha2 desynchronization than CLU CT&TT carriers in the absence of any differences in LFT performance. In CLU CC carriers, alpha2 desynchronization was significantly correlated with age. Increased task-related activation in individuals at genetic risk for AD may reflect greater "effort" to perform the task and/or neuronal hyperexcitability. The results show that the CLU genotype is associated with neuronal hyperactivation in the frontal cortex during cognitive tasks performances in nondemented individuals, suggesting systematic vulnerability of LFT related cognitive networks in people carrying unfavorable CLU alleles.
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Affiliation(s)
- Natalya V. Ponomareva
- Research Center of Neurology, 125367 Moscow, Russia
- Center for Genetics and Life Science, Sirius University of Science and Technology, 354349 Sochi, Russia
| | - Tatiana V. Andreeva
- Center for Genetics and Life Science, Sirius University of Science and Technology, 354349 Sochi, Russia
- Vavilov Institute of General Genetics, Russian Academy of Sciences, 119991 Moscow, Russia
- Centre for Genetics and Genetic Technologies, Faculty of Biology, Lomonosov Moscow State University, 119192 Moscow, Russia
| | - Maria S. Protasova
- Vavilov Institute of General Genetics, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Svetlana S. Kunizheva
- Center for Genetics and Life Science, Sirius University of Science and Technology, 354349 Sochi, Russia
- Vavilov Institute of General Genetics, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Irina L. Kuznetsova
- Center for Genetics and Life Science, Sirius University of Science and Technology, 354349 Sochi, Russia
- Vavilov Institute of General Genetics, Russian Academy of Sciences, 119991 Moscow, Russia
| | | | | | | | | | | | - Evgeny I. Rogaev
- Center for Genetics and Life Science, Sirius University of Science and Technology, 354349 Sochi, Russia
- Department of Psychiatry, Umass Chan Medical School, Shrewsbury, MA 01545, USA
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Lu H, Li J, Fung AWT, Lam LCW. Diversity in verbal fluency performance and its associations with MRI-informed brain age matrices in normal ageing and neurocognitive disorders. CNS Neurosci Ther 2023. [PMID: 36914578 DOI: 10.1111/cns.14144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 02/13/2023] [Accepted: 02/17/2023] [Indexed: 03/15/2023] Open
Abstract
INTRODUCTION Category verbal fluency test (CVFT) has been widely used to assess and monitor the cognitive capacities in epidemiological studies and clinical trials. Pronounced discrepancy in CVFT performance has been found in individuals with different cognitive statuses. This study aimed to combine the psychometric and morphometric approaches to decode the complex verbal fluency performance in senior adults with normal ageing and neurocognitive disorders. METHODS This study adopted a two-stage cross-sectional design involving quantitative analyses of neuropsychological and neuroimaging data. In study I, capacity- and speed-based measures of CVFT were developed to evaluate the verbal fluency performance in normal ageing seniors (n = 261), those with mild cognitive impairment (n = 204), and those with dementia (n = 23) whose age range is from 65 to 85 years. In study II, structural magnetic resonance imaging-informed gray matter volume (GMV) and brain age matrices were calculated in a subsample (n = 52) from Study I through surface-based morphometry analysis. With age and gender as covariates, Pearson's correlation analysis was used to examine the associations of CVFT measures, GMV, and brain age matrices. RESULTS Speed-based measures showed extensive and stronger associations with other cognitive functions than capacity-based measures. The component-specific CVFT measures showed shared and unique neural underpinnings with lateralized morphometric features. Moreover, the increased CVFT capacity was significantly correlated with younger brain age in mild neurocognitive disorder (NCD) patients. CONCLUSION We found that the diversity of verbal fluency performance in normal ageing and NCD patients could be explained by a combination of memory, language, and executive abilities. The component-specific measures and related lateralized morphometric correlates also highlight the underlying theoretical meaning of verbal fluency performance and its clinical utility in detecting and tracing the cognitive trajectory in individuals with accelerated ageing.
