ADHD Endophenotypes in Caribbean Families

A person who has suffered the total loss of a sensory system has, indirectly, suffered a brain lesion. Semantic and phonologic verbal fluency are used for evaluation of executive function and language. The aim of this study is evaluation and comparison of phonemic and semantic verbal fluency in acquired blinds. We compare 137 blinds and 124 sighted people in verbal fluency task. The tasks were phonemic and semantic verbal fluency test that subjects should be generate as many word as possible in a limited amount of time for a given letter (Phonemic fluency) or a given category (Semantic fluency). Independent T Test was used to comparing blind with sighted. Findings show significant difference between two groups so that that sighted subjects have higher performance in semantic verbal fluency task (p = 0.000). Comparing sighted and blind subjects in phonemic verbal fluency task shows performance in sighted subjects (p = 0.000). Based on this study blinds have lower performance in semantic and phonemic verbal fluency task as a executive function of frontal lobe.

Changes of cognitive function in PD have been extensively documented and defined as a ‘frontal’ type executive dysfunction. One of the main components of this executive dysfunction is the impairment of verbal fluency. The aim of the present study was to assess semantic and phonemic fluency in a large sample of PD patients and to investigate the effect of clinical and sociodemographic variables on verbal fluency in this patient group.Three hundred patients with idiopathic Parkinson's disease who were consecutive referrals to our clinic and 50 age and education matched healthy controls completed the phonemic and semantic verbal fluency tasks. Both phonemic and semantic verbal fluency were significantly impaired in PD patients relative to matched controls. Stage of illness, presence of depression, education and age influenced verbal fluency measures. Regression analyses established that global measures of cognitive ability (MMSE) and executive function (FAB) and side of onset of motor symptoms predicted 36–37% of variance of phonemic or semantic verbal fluency measures. Thus, future studies aimed at assessing cognitive functioning in PD patients treated by deep brain stimulation (DBS) should adequately take into account several factors (stage of illness, depression, executive functioning) which may potentially influence performance on verbal fluency tasks.

The left inferior frontal gyrus (LIFG) has consistently been associated with both phonologic and semantic operations in functional neuroimaging studies. Two main theories have proposed a different functional organization in the LIFG for these processes. One theory suggests an anatomic parcellation of phonologic and semantic operations within the LIFG. An alternative theory proposes that both processes are encompassed within a supramodal executive function in a single region in the LIFG. To test these theories, we carried out a systematic review of functional magnetic resonance imaging studies employing phonologic and semantic verbal fluency tasks. Seventeen articles meeting our pre-established criteria were found, consisting of 22 relevant experiments with 197 healthy subjects and a total of 41 peak activations in the LIFG. We determined 95% confidence intervals of the mean location (x, y, and z coordinates) of peaks of blood oxygenation level-dependent (BOLD) responses from published phonologic and semantic verbal fluency studies using the nonparametric technique of bootstrap analysis. Significant differences were revealed in dorsal-ventral (z-coordinate) localizations of the peak BOLD response: phonologic verbal fluency peak BOLD response was significantly more dorsal to the peak associated with semantic verbal fluency (confidence interval of difference: 1.9-17.4 mm). No significant differences were evident in antero-posterior (x-coordinate) or medial-lateral (y-coordinate) positions. The results support distinct dorsal-ventral locations for phonologic and semantic processes within the LIFG. Current limitations to meta-analytic integration of published functional neuroimaging studies are discussed.

Objective:Semantic verbal fluency (SVF) has traditionally been correlated with activity in the left anterior temporal lobe. Damage to the anterior temporal lobe, such as from a traumatic brain injury (TBI) or neurodegenerative disease, can result in impairments in semantic fluency and language expression. Although the orbitofrontal cortex (OFC) is not well studied as being correlated to this process, its functional connectivity to language-related brain regions, such as the inferior frontal gyrus (Broca’s area), suggests it may also play a role in SVF. In fact, preliminary research has shown that lesions in the OFC are associated with semantic fluency deficits (Almairac et al. 2015). As such, the goal of this study was to investigate whether OFC volume correlates with SVF in a population of Veterans with a prior TBI.Participants and Methods:Thirty-five Veterans who sustained TBIs were included in this study (11% female, age M = 41.77, SD = 11.27; years of education M =14.94, SD = 1.62). All participants underwent a magnetic resonance imaging (MRI) and regional normative volumes were standardized to account for differences in brain size (volume of brain area/total brain volume). Participants were given the Delis Kaplan Executive Function System (D-KEFS) verbal fluency subtest to measure verbal generativity. A Pearson correlation was conducted to investigate the relationship between OFC volume and SVF performance. Post hoc analysis was conducted with Veterans who met the criteria for a TBI sustained by a blast to the head (n = 25).Results:A significant positive correlation emerged between left OFC volume and semantic fluency (category subtest; p = .03, r = .35). Additional analyses with Veterans with blast-related TBIs indicated a significant correlation between the volume of the OFC and performance on the category (p = .02, r = .45), and switching (p = .02, r = .43) subtests of the D-KEFS verbal fluency test.Conclusions:These findings demonstrate a correlation between the volume of the left OFC and SVF performance. Specifically, Veterans with TBIs had decreased volume of the OFC which correlated with deficits on a SVF task. Among Veterans with blast-related TBIs, both category and category switching subtests correlated with OFC volume. Given the functional connectivity between the OFC and language areas of the brain, this study highlights the importance of analyzing associated cortical regions beyond the anterior temporal lobe when studying SVF performance.

