Visual and verbal learning in a genetic metabolic disorder

Two experiments examined dose-related effects of 200, 400 and 600 micrograms scopolamine (n = 24, s.c.) and 5 and 10 mg diazepam (n = 6, PO) on parallel tests of visual memory and learning taken from the CANTAB battery. Scopolamine significantly impaired accuracy of performance on a delayed matching to sample test of visual recognition memory in a dose- and delay-dependent manner, but had only marginal decremental effects on a test of visuospatial paired associates learning. Scopolamine significantly lengthened decision times in a visual search matching to sample task at the 400 and 600 micrograms doses, without significantly affecting accuracy. The drug also impaired performance on tests of spatial (on accuracy and response time measures) and pattern (on response time only) memory. Most of the deleterious effects on scopolamine were removed by covariance analyses with indices of subjective sedation, but the effects of delayed matching accuracy and latency remained. By contrast, diazepam significantly impaired paired associates learning but affected delayed matching to sample in a delay-independent manner. These results suggest that scopolamine can produce selective deficits in tests of short-term visual recognition memory which do not depend on overall impairments in arousal and which contrast with deficits in visual associative learning produced by diazepam. They have implications for the pharmacological modelling of dementia and memory disorders in man and for the neurochemical substrates of the short-term recognition memory and associative learning for visual stimuli.

Aim of the study To explore differences in working memory and learning between individuals with deficit schizophrenia (DS), non-deficit schizophrenia (NDS), and healthy controls (HC), and to assess whether working memory mediates the relationship between negative symptoms and learning in schizophrenia. Subject or material and methods Twenty‑nine DS patients, 45 NDS patients, and 39 HC were assessed. Working memory and learning were measured using the Letter-Number Span Test, Spatial Span Subtest, Hopkins Verbal Learning Test – Revised, and Brief Visuospatial Memory Test – Revised. Psychopathological symptoms were evaluated with the Positive and Negative Syndrome Scale, Brief Negative Symptom Scale, and Self‑evaluation of Negative Symptoms. Results DS patients scored lower on all working memory and learning measures compared with their NDS counterparts and HC. Despite similar learning profiles, DS patients exhibited significantly reduced performance. The mediation model showed good fit indices, suggesting that verbal and visual working memory significantly mediate the relationships between negative symptoms and both verbal and visual learning in patients with schizophrenia. Discussion Patients with DS exhibit impairments in both verbal and visual working memory and learning. Nonetheless, the capacity for new learning is preserved, albeit to a reduced degree. These findings suggest working memory’s role as a neurocognitive mechanism linking negative symptoms to learning deficits in schizophrenia. Conclusions Cognitive remediation programs for schizophrenia should incorporate tasks aimed at enhancing working memory.

BackgroundClassical literature has pointed at lateralization of the relationship between memory scores and cerebral hemisphere injury. Epilepsy studies have suggested an association between left hippocampal damage and verbal memory deficits, and between right hippocampal damage and visual memory deficits. We aimed to explore this concept in the context of tauopathy due to Alzheimer’s disease.Methodwe assessed 132 cognitively unimpaired (CU) older adults, and 44 cognitively impaired (CI), amyloid‐β positive individuals from the Translational Biomarkers in Aging and Dementia (TRIAD) cohort. All participants had amyloid‐PET with [18F]AZD4694 and tau‐PET with [18F]MK6240, verbal memory assessments with Rey Auditory Verbal Learning Test (RAVLT), and visual memory assessments with Aggie Figures Learning Test (AFLT). We conducted voxel‐wise analyses to explore the relationship between tau PET and memory modality. In addition, we run regression models with right or left tau temporal metaROI as predictor and memory scores as outcome variables. We entered global amyloid (PET), sex, age, years of education, ApoE status, grey matter volume and handedness as covariates. Finally, we used the laterality index (LI) to investigate correlations with memory modality. Right laterality is indicated by an LI below 0, while left laterality would be signaled by an LI above 0.Resultvoxel‐wise analyses suggested a lateralized relationship between tau and visual memory scores on the right hemisphere, whereas tau and verbal memory scores were bilaterally associated. Regression analyses showed a trend towards a stronger relationship between temporal tau on the right and visual memory scores. The LI was significantly associated with visual memory performance. Further analyses showed that this relationship seems to be driven by tau positive individuals.Conclusionvisual memory performance might be more prominently affected by tau load on the right hemisphere in Alzheimer’s disease. Furthermore, a hemispheric imbalance in the amount of tau is related to visual, but not verbal, memory scores.

P.2.d.008 - Are theory of mind impairments a trait marker of bipolar disorder?

