Autobiographical Cerebral Network Activation in Older Adults Before and After Reminiscence Therapy: A Preliminary Report

INTRODUCTION

Reminiscence therapy (RT), which engages individuals to evoke positive memories, has been shown to be effective in improving psychological well-being in older adults suffering from PTSD, depression, and anxiety. However, its impact on brain function has yet to be determined. This paper presents functional magnetic resonance imaging (fMRI) data to describe changes in autobiographical memory networks (AMN) in community-dwelling older adults.

METHODS

This pilot study used a within-subject design to measure changes in AMN activation in 11 older adults who underwent 6 weeks of RT. In the scanner, participants retrieved autobiographical memories which were either recent or remote, rehearsed or unrehearsed. Participants also underwent a clinical interview to assess changes in memory, quality of life, mental health, and affect.

FINDINGS

Compared to pretreatment, anxiety decreased (z = -2.014, p = .040) and activated significant areas within the AMN, including bilateral medial prefrontal cortex, left precuneus, right occipital cortex, and left anterior hippocampus.

CONCLUSION

Although RT had subtle effects on psychological function in this sample with no evidence of impairments, including depression at baseline, the fMRI data support current thinking of the effect RT has on the AMN. Increased activation of right posterior hippocampus following RT is compatible with the Multiple Trace Theory Theory (Nadel & Moscovitch, 1997).

Cognitive interventions for memory and psychological well-being in aging and dementias

The human lifespan has expanded drastically in the last few centuries, due to improvements in sanitation, medicine, and nutrition, but with this increase in longevity comes higher rates of cognitive pathology such as mild cognitive impairment (MCI) and dementia; the latter is estimated to reach more than 75 million people by 2030. Pathology risk is related to measures of executive function, lifestyle factors (e.g., education, occupation, and leisure activities), and cognitive reserve. One way of building cognitive reserve may be to structure the environment to encourage lifelong engagement and learning, and since a pharmacological "cure" for dementia remains elusive, non-pharmacological approaches such as physical activity, social engagement, and cognitive stimulation are becoming increasingly essential to preserving and protecting brain health. Here, we describe our recent research into Reminiscence Therapy (RT) to promote cognitive and psychological function in old age and early dementia. We review the Recall Initiative, which involved brain imaging and behavioral indices of memory pre- and post-RT. We also report results from a pilot study-AIM WARM-in which RT was combined with physical activity, specifically walking, for early-stage dementia. Finally, we outline our future directions for tailored reminiscence interventions in combination with other activities (e.g., yoga and meditation) for different groups, namely early Alzheimer's disease, Semantic Dementia, and older individuals in the prison system.

The Impact of Reminiscence on Autobiographical Memory, Cognition and Psychological Well-Being in Healthy Older Adults

Reminiscence therapy has improved autobiographical memory in older adults with memory impairment. However, there has been a relative lack of research examining the impact of reminiscence interventions on healthy older adults, despite the fact that healthy ageing has been associated with a reduction in episodic autobiographical memory. The current study examined the effects of a semi-structured reminiscence program, compared to a no-intervention control and an active control group focused on current life, in healthy older adults. Before and after reminiscence or control, we assessed episodic and semantic autobiographical memory, as well as reliving of the memory and re-experiencing the emotion associated with the memory. We also examined new learning and executive function, as well as quality of life, satisfaction with life, anxiety, depression, and mood. The reminiscence intervention did not lead to a differing impact on autobiographical memory, cognition or psychological well-being, compared to the control groups. The current results indicate that simple reminiscence does not lead to enhanced autobiographical memory performance in healthy older adults.