Sex differences in lateralization of semantic verbal fluency in temporal lobe epilepsy

Verbal Fluency Tasks: Influence of Age, Gender, and Education and Normative Data for the Spanish Native Adult Population.

In Alzheimer’s dementia (AD), greater declines in semantic fluency (SF) relative to letter fluency (LF) have been assumed to reflect semantic disintegration. However, the same pattern is observed in typical aging and neurodegenerative disorders besides AD. We examined this assumption by comparing different aspects of SF and LF performance in older adults with and without dementia, and identifying which verbal fluency measures most clearly distinguish AD from typical aging. Verbal fluency data were compared from 109 individuals with AD and 66 typically aging adults. Correct items, clusters, and errors were analyzed using both raw counts and proportions. Regression analyses examined Task-by-Group interactions and the impact of demographic variables on verbal fluency measures. ROC analyses examined the sensitivity and specificity of the different outcome measures. In regressions, interactions were found for raw but not proportional data, indicating that different group patterns were driven largely by the number of correct items produced. Similarly, in ROC analyses, raw SF totals showed stronger discriminability between groups than either raw discrepancy scores (SF–LF) or discrepancy ratios (SF/LF). Age and cognitive status (MMSE) were the strongest individual predictors of performance. Findings suggest that AD entails quantitative declines in verbal fluency, but qualitatively similar patterns of performance relative to typically aging adults. Thus, SF declines in AD seem to be at least partially attributable to an exaggeration of the underlying mechanisms common to typical aging, and do not necessarily implicate semantic disintegration.

Background/Aims: Fampridine is sometimes reported to improve cognition and especially the information-processing speed. Motor improvement might be a confounding factor. The aim of this study was to evaluate the effects of fampridine on verbal fluencies in patients with multiple sclerosis (MS). Methods: Fifty MS patients were included in a prospective monocentric open label trial with a mean Expanded Disability Status Scale of 5.3 ± 1.1. Assessments of verbal phonological and semantic fluencies were repeated twice (within 1 week) before fampridine treatment and twice after fampridine treatment in order to have the maximal practice effect. Gait velocity and fatigue (visual analogical scale) were also assessed. Distribution into gait responders, gait non-responders, fluency responders and fluency non-responders, was described. Results: Verbal fluencies were significantly higher after fampridine treatment. No correlation was observed between phonological fluency improvement and semantic fluency improvement. Gait responders and gait non-responders did not present significant differences in verbal fluency performance and fatigue score. No correlation between gait velocity improvement and fatigue improvement compared with verbal fluency improvement was observed. Conclusion: Our results suggest that fampridine could have a selective procognitive effect on phonological fluency in MS, even in the gait non-responder patients.

Numerous variants of verbal fluency tasks exist within clinical and research domains that purport to measure “executive function.” However, to date, there has been a paucity of research examining what specific abilities are measured by these tasks. In this study, the relationships between a select group of cognitive constructs and phonemic, semantic, alternating, and excluded-letter verbal fluency tests were examined in 93 young healthy individuals (aged 18 to 35 years old). Forward-selection multiple regression analyses were performed for each fluency task. Phonemic fluency was associated with verbal intellectual function and processing speed; semantic fluency was associated with working memory and semantic word retrieval; excluded-letter fluency was associated with processing speed; and alternating fluency was associated with semantic word retrieval. These results highlight verbal intellectual function, processing speed, and semantic word-retrieval contributions to verbal fluency performances. The main conclusion from this study is that the abilities associated with verbal fluency performance in a young healthy population are multifactorial and differ across fluency variants. These findings progress our theoretical understanding of what is measured by different verbal fluency tasks and will assist interpretation of performance.