ABSTRACTIntroduction: Intrusions on verbal memory tests have been used as an index for clinical confabulation. Severe memory impairments in combination with executive dysfunction have been suggested to be the underlying mechanism of confabulation, but to date, this relation is unclear. The aim of this study was (a) to examine the relation between (different types of) intrusions and confabulations in a large sample of confabulating patients with Korsakoff’s syndrome (KS) and (b) to investigate whether different measures of executive functioning and memory performance are related to provoked and spontaneous confabulation. Method: The Dutch version of the California Verbal Learning Test (CVLT) and various executive function and memory tests were administered to a group of 51 confabulating patients with KS. Professional caregivers rated the severity of provoked and spontaneous confabulation behavior of the patients using the Nijmegen–Venray Confabulation List–20 (NVCL–20). Results: The total number of intrusions on the CVLT was not related to either provoked or spontaneous confabulation scores. None of the CVLT intrusion scores correlated significantly with any of the confabulation scores, but we did find small-to-medium, positive correlations between unrelated intrusions and both provoked confabulations and spontaneous confabulation. Provoked confabulation behavior was associated with executive dysfunction and poorer memory performances. Spontaneous confabulation was not related to performance on measures of executive function and memory. Conclusions: The total number of intrusions on verbal memory tests and clinical confabulations appear to be different phenomena. Only unrelated intrusions produced on the CVLT might possibly be related to confabulations. The production of provoked, but not spontaneous, confabulation is associated with executive dysfunction and memory deficits.

Visual learning and memory as functions of age

Deficits in memory have been suggested as an influential mechanism of anhedonia, because while pleasant experiences may be enjoyed in-the-moment, the cognitive processes involved in reporting anticipated or remembered enjoyable experiences is thought to be impaired. This study will determine whether any aspects of memory, including visual memory, verbal memory or working memory, are significantly predictive of anhedonia in a sample of schizophrenia, psychotic bipolar disorder and healthy controls. The study included 38 individuals with schizophrenia, 19 individuals with bipolar disorder with psychosis, and 43 age-matched healthy controls. All participants completed a self-report social and physical anhedonia questionnaire along with a cognitive screening battery, which assessed the domains of attention/vigilance, working memory, verbal learning, visual learning, and reasoning and problem-solving. Anhedonia scores were regressed onto domain scores to determine which areas of cognition uniquely predicted level of anhedonia in each group. For the schizophrenia group, physical anhedonia was significantly predicted by worse visual memory performance. The regression models did not find significant cognitive predictors of physical or social anhedonia in the bipolar disorder or control groups. This study found a significant relationship between visual memory and physical anhedonia in schizophrenia patients that was not present in a sample of psychotic bipolar patients or healthy controls, adding to an accumulating body of evidence that visual memory is related to anhedonia in schizophrenia. This relationship may be explained by underlying abnormalities in the orbitofrontal cortex in schizophrenia.

BackgroundThough cognitive remediation has shown modest benefits for schizophrenia, relatively few training programs for have targeted the visual processing deficits common in the illness. Residual visual processing deficits following cognitive remediation may explain why cognitive remediation has had limited effects on visual learning and memory compared to auditory learning and memory. We sought to test whether training early visual processing would improve visual memory and facial affect recognition by targeting a well-characterized visual deficit in schizophrenia: visual backward masking (VBM). The deficit is so common in schizophrenia, and in non-affected family members to a lesser degree, that it is viewed as an endophenotype. The VBM deficit, however, can normalize as we have previously shown. In our prior open-label pilot study, individuals with schizophrenia (Surti and Wexler, 2012) made substantial gains in VBM performance with rudimentary computerized VBM training. The VBM improvements were also accompanied by improvements in visual memory.To test the hypothesis that improved early sensory training could lead to other cognitive gains in the same domain, we conducted a randomized control study with a new, more sophisticated computerized VBM training program, and compared it to an active control condition. We expected that visual memory and facial affect recognition would improve with the novel visual training (VT), and that VBM would improve with the VT as well.Methods23 individuals with stable schizophrenia or schizoaffective disorder were randomized to receive 20 sessions of VT or an active control. The VT consisted of VBM training with multiple levels of difficulty, adaptive tracking, virtual rewards, and a variety of letters, numbers, and shapes to train different areas of the visual field. The active control condition was a commercially available computerized typing tutorial (TT) with animation, game narrative, and multiple typing activities. Participants were tested before and after training with: the Matrics Cognitive Consensus Battery (MCCB), including the Brief Visuospatial Memory Test-Revised (BVMT) as the study’s primary outcome; the Profile of Nonverbal Sensitivity (mini-PONS) to assess non-verbal social cues; standardized VBM tests; and typing assessments. Repeated measure ANOVAs were conducted in SPSS24 after checking for normality.Results22 of 23 individuals completed the study, and by participants’ reports, both interventions were well tolerated, equally enjoyable and equally motivating, though the VT was slightly more frustrating for participants. Even when co-varying for education, which was higher in the VT group, there were no condition by time interactions for the BVMT, the mini-PONS, overall MCCB, or typing ability. There was a significant condition by time interactions for VBM performance (F = 5.8, p =0.028), with a substantial improvement in the VT group (Cohen’s d = 0.54; p=0.004).DiscussionPatients with schizophrenia equally tolerated a computerized visual training designed in-house and an off-the shelf highly gamified control training, but only the visual training, specifically designed for individuals with schizophrenia, had effects on the trained task. The effects of the visual training did not generalize to visual memory, facial affect recognition, or global cognition, so further work is needed to facilitate generalization.