Self-initiated learning reveals memory performance and electrophysiological differences between younger, older and older adults with relative memory impairment

Older adults display difficulties in encoding and retrieval of information, resulting in poorer memory. This may be due to an inability of older adults to engage elaborative encoding strategies during learning. This study examined behavioural and electrophysiological effects of explicit cues to self-initiate learning during encoding and subsequent recognition of words in younger adults (YA), older control adults (OA) and older adults with relative memory impairment (OD). The task was a variation of the old/new paradigm, some study items were preceded by a cue to learn the word (L) while others by a do not learn cue (X). Behaviourally, YA outperformed OA and OD on the recognition task, with no significant difference between OA and OD. Event-related potentials at encoding revealed enhanced early visual processing (70-140 ms) for L- versus X-words in young and old. Only YA exhibited a greater late posterior positivity (LPP; 200-500 ms) for all words during encoding perhaps reflecting superior encoding strategy. During recognition, only YA differentiated L- versus X-words with enhanced frontal P200 (150-250 ms) suggesting impaired early word selection for retrieval in older groups; however, OD had enhanced P200 activity compared to OA during L-word retrieval. The LPP (250-500 ms) was reduced in amplitude for L-words compared to both X- and new words. However, YA showed greater LPP amplitude for all words compared to OA. For older groups, we observed reduced left parietal hemispheric asymmetry apparent in YA during encoding and recognition, especially for OD. Findings are interpreted in the light of models of compensation and dedifferentiation associated with age-related changes in memory function.

Comparable walking gait performance during executive and non-executive cognitive dual-tasks in chronic stroke: A pilot study

BACKGROUND

Falls are a serious problem among stroke survivors due to subsequent injuries, recovery setbacks, dependence, and mortality. A growing body of dual-task (DT) studies suggests a role of executive functions in gait control and falls, particularly in subacute stroke. However, few studies have compared distinct executive and non-executive tasks, nor their effects on chronic stroke gait.

RESEARCH QUESTION

The purpose of this cross-sectional study was to compare the effects of distinct working memory (2-back) and inhibition (Stroop) tasks on walking gait performance in chronic stroke survivors.

METHODS

A pilot sample of chronic stroke survivors (n = 11, 8 males, mean age = 70.91, 6-12months post-stroke event) and age-matched healthy controls (n = 13, 4 male; mean age = 68.46) were tested. Gait performance (speed, stride time, stride time variability, stride length and stride length variability) was measured using 2 wireless inertial measurement sensors under 4 walking conditions: 1) preferred walking (single-task: ST), 2) walking with a 2-back DT, 3) walking with a Stroop DT, and 4) walking with a non-executive motor response DT. The secondary tasks were also carried out in both ST (seated) and DT conditions, to examine bidirectional effects.

RESULTS

While the stroke survivor sample had a slower gait speed across conditions and tasks, there were no significant differences between the groups [F(1, 22) = 1.13, p =.299, η²p =  .049] on the spatial or temporal gait characteristics recorded: gait performance was maintained during executive and non-executive DTs. In addition, we did not find a significant effect of group on cognitive task performance (all p > .052). However, we observed a cost in accuracy on the 2-back DT for both groups, suggesting resource overlap and greater cognitive load (all t > 19.72, all p <  .001).

SIGNIFICANCE

Our gait data contradict previous studies evidencing impaired gait post-stroke, suggesting functional recovery in this chronic stroke sample.

Inhibition and Updating, but Not Switching, Predict Developmental Dyslexia and Individual Variation in Reading Ability

To elucidate the core executive function profile (strengths and weaknesses in inhibition, updating, and switching) associated with dyslexia, this study explored executive function in 27 children with dyslexia and 29 age matched controls using sensitive z-mean measures of each ability and controlled for individual differences in processing speed. This study found that developmental dyslexia is associated with inhibition and updating, but not switching impairments, at the error z-mean composite level, whilst controlling for processing speed. Inhibition and updating (but not switching) error composites predicted both dyslexia likelihood and reading ability across the full range of variation from typical to atypical. The predictive relationships were such that those with poorer performance on inhibition and updating measures were significantly more likely to have a diagnosis of developmental dyslexia and also demonstrate poorer reading ability. These findings suggest that inhibition and updating abilities are associated with developmental dyslexia and predict reading ability. Future studies should explore executive function training as an intervention for children with dyslexia as core executive functions appear to be modifiable with training and may transfer to improved reading ability.