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Affiliation(s)
- Hanna Lu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China.,The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jing Li
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ada Wai Tung Fung
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Linda Chiu Wa Lam
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
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Lee D, Park JY, Kim WJ. Altered functional connectivity of the default mode and dorsal attention network in subjective cognitive decline. J Psychiatr Res 2023; 159:165-171. [PMID: 36738647 DOI: 10.1016/j.jpsychires.2023.01.040] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 12/23/2022] [Accepted: 01/26/2023] [Indexed: 01/31/2023]
Abstract
Subjective cognitive decline (SCD) is a clinical condition in which performance on standardized cognitive tests does not indicate impairment like mild cognitive impairment (MCI), but self-experienced cognitive capacity persistently declines. We aimed to explore the functional connectivity (FC) characteristics of SCD subjects compared to healthy controls and MCI patients. Resting-state functional MRI was performed on 152 elderly subjects: 65 normal controls, 62 SCD subjects, and 25 MCI patients. A seed-based FC analysis was performed to compare groups. The major brain regions of the default mode network (DMN) and dorsal attention network (DAN), large-scale brain networks disrupted in patients with dementia, were selected as seed regions. As a result, the SCD group showed stronger FC than the MCI group between DMN seeds and the supramarginal gyrus. Both the SCD and MCI groups showed stronger FC between the left lateral parietal cortex and right dorsolateral prefrontal cortex. In the FC analysis centred on DAN seeds, both the SCD and MCI groups showed weaker FC of the right posterior intraparietal sulcus in the left anterior cingulate cortex and the left insula, compared to those in the control group. Within the SCD group, hyperconnectivity between the right lateral parietal cortex and left supramarginal gyrus was significantly correlated with better performance on the Controlled Oral Word Association Test. In conclusion, the SCD group showed several DMN- and DAN-related FC alterations, similar to the MCI group, but with distinct hyperconnectivity between DMN seeds and the supramarginal gyrus. In particular, SCD has DMN-related FC patterns distinct from those of MCI that are associated with verbal fluency retention.
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Affiliation(s)
- Deokjong Lee
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea; Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Jin Young Park
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea; Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea; Center for Digital Health, Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea.
| | - Woo Jung Kim
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea; Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea.
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Soltani A, Schworer EK, Esbensen AJ. Executive functioning and verbal fluency performance in youth with Down syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 131:104358. [PMID: 36209524 PMCID: PMC9701181 DOI: 10.1016/j.ridd.2022.104358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 09/02/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Executive functioning (EF) is an area of challenge for individuals with Down syndrome (DS) associated with a variety of downstream difficulties. Verbal fluency performance is one potential downstream effect that is commonly assessed in individuals with DS due to the measure's utility as a predictor of dementia. Verbal fluency requires individuals to inhibit irrelevant responses, shift between groupings of related words, and monitor to prevent repetition, all skills related to EF. AIMS This study aimed to determine the association between semantic verbal fluency performance and three EF subdomains (inhibition, shifting, and working memory) in youth with DS after taking into account vocabulary and cognitive ability. METHODS AND PROCEDURES Neuropsychological assessments (verbal and visuospatial), and parent reports of EF, were completed at one time point by 69 youth with DS 6-17 years old and their caregivers. Expressive and receptive vocabulary skills and cognitive ability were also assessed. OUTCOMES AND RESULTS The results revealed that verbal fluency performance was significantly associated with neuropsychological assessments of EF and parent report of inhibition even after controlling for the effects of vocabulary and cognitive ability. CONCLUSIONS AND IMPLICATIONS The findings highlight the underlying importance of EF in verbal fluency tasks in youth with DS.
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Affiliation(s)
- Amanallah Soltani
- Department of Educational Psychology, Kerman Branch, Islamic Azad University, Kerman, Iran
| | - Emily K Schworer
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Anna J Esbensen
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
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13
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Tian Y, Li D, Wang D, Zhu T, Xia M, Jiang W. Decreased Hemodynamic Responses in Left Parietal Lobule and Left Inferior Parietal Lobule in Older Adults with Mild Cognitive Impairment: A Near-Infrared Spectroscopy Study. J Alzheimers Dis 2022; 90:1163-1175. [DOI: 10.3233/jad-220691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: The brain activation patterns of mild cognitive impairment (MCI) are still unclear and they involve multiple brain regions. Most previous studies have focused on abnormal activation in the frontal and temporal lobes, with few investigating the entire brain. Objective: To identify and compare the changes in cerebral hemodynamics and abnormal activation patterns in the entire brain of MCI patients and healthy older adults. Methods: Patients with MCI (n = 22) and healthy controls (HC, n = 34) matched by age, education levels, sex, and mental state were enrolled. They performed the same letter and category verbal fluency test (VFT) tasks while their behavioral performance and global cerebral hemodynamics were analyzed. Results: The performance during the category VFT task was significantly better than that during the letter VFT task across all participants (HC: correct: p < 0.001; intrusions: p < 0.001; MCI: correct: p < 0.001; intrusions: p < 0.001). The number of correct words during the letter and category VFT tasks was significantly higher in the HC group than in the MCI group (p < 0.001). The deoxygenated-hemoglobin (HbR) concentrations in the left parietal lobule (p = 0.0352) and left inferior parietal lobule (p = 0.0314) were significantly different during the category VFT task. Conclusion: The differences between HC and MCI groups were greater in the category task. The HbR concentration was more sensitive for the category VFT task and concentration changes in the left parietal lobule and left inferior parietal lobule may be useful for clinical screening and application; thus, they deserve more attention.