ObjectiveCognitive problems, especially disturbances in episodic memory, and hippocampal sclerosis are common in temporal lobe epilepsy (TLE), but little is known about the relationship of hippocampal morphology with memory. We aimed to relate hippocampal surface‐shape patterns to verbal and visual learning.MethodsWe analyzed hippocampal surface shapes on high‐resolution magnetic resonance images and the Adult Memory and Information Processing Battery in 145 unilateral refractory TLE patients undergoing epilepsy surgery, a validation set of 55 unilateral refractory TLE patients, and 39 age‐ and sex‐matched healthy volunteers.ResultsBoth left TLE (LTLE) and right TLE (RTLE) patients had lower verbal (LTLE 44 ± 11; RTLE 45 ± 10) and visual learning (LTLE 34 ± 8, RTLE 30 ± 8) scores than healthy controls (verbal 58 ± 8, visual 39 ± 6; p < 0.001). Verbal learning was more impaired the greater the atrophy of the left superolateral hippocampal head. In contrast, visual memory was worse with greater bilateral inferomedial hippocampal atrophy. Postsurgical verbal memory decline was more common in LTLE than in RTLE (reliable change index in LTLE 27% vs RTLE 7%, p = 0.006), whereas there were no differences in postsurgical visual memory decline between those groups. Preoperative atrophy of the left hippocampal tail predicted postsurgical verbal memory decline.InterpretationMemory deficits in TLE are associated with specific morphological alterations of the hippocampus, which could help stratify TLE patients into those at high versus low risk of presurgical or postsurgical memory deficits. This knowledge could improve planning and prognosis of selective epilepsy surgery and neuropsychological counseling in TLE. ANN NEUROL 2020 ANN NEUROL 2020;88:170–182

Visual memory deficits following cortical and limbic lesions: effect of field of presentation

BackgroundsDigital, online assessments are efficient means to detect early cognitive decline, but few studies have investigated the relationship between remotely collected subjective cognitive change and cognitive decline. We hypothesized that the Everyday Cognition Scale (ECog), a subjective change measure, predicts longitudinal change in cognition in the Brain Health Registry (BHR), an online registry for neuroscience research.MethodsThis study included BHR participants aged 55 + who completed both the baseline ECog and repeated administrations of the CANTAB® Paired Associates Learning (PAL) visual learning and memory test. Both self-reported ECog (Self-ECog) and study partner-reported ECog (SP-ECog), and two PAL scores (first attempt memory score [FAMS] and total errors adjusted [TEA]) were assessed. We estimated associations between multiple ECog scoring outputs (ECog positive [same or above cut-off score], ECog consistent [report of consistent decline in any item], and total score) and longitudinal change in PAL. Additionally we assessed the ability of ECog to identify ‘decliners’, who exhibited the worst PAL progression slopes corresponding to the fifth percentile and below.ResultsParticipants (n = 16,683) had an average age of 69.07 ± 7.34, 72.04% were female, and had an average of 16.66 ± 2.26 years of education. They were followed for an average of 2.52 ± 1.63 visits over a period of 11.49 ± 11.53 months. Both Self-ECog positive (estimate = -0.01, p < 0.001, R²m = 0.56) and Self-ECog consistent (estimate=-0.01, p = 0.002, R²m = 0.56) were associated with longitudinal change in PAL FAMS after adjusting demographics and clinical confounders. Those who were Self-ECog total (Odds ratio [95% confidence interval] = 1.390 [1.121–1.708]) and SP-ECog consistent (2.417 [1.591–3.655]) had higher probability of being decliners based on PAL FAMS.ConclusionIn the BHR’s unsupervised online setting, baseline subjective change was feasible in predicting longitudinal decline in neuropsychological tests. Online, self-administered measures of subjective cognitive change might have a potential to predict objective subjective change and identify individuals with cognitive impairments.