Synaesthesia lost and found: two cases of person- and music-colour synaesthesia

Synaesthesia is a developmental condition involving cross-communication between sensory modalities or substreams whereby an inducer (e.g. a sound) automatically evokes a concurrent percept in another modality (e.g. a colour). Whether this condition arises due to atypical structural connectivity (e.g., between normally unconnected cortical areas) or altered neurochemistry remains a central question. We report the exceptional cases of two synaesthetes - subjects AB and CD - both of whom experience coloured auras around individuals, as well as coloured perceptions in response to music. Both subjects have, in recent years, suffered a complete loss or reduction of their synaesthetic experiences, one (AB) through successive head traumas, including a lightning strike, followed by a number of medications, and the other (CD) while taking anxiolytic medications. Using semi-structured interviews and data from the Synaesthesia Battery and a colourpicker task, we characterize the phenomenological characteristics of their pre-loss synaesthesia, as well as the subsequent restoration of each subject's synaesthetic experiences (in the months post-trauma for AB, and after cessation of medication for CD). Even after years of suppression, the patterns of associations were highly consistent with those experienced pre-injury. The phenomenological experience of synaesthesia can, thus, like most conscious experiences, be modulated by pharmacologically diverse medications or head injury. However, the underlying neural substrates mediating specific synaesthetic pairings appear remarkably 'hard-wired' and can persist over very long periods even under conditions that alter or completely suppress the conscious synaesthetic experience itself.

Impaired auditory selective attention ameliorated by cognitive training with graded exposure to noise in patients with traumatic brain injury

Patients who suffer traumatic brain injury frequently report difficulty concentrating on tasks and completing routine activities in noisy and distracting environments. Such impairments can have long-term negative psychosocial consequences. A cognitive control function that may underlie this impairment is the capacity to select a goal-relevant signal for further processing while safeguarding it from irrelevant noise. A paradigmatic investigation of this problem was undertaken using a dichotic listening task (study 1) in which comprehension of a stream of speech to one ear was measured in the context of increasing interference from a second stream of irrelevant speech to the other ear. Controls showed an initial decline in performance in the presence of competing speech but thereafter showed adaptation to increasing audibility of irrelevant speech, even at the highest levels of noise. By contrast, patients showed linear decline in performance with increasing noise. Subsequently attempts were made to ameliorate this deficit (study 2) using a cognitive training procedure based on attention process training (APT) that included graded exposure to irrelevant noise over the course of training. Patients were assigned to adaptive and non-adaptive training schedules or to a no-training control group. Results showed that both types of training drove improvements in the dichotic listening and in naturalistic tasks of performance in noise. Improvements were also seen on measures of selective attention in the visual domain suggesting transfer of training. We also observed augmentation of event-related potentials (ERPs) linked to target processing (P3b) but no change in ERPs evoked by distractor stimuli (P3a) suggesting that training heightened tuning of target signals, as opposed to gating irrelevant noise. No changes in any of the above measures were observed in a no-training control group. Together these findings present an ecologically valid approach to measure selective attention difficulties after brain injury, and provide a means to ameliorate these deficits.

Dual-task and electrophysiological markers of executive cognitive processing in older adult gait and fall-risk

The role of cognition is becoming increasingly central to our understanding of the complexity of walking gait. In particular, higher-level executive functions are suggested to play a key role in gait and fall-risk, but the specific underlying neurocognitive processes remain unclear. Here, we report two experiments which investigated the cognitive and neural processes underlying older adult gait and falls. Experiment 1 employed a dual-task (DT) paradigm in young and older adults, to assess the relative effects of higher-level executive function tasks (n-Back, Serial Subtraction and visuo-spatial Clock task) in comparison to non-executive distracter tasks (motor response task and alphabet recitation) on gait. All DTs elicited changes in gait for both young and older adults, relative to baseline walking. Significantly greater DT costs were observed for the executive tasks in the older adult group. Experiment 2 compared normal walking gait, seated cognitive performances and concurrent event-related brain potentials (ERPs) in healthy young and older adults, to older adult fallers. No significant differences in cognitive performances were found between fallers and non-fallers. However, an initial late-positivity, considered a potential early P3a, was evident on the Stroop task for older non-fallers, which was notably absent in older fallers. We argue that executive control functions play a prominent role in walking and gait, but the use of neurocognitive processes as a predictor of fall-risk needs further investigation.