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Affiliation(s)
- Yizhu Tian
- Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Deyu Li
- Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
- State Key Laboratory of Virtual Reality Technology and System, Beihang University, Beijing, China
| | - Daifa Wang
- Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Ting Zhu
- Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Meiyun Xia
- State Key Laboratory of Virtual Reality Technology and System, Beihang University, Beijing, China
- School of Mechanical Engineering and Automation, Beihang University, Beijing, China
| | - Wenyu Jiang
- Department of Neurological Rehabilitation, Guangxi Jiangbin Hospital, Nanning, China
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14
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Magnetoencephalography resting-state correlates of executive and language components of verbal fluency. Sci Rep 2022; 12:476. [PMID: 35013361 PMCID: PMC8748602 DOI: 10.1038/s41598-021-03829-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 12/03/2021] [Indexed: 12/21/2022] Open
Abstract
Verbal fluency (VF) is a heterogeneous cognitive function that requires executive as well as language abilities. The purpose of this study was to elucidate the specificity of the resting state MEG correlates of the executive and language components. To this end, we administered a VF test, another verbal test (Vocabulary), and another executive test (Trail Making Test), and we recorded 5-min eyes-open resting-state MEG data in 28 healthy participants. We used source-reconstructed spectral power estimates to compute correlation/anticorrelation MEG clusters with the performance at each test, as well as with the advantage in performance between tests, across individuals using cluster-level statistics in the standard frequency bands. By obtaining conjunction clusters between verbal fluency scores and factor loading obtained for verbal fluency and each of the two other tests, we showed a core of slow clusters (delta to beta) localized in the right hemisphere, in adjacent parts of the premotor, pre-central and post-central cortex in the mid-lateral regions related to executive monitoring. We also found slow parietal clusters bilaterally and a cluster in the gamma 2 and 3 bands in the left inferior frontal gyrus likely associated with phonological processing involved in verbal fluency.
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15
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Paek EJ. Emotional Valence Affects Word Retrieval During Verb Fluency Tasks in Alzheimer's Dementia. Front Psychol 2021; 12:777116. [PMID: 34925179 PMCID: PMC8674734 DOI: 10.3389/fpsyg.2021.777116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 11/10/2021] [Indexed: 12/01/2022] Open
Abstract
Individuals with amnestic Alzheimer's disease (AD) often demonstrate preserved emotional processing skills despite the neurodegenerative disease that affects their limbic system. Emotional valence encompasses the encoding and retrieval of memory and it also affects word retrieval in healthy populations, but it remains unclear whether these effects are preserved in individuals with amnestic AD. Previous studies used a variety of encoding procedures and different retrieval methods that resulted in mixed findings. Therefore, the purpose of the current study is to investigate whether emotional enhancement of memory effects is observed in an experimental condition where the memory encoding process is not required, namely verb (action) fluency tasks. Seventeen participants who were cognitively healthy older adults (CHOA) and 15 participants with amnestic AD were asked to complete verb fluency tasks, and the relative degree of emotional valence observed in their responses was compared between the two groups. A neuropsychological test battery was administered to determine the participants' cognitive and linguistic profiles, and correlational analyses were conducted to delineate relationships between emotional valence, verbal memory, and learning abilities. The results indicated that the participants with amnestic AD produced words with higher emotional valence (i.e., more pleasant words) compared to CHOA during action fluency testing. In addition, the degree of emotional valence in the words was negatively correlated with verbal memory and learning skills, showing that those with poorer memory skills tend to retrieve words with higher emotional valence. The findings are consistent with those previous studies that stressed that individuals with AD have preserved emotional enhancement of memory effects and may benefit from them for retrieval of information, which may offer some insight into the development of novel rehabilitative strategies for this population.