Neurobehavioral Performance in Multiple Chemical Sensitivities

Learning and memory deficits are commonly reported in children with heavy prenatal alcohol exposure. Our recent work suggested that children with heavy prenatal alcohol exposure retained information as well as controls on a verbal learning test but not on a test of nonverbal learning and memory. To better understand the cause of this differential pattern of performance, the current study re-analyzed data from our previous study to determine if the presence of an implicit learning strategy may account, at least in part, for the finding of spared retention. The current study examined verbal learning and memory abilities in 35 children with Fetal Alcohol Spectrum Disorders (FASD) and 34 nonexposed controls (CON) matched for age (9-16 years), sex, ethnicity, handedness, and socioeconomic status. Groups were compared on two measures of verbal learning, one with an implicit strategy (California Verbal Learning Test-Children's Version; CVLT-C) and one without (Verbal Learning subtest of the Wide Range Assessment of Memory and Learning; VL-WRAML). Children with FASD learned less information overall than children in the CON group. Both groups learned a greater percentage of information and reached a learning plateau earlier on the CVLT-C compared with the VL-WRAML. Groups also showed comparable rates of retention after a delay on the CVLT-C. In contrast, on the VL-WRAML, children with FASD showed poorer retention rates than children in the CON group. Interestingly, children with FASD did not differ from children in the CON group on CVLT-C semantic clustering scores for learning trials 1 through 3, and greater utilization of semantic clustering was correlated with better learning and memory performance in both groups. This overall pattern of results was not related to overall intellectual level. The finding of spared retention of verbal information on the CVLT-C in our earlier studies may be related to test characteristics of the CVLT-C rather than a finding of spared verbal retention per se, given that spared retention was not found on a separate test of verbal learning and memory without an implicit learning strategy. These results suggest that the use of an implicit strategy positively affected the ability of alcohol-exposed children to learn and retain new verbal information.

SUMMARYThe principal study objective was to define whether memory deficits (numerical, working, verbal-mechanical, verbal-logical and visual memory) occurred in patients submitted to surgery for brain artery aneurysm and whether significant recovery of memory took place with time. The study sample included 92 patients, i.e. 35 (38%) male and 57 (62%) female patients aged 27 to 76 years. Neuropsychological testing was conducted at Zagreb University Hospital Centre, Department of Neurosurgery, from 1998 to 2012, in two time intervals: first within 11 months following surgery, and then 12 to 48 months after surgery. The obtained results showed that verbal-mechanical, verbal-logical, and visual memory deficits were present in the first testing interval. In the second testing, the verbal-logical and visual memory deficits were still present, while the tests of verbal-mechanical memory showed deficits in capacity and learning curve, but the results for short- and long-term memory were within the normal ranges. Neither the first nor the second testing showed deficits of numerical and working memory. Based on our results, we can conclude that long-term verbal-mechanical and visual short- and long-term memory had recovered to a statistically significant level, whereas other types of memory showed no significant recovery.

<b>Purpose: </b>The study aimed to test a combination of semantic memory and traditional episodic memory therapies on episodic memory deficits in adults with traumatic brain injury.<b>Method: </b>Twenty-five participants who had been diagnosed with traumatic brain injury and had episodic memory deficits were randomly assigned either to a combined memory treatment group (<i>n</i> = 16) or to a wait-list control group (<i>n</i> = 9). Before and after treatment, they completed standardized neuropsychological testing for episodic memory and related cognitive domains, including the California Verbal Learning Test–Second Edition, the Controlled Oral Word Association Test, the University of Southern California Repeatable Episodic Memory Test, the Wechsler Abbreviated Scale of Intelligence–Second Edition Matrices, the Test of Everyday Attention, the Memory Assessment Clinics Self-Rating Scale, the Expressive Vocabulary Test–Second Edition, and the Story Recall subtest from the Rivermead Behavioural Memory Test. In addition to a traditional episodic memory therapy, the treatment group received a novel semantic memory–focused therapy, which involved participants finding meaningful connections between diverse concepts represented by sets of two or three words.<b>Results:</b> The treatment group demonstrated statistically significant improvement in memory for list learning tasks, and there was a significant difference from pretest to posttest between the treatment group and the wait-list control group. Clinical significance was demonstrated for the treatment group using minimally important difference calculations.<b>Conclusion: </b>Combined memory therapy resulted in significant improvements in episodic memory, semantic memory, and attention, in comparison to no treatment.<b><br></b><b>Supplemental Material S1. </b>Time-ordered session treatment plan.<br>D'Angelo, E. C., Ober, B. A., &amp; Shenaut, G. K. (2021). Combined memory training: An approach for episodic memory deficits in traumatic brain injury.<i> American Journal of Speech-Language Pathology</i>. Advance online publication. https://doi.org/10.1044/2020_AJSLP-20-00075<br><b>Publisher Note: </b>This article is part of the Special Issue: Select Papers From the International Cognitive-Communication Disorders Conference.<br>