Facial emotion recognition in adolescents with psychotic-like experiences: a school-based sample from the general population

BACKGROUND

Psychotic symptoms, also termed psychotic-like experiences (PLEs) in the absence of psychotic disorder, are common in adolescents and are associated with increased risk of schizophrenia-spectrum illness in adulthood. At the same time, schizophrenia is associated with deficits in social cognition, with deficits particularly documented in facial emotion recognition (FER). However, little is known about the relationship between PLEs and FER abilities, with only one previous prospective study examining the association between these abilities in childhood and reported PLEs in adolescence. The current study was a cross-sectional investigation of the association between PLEs and FER in a sample of Irish adolescents.

METHOD

The Adolescent Psychotic-Like Symptom Screener (APSS), a self-report measure of PLEs, and the Penn Emotion Recognition-40 Test (Penn ER-40), a measure of facial emotion recognition, were completed by 793 children aged 10-13 years.

RESULTS

Children who reported PLEs performed significantly more poorly on FER (β=-0.03, p=0.035). Recognition of sad faces was the major driver of effects, with children performing particularly poorly when identifying this expression (β=-0.08, p=0.032).

CONCLUSIONS

The current findings show that PLEs are associated with poorer FER. Further work is needed to elucidate causal relationships with implications for the design of future interventions for those at risk of developing psychosis.

Subtle memory and attentional deficits revealed in an Irish stroke patient sample using domain-specific cognitive tasks

Stroke disrupts motor, sensory, and cognitive systems in survivors. Unlike in physical impairments, assessment of cognitive function is often inadequate, as no standardized procedure to monitor cognitive recovery post stroke exists. We evaluated a number of novel task-orientated tools designed to assess subtle cognitive deficits (including memory, attention, and executive functioning) in a sample of stroke patients. Although unimpaired on MMSE (Mini-Mental State Examination)-based indices of cognition, memory, and intelligence, stroke survivors were significantly impaired on tasks testing visual attention, spatial/relational processing, and associative memory. We recommend a standardized multidomain cognitive assessment and propose that cognitive deficits post stroke require in-depth assessment to inform patient-orientated rehabilitation.

Language processing abnormalities in adolescents with psychotic-like experiences: an event related potential study

Language impairments are a well established finding in patients with schizophrenia and in individuals at-risk for psychosis. A growing body of research has revealed shared risk factors between individuals with psychotic-like experiences (PLEs) from the general population and patients with schizophrenia. In particular, adolescents with PLEs have been shown to be at an increased risk for later psychosis. However, to date there has been little information published on electrophysiological correlates of language comprehension in this at-risk group. A 64 channel EEG recorded electrical activity while 37 (16 At-Risk; 21 Controls) participants completed the British Picture Vocabulary Scale (BPVS-II) receptive vocabulary task. The P300 component was examined as a function of language comprehension. The at-risk group were impaired behaviourally on receptive language and were characterised by a reduction in P300 amplitude relative to the control group. The results of this study reveal electrophysiological evidence for receptive language deficits in adolescents with PLEs, suggesting that the earliest neurobiological changes underlying psychosis may be apparent in the adolescent period.