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Affiliation(s)
- Eun Jin Paek
- Department of Audiology and Speech Pathology, College of Health Professions, The University of Tennessee Health Science Center, Knoxville, TN, United States
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16
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Lee S, Kim TD, Kim RY, Joo Y, Chung YA, Lim SM, Lyoo IK, Kim J, Yoon S. Hippocampal subregional alterations and verbal fluency in the early stage of type 2 diabetes mellitus. Eur J Neurosci 2021; 54:7550-7559. [PMID: 34687097 DOI: 10.1111/ejn.15505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 10/16/2021] [Accepted: 10/21/2021] [Indexed: 11/30/2022]
Abstract
Growing evidence indicates that type 2 diabetes mellitus (T2DM)-related cognitive dysfunction may develop in the early stage of the disease and is often accompanied by hippocampal structural alterations. In the current study, we investigated volume and shape alterations of the hippocampus at a subregional level in patients with T2DM. With the use of high-resolution brain structural images that were obtained from 30 T2DM patients with less than 5 years of disease duration and 30 healthy individuals, volumetric and shape analyses were performed. We also assessed the relationship between T2DM-related hippocampal structural alterations and performance on verbal fluency. In volumetric analysis, total hippocampal volume was smaller in the T2DM group, relative to the control group. At a subregional level, T2DM patients showed significant inward deformation and volume reduction of the right dentate gyrus and cornu ammonis 2/3 subregions as compared with healthy individuals. In particular, T2DM patients with lower performance on verbal fluency had smaller right dentate gyrus volumes relative to those with higher performance. These findings suggest that the hippocampus may undergo atrophy at a subregional level even in the early stage of T2DM, and this subregion-specific atrophy may be associated with reduced performance on verbal fluency.
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Affiliation(s)
- Suji Lee
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
| | - Tammy D Kim
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
| | - Rye Young Kim
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.,Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, South Korea
| | - Yoonji Joo
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.,Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, South Korea
| | - Yong-An Chung
- Department of Radiology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, South Korea
| | - Soo Mee Lim
- Department of Radiology, College of Medicine, Ewha Womans University, Seoul, South Korea
| | - In Kyoon Lyoo
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.,Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, South Korea.,Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea.,The Brain Institute and Department of Psychiatry, University of Utah, Salt Lake City, Utah, USA
| | - Jungyoon Kim
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.,Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Sujung Yoon
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.,Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
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17
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Umegaki H, Suzuki Y. Association of verbal fluency test with progression to dementia in non-demented older adults. Geriatr Gerontol Int 2021; 21:868-869. [PMID: 34250698 DOI: 10.1111/ggi.14230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 05/29/2021] [Accepted: 06/16/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Hiroyuki Umegaki
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yusuke Suzuki
- Centre for Community Liaison and Patient Consultations, Nagoya University Hospital, Nagoya, Japan
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18
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fMRI Investigation of Semantic Lexical Processing in Healthy Control and Alzheimer's Disease Subjects Using Naming Task: A Preliminary Study. Brain Sci 2021; 11:brainsci11060718. [PMID: 34071377 PMCID: PMC8226532 DOI: 10.3390/brainsci11060718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 05/25/2021] [Accepted: 05/25/2021] [Indexed: 11/17/2022] Open
Abstract
For decades, scientists have been trying to solve the problem of dementia, with no cure currently available. Semantic-lexical impairment is well established as the early critical sign of dementia, although there are still gaps in knowledge that must be investigated. In this study, we used fMRI to observe the neural activity of 31 subjects, including 16 HC (Healthy Control) and 15 AD (Alzheimer's Disease), who participated in the naming task. The neuropsychology profile of HC (Healthy Control) and AD (Alzheimer's Disease) are discussed in this study. The involvement of FG (Fusiform Gyrus) and IFG (Inferior Frontal Gyrus) shows dominant activation in both of the groups. We observed a decrease in neural activity in the AD group, resulting in semantic deficit problems in this preliminary study. Furthermore, ROI analysis was performed and revealed both hyperactivation and hypoactivation in the AD group. The compensatory mechanism demonstrated during the task, due to the effort required to identify an animal's name, represents the character profile of AD.