P03-121 - Verbal fluency improves significantly after cognitive remediation in first episode psychosis

ABSTRACTPurposeThe aim of this study is to analyze and compare the performance and strategies used by control subjects and patients with unilateral brain damage on phonemic and semantic Verbal Fluency tasks.MethodsThe sample consisted of 104 participants divided into four groups (26 with left hemisphere damage and aphasia- LHDa, 28 with left hemisphere damage and no aphasia- LHDna, 25 with right hemisphere damage- RHD and 25 neurologically healthy control subjects). All participants were administered the phonemic (“M” letter-based) and semantic (animals) verbal fluency tasks from the Montreal-Toulouse Language Assessment Battery (MTL-BR).ResultsPatients in the LHDa group showed the worst performance (fewer words produced, fewer clusters and switches) in both types of fluency task. RHD group showed fewer switching productions when compared with controls and LHDna had fewer words productions than controls in the first 30 seconds block.ConclusionOur findings suggest that the LHDa group obtained lower scores in most measures of SVF and PVF when compared to the other groups.

ABSTRACTBackground:Performance on the verb fluency (VF) task may be influenced by administration procedures and demographic factors of each population. Objective:The aim of this study was to verify whether the previous administration of semantic and phonemic verbal fluency tasks can influence performance on VF; and to analyze the correlation of VF performance with education, age and type of errors in Brazilian healthy elderly. Methods:Sixty-two participants were subdivided into experimental (semantic and the phonemic fluency tasks were administered before the VF) and control groups (VF only). The total score and the types of errors on the VF task were determined. Additional information was computed for the correlational analysis. Results:VF performance did not differ statistically between experimental and control groups, but correlated positively with education and negatively with intrusions. Conclusion:The lack of influence of other verbal fluency tasks on performance of the VF task in elderly individuals allows the use of this order of administration. A strong influence of educational level on VF task performance reinforces the need for further studies in different populations.

Using semantic verbal fluency to estimate the relative and absolute vocabulary size of bilinguals: An exploratory study of children and adolescents

BackgroundVerbal Fluency Tests measure the ability to produce words in a given time. Semantic fluency (SF) is related to the production of words within a category and phonological fluency (PF) with words that start with the same letter1. These tests are frequently used in the standard neuropsychological evaluation. Age, education2,3 and the order of administration4,5 can affect the performance. This study aims to evaluate the impact in the order of administration on verbal fluences performance in spanish.MethodCross‐sectional analytical study.52 healthy adults participated in this study. Participants were divided into two groups (G1 and G2) matched by age (M 64.48 DS 9.37), education (M 13.21 SD 4.65), gender (F: 31 M: 17) and estimated CI level based on years of education and their performance on a word accentuation test (WAT‐R)6. In G1 it was applied first SF and later PF. In G2 the order of presentation was inverted. T test and Pearson correlations were calculated in SPSS statistical program.ResultTwo outliers were found in G1. Taking out outliers and their matches, no significant effect in the order of application was observed when comparing both groups in the SF (t= 888 p = .379) and PF (t = ‐1.510 p = .138). When analyzing whether the order of fluencies administration varied the performance in G1 and G2, no differences were found for gender but a correlation with education was observed (SF: r = .30 p = .037; PF: r = .60 p <.001) and age (SF: r = .40 p = .005; PF r = .32 p = .027). When making a more detailed analysis of the groups, significant effect was observed for the years of education and FP (p = .002): the group with less than 7 years of schooling differed from groups from 8 to 12 (p =. 012) and more than 12 years of schooling (p =. 003).ConclusionThe results suggest that the performance in verbal fluences of older adults may be influenced by normal aging and years of education. This must be taken into account when choosing standards and interpreting the results of neuropsychological tests.

BackgroundNumerous studies have noted the presence of a dysexecutive component of the ALS-FTD. The most widely replicated result refers to the significantly reduced verbal fluency of ALS patients when compared to healthy people. As ALS patients have motor alterations that interfere with production, qualitative studies have the advantage of being independent of the degree of motor disability and revealing patients’ cognitive state. This study examined the production differences between 42 ALS patients who presented with different degrees of dementia and motor impairment and 42 healthy people. Production processes were studied by extending the administration time of a letter fluency task to 2 minutes for the phonemic verbal fluency (PVF) and semantic verbal fluency (SVF) categories. This ensured that the qualitative aspects of verbal fluency were addressed, paying special attention to the new perseverations and intrusions, as well as any clinical correlates that may exist.ResultsThe ALS patients produced a significantly lower number of responses in PVF (p = .017) and SVF (p = .008). The rest of the indicators for frontal lobe alteration also suggested the existence of a dysfunction. The most remarkable results were the number of intrusions on the PVF task, which was much higher in the ALS group (p = .002). However, the number of perseverations did not differ significantly.ConclusionsThis study highlights the value of intrusions in addressing cognitive deterioration in ALS patients. This deterioration seems to be independent of the degree of motor impairment and of behavioural alterations. Therefore, the value of the intromissions on the verbal fluency task was highlighted as an indicator of a new cognitive alteration, which can be easily evaluated, even retrospectively.