Concurrent task performance enhances low-level visuomotor learning

Visuomotor association learning involves learning to make a motor response to an arbitrary visual stimulus. This learning is essential for visual search and discrimination performance and is reliant upon a well-defined neural circuit in the brain that includes the prefrontal cortex and the hippocampal formation. In the present study, we investigated the possible role of attentional processes during such learning using dual-task interference. A motor, verbal, or perceptual concurrent task was performed during the learning/training block of a simple visual discrimination task. Contrary to expectation, the dual-task groups showed improved learning and learning-dependent performance compared with untrained control and non-dual-task trained groups. A second experiment revealed that this effect did not appear to be due to increased arousal level; the inclusion of alerting tones during learning did not result in facilitation. These findings suggest that the engagement of attention, but not arousal, during the acquisition of a visuomotor association can facilitate this learning and its expression.

Electrophysiological and information processing variability predicts memory decrements associated with normal age-related cognitive decline and Alzheimer's disease (AD)

Recent theoretical models of cognitive aging have implicated increased intra-individual variability as a critical marker of decline. The current study examined electrophysiological and information processing variability and memory performance in normal younger and older controls, and older adults with Alzheimer's disease (AD). It was hypothesized that higher levels of variability would be indicative of age-related and disease-related memory deficits. Results indicated both implicit and explicit memory deficits associated with AD. Consistent with previous research, behavioral speed and variability emerged as sensitive to age- and disease-related change. Amplitude variability of P3 event-related potentials was a unique component of electrophysiological activity and accounted for significant variance in reaction time (RT) mean and RT standard deviation, which in turn accounted for significant variance in memory function. Results are discussed in light of theoretical and applied issues in the field of cognitive aging.

Hippocampal contributions to neurocognitive mapping in humans: A new model

The ability of an organism to develop, maintain, and act upon an abstracted internal representation of spatially extensive environments can provide an increased chance in ensuring that organism's survival. Here, we propose a neurocognitive model of spatial representation describing how several different processes interact and segregate the differing types of information used to produce a unified cognitive map. This model proposes that view-based egocentric and vestibulomotor translational information are functionally and anatomically separate, and that these parallel systems result in independent, but interacting, models within a neurocognitive map of space. In this context, we selectively review relevant portions of the large literature, addressing the establishment and operation of such spatial constructs in humans and the brain systems that underpin them, with particular reference to the hippocampal formation (HF). We present a reinterpretation of the types of knowledge used in the formation of this spatial construct, the processes that act upon this information, the nature of the final spatial representation, and describe how these universal concepts relate to the proposed model of spatial processing. The relevant experimental paradigms used to examine the neural basis of spatial representation and the main findings from previous research are also briefly presented. Finally, we detail a series of testable theoretical, behavioral, and anatomical predictions made by the model.

Individual differences discriminate event-related potentials but not performance during response inhibition

Event-related brain potentials (ERPs) were recorded from 20 normal participants while they completed a Go/NoGo response inhibition task. Previous ERP studies have implicated the N2 and P3 waveforms as the main indices of processing in this task, and functional brain imaging has shown parietal, prefrontal and anterior cingulate cortices to be involved in response inhibition. 32-channel ERP analysis revealed amplitude differences in the N2/P3 components when stimuli that required a button-press (Go stimuli) were compared with stimuli for which the response had to be withheld (No-Go stimuli), and in N2 and P3 latencies when successful withholds to No-Go stimuli were compared with unsuccessful attempts to inhibit. Further differences in the N2/P3 complex emerged when participants were grouped in terms of a measure of absentmindedness (the Cognitive Failures Questionnaire, CFQ); larger and earlier components were found for high CFQ respondents. We conclude that the latencies of the N2 and P3 may be the critical indicators of active inhibitory processes for this task, suggesting that a pattern of sequential activation rather than altered activity level in key structures may mediate success on the task. In addition, highly absentminded participants exhibited larger components for errors than did less absentminded participants when performing at the same level, which implies that the absentminded may require greater activity in the neural substrates of response inhibition in order to accomplish this task at a comparable level of performance to less absentminded participants.