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19
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Acute cognitive impairment after traumatic brain injury predicts the occurrence of brain atrophy patterns similar to those observed in Alzheimer's disease. GeroScience 2021; 43:2015-2039. [PMID: 33900530 DOI: 10.1007/s11357-021-00355-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 03/10/2021] [Indexed: 10/21/2022] Open
Abstract
Traumatic brain injuries (TBIs) are often followed by persistent structural brain alterations and by cognitive sequalae, including memory deficits, reduced neural processing speed, impaired social function, and decision-making difficulties. Although mild TBI (mTBI) is a risk factor for Alzheimer's disease (AD), the extent to which these conditions share patterns of macroscale neurodegeneration has not been quantified. Comparing such patterns can not only reveal how the neurodegenerative trajectories of TBI and AD are similar, but may also identify brain atrophy features which can be leveraged to prognosticate AD risk after TBI. The primary aim of this study is to systematically map how TBI affects white matter (WM) and gray matter (GM) properties in AD-analogous patterns. Our findings identify substantial similarities in the regional macroscale neurodegeneration patterns associated with mTBI and AD. In cerebral GM, such similarities are most extensive in brain areas involved in memory and executive function, such as the temporal poles and orbitofrontal cortices, respectively. Our results indicate that the spatial pattern of cerebral WM degradation observed in AD is broadly similar to the pattern of diffuse axonal injury observed in TBI, which frequently affects WM structures like the fornix, corpus callosum, and corona radiata. Using machine learning, we find that the severity of AD-like brain changes observed during the chronic stage of mTBI can be accurately prognosticated based on acute assessments of post-traumatic mild cognitive impairment. These findings suggest that acute post-traumatic cognitive impairment predicts the magnitude of AD-like brain atrophy, which is itself associated with AD risk.
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20
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Karamaouna P, Zouraraki C, Giakoumaki SG. Cognitive Functioning and Schizotypy: A Four-Years Study. Front Psychiatry 2020; 11:613015. [PMID: 33488431 PMCID: PMC7820122 DOI: 10.3389/fpsyt.2020.613015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 12/08/2020] [Indexed: 12/02/2022] Open
Abstract
Although there is ample evidence from cross-sectional studies indicating cognitive deficits in high schizotypal individuals that resemble the cognitive profile of schizophrenia-spectrum patients, there is still lack of evidence by longitudinal/follow-up studies. The present study included assessments of schizotypal traits and a wide range of cognitive functions at two time points (baseline and 4-years assessments) in order to examine (a) their stability over time, (b) the predictive value of baseline schizotypy on cognition at follow-up and (c) differences in cognition between the two time points in high negative schizotypal and control individuals. Only high negative schizotypal individuals were compared with controls due to the limited number of participants falling in the other schizotypal groups at follow-up. Seventy participants (mean age: 36.17; 70% females) were assessed at baseline and follow-up. Schizotypal traits were evaluated with the Schizotypal Personality Questionnaire. We found that schizotypal traits decreased over time, except in a sub-group of participants ("schizotypy congruent") that includes individuals who consistently meet normative criteria of inclusion in either a schizotypal or control group. In these individuals, negative schizotypy and aspects of cognitive-perceptual and disorganized schizotypy remained stable. The stability of cognitive functioning also varied over time: response inhibition, aspects of cued attention switching, set-shifting and phonemic/semantic verbal fluency improved at follow-up. High negative schizotypy at baseline predicted poorer response inhibition and semantic switching at follow-up while high disorganized schizotypy predicted poorer semantic processing and complex processing speed/set-shifting. The between-group analyses revealed that response inhibition, set-shifting and complex processing speed/set-shifting were poorer in negative schizotypals compared with controls at both time points, while maintaining set and semantic switching were poorer only at follow-up. Taken together, the findings show differential stability of the schizotypal traits over time and indicate that different aspects of schizotypy predict a different pattern of neuropsychological task performance during a 4-years time window. These results are of significant use in the formulation of targeted early-intervention strategies for high-risk populations.
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Affiliation(s)
- Penny Karamaouna
- Laboratory of Neuropsychology, Department of Psychology, Faculty of Social Sciences, University of Crete, Rethymno, Greece.,University of Crete Research Center for the Humanities, The Social and Educational Sciences (UCRC), University of Crete, Rethymno, Greece
| | - Chrysoula Zouraraki
- Laboratory of Neuropsychology, Department of Psychology, Faculty of Social Sciences, University of Crete, Rethymno, Greece.,University of Crete Research Center for the Humanities, The Social and Educational Sciences (UCRC), University of Crete, Rethymno, Greece
| | - Stella G Giakoumaki
- Laboratory of Neuropsychology, Department of Psychology, Faculty of Social Sciences, University of Crete, Rethymno, Greece.,University of Crete Research Center for the Humanities, The Social and Educational Sciences (UCRC), University of Crete, Rethymno, Greece
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