Behavioural and physiological impairments of sustained attention after traumatic brain injury

Sustaining attention under conditions of low external demand taxes our ability to stay on task and to avoid more appealing trains of thought or environmental distractions. By contrast, a stimulating, novel environment engages attention far more freely without the subjective feeling of having to override monotony. Our ability to maintain a goal-directed focus without support from the environment requires the endogenous control of behaviour. This control can be modulated by fronto-parietal circuits and this ability is compromised following traumatic brain injury (TBI) leading to increased lapses of attention. In this paper, we further explore a laboratory paradigm that we argue is particularly sensitive to sustained attention as opposed to other aspects of attentional control involving the selection and management of goals in working memory. The paradigm (fixed sequence Sustained Attention to Response Task--SARTfixed) involves withholding a key press to an infrequent no-go target embedded within a predictable sequence of numbers. We demonstrate that TBI patients in this study make disproportionately more errors than controls on this task. An analysis of response times (RTs) and EEG alpha power across the task demonstrates group differences preceding the critical no-go trial. Controls demonstrate a lengthening of RTs accompanied by desynchronization of power within the alpha band (approximately 10 Hz) preceding the no-go trial. Conversely, the TBI group showed a shortening of RTs during this period with no evidence of alpha desynchronization. These findings suggest that TBI patients may have dysfunctional alpha generators as a consequence of their injury that impairs endogenous control during the task.

EEG alpha power changes reflect response inhibition deficits after traumatic brain injury (TBI) in humans

Brain damage due to traumatic brain injury (TBI) has been associated with deficits in executive functions and the dynamic control of behaviour. Event-related brain potentials and spectral power data were recorded from eight TBI participants and eight matched controls while they completed a Go/NoGo response inhibition task. The TBI group was found to be significantly impaired at the task compared to controls, and exhibited abnormal N2 and P3 waveform components in response to NoGo stimuli relative to controls. Significant correlations were also found between alpha power, Go-trial RT and errors. We conclude that abnormal activity in the structures damaged in this group may render such patients less capable of maintaining a state of alpha desynchronisation compared to controls, resulting in poorer performance on the task.

Behavioural and electrophysiological correlates of visuomotor learning during a visual search task

Visuomotor association learning involves learning specific motor responses to arbitrary cues, and is dependent on a distributed and highly flexible network in the brain. We investigated the behavioural and electrophysiological correlates of arbitrary visuomotor learning in 20 normal participants. An experimental group learned an arbitrary association between a visual stimulus and a motor response during a training block. Their performance was compared with that of untrained controls on a subsequent visual discrimination task in which the learned association was a crucial element. Event-related brain potentials (ERPs) were recorded from the scalp of each participant during learning and discrimination blocks. Reaction times to stimuli in the discrimination task were significantly faster in the trained group compared to controls. There was a corresponding difference in the ERP waveforms recorded during the task, with larger P3b amplitude for the trained group over midline and centroparietal scalp areas. A latency difference in P3b was also observed for trained targets compared to distractors. RTs during the training block decreased in a manner consistent with learning effects. We conclude that training of a visuomotor association facilitates subsequent performance on a related task, and that the waveform correlates found here may reflect the involvement of parts of the network underlying arbitrary association mapping.

Dissociable executive functions in the dynamic control of behavior: inhibition, error detection, and correction

The present study employed event-related fMRI and EEG to investigate the biological basis of the cognitive control of behavior. Using a GO/NOGO task optimized to produce response inhibitions, frequent commission errors, and the opportunity for subsequent behavioral correction, we identified distinct cortical areas associated with each of these specific executive processes. Two cortical systems, one involving right prefrontal and parietal areas and the second regions of the cingulate, underlay inhibitory control. The involvement of these two systems was predicated upon the difficulty or urgency of the inhibition and each was employed to different extents by high- and low-absent-minded subjects. Errors were associated with medial activation incorporating the anterior cingulate and pre-SMA while behavioral alteration subsequent to errors was associated with both the anterior cingulate and the left prefrontal cortex. Furthermore, the EEG data demonstrated that successful response inhibition depended upon the timely activation of cortical areas as predicted by race models of response selection. The results highlight how higher cognitive functions responsible for behavioral control can result from the dynamic interplay of distinct cortical systems.