Alterations in episodic memory in patients with systemic lupus erythematosus.

The purpose of this paper was to examine memory performance in patients with SLE by studying the overall deterioration in memory, analyzing the differences and frequency of impairment in the variables from the visual and verbal memory tests, and studying the alterations in the memory. This study included 59 patients with a diagnosis of systemic lupus erythematosus (SLE) and 18 with a diagnosis of chronic discoid lupus (CDL), who were administered the Spanish complutense verbal learning test (TAVEC) and the Rey complex figure test (RCFT). Statistically significant differences were detected between the two groups on the immediate visual recall and delayed visual recall variables, with the mean of the SLE group being lower than that of the CDL group. The difference between the frequency of verbal and visual impairment could be explained by various factors, one of which would be a lateralization of memory impairment.     

Memory encoding and retrieval in frontotemporal dementia and Alzheimer's disease

Memory encoding and retrieval strategies were assessed in patients with behavior-executive variant frontotemporal dementia (FTD), language variant FTD, and Alzheimer's disease (AD) using verbal and visuospatial supraspan learning tests. FTD patients obtained higher free recall, cued recall, and recognition scores than AD patients. Comparison of free recall scores with cued recall and recognition scores was similar in the 3 dementia groups. Groups did not differ in semantic clustering strategies during learning, but serial-order recall was more common in FTD patients. These data do not support the idea that FTD patients' poor memory is due to a selective retrieval disorder, though FTD patients may fail to implement sophisticated organizational strategies during learning. FTD patients' retained capacity for encoding new information into long-term declarative memory is likely due to relatively spared medial temporal lobe involvement.     

Performance of alcoholic and brain-damaged subjects on the Luria memory words test

Verbal memory was evaluated in groups of 36 community controls, 50 pseudoneurological controls, 50 alcoholics, and 50 brain-damaged patients. All participants were men between the ages of 22-61. Groups did not differ in age or educational levels (F < 1). Groups were compared on their performance on the Luria Memory Words Test. Dependent variables included the number of correct words over learning trials, the trial of best performance, and the number of words recalled at three delayed trials (2, 8, and 30 min after learning). Brain-damaged subjects were inferior to community controls on all measures. Pseudoneurological controls were inferior to community controls on delayed recall, but were equivalent on measures of learning. Alcoholics were inferior to controls on measures of learning but did not differ on measures of recall. Implications regarding the underlying deficit in alcoholics' verbal memory, the use and interpretation of the Luria Memory Words test, and the use of pseudoneurological patients as controls are discussed.     

Cognitive functioning in depression

Verbal learning and memory, and recognition of famous faces, were assessed in 21 non-demented inpatients with RDC endogenous depression. Severity of depression was related to attention span, and patient age was related to measures of learning and recall. However, even in this severely depressed sample, verbal learning/memory measures were not below normative values. Facial recognition was significantly impaired relative to test norms. The results suggest that mild impairment in the early stages of verbal information encoding, and more marked impairment in the recognition of famous faces, may be associated with depression. These impairments differ from the cognitive changes associated with aging.     

Amnestic mild cognitive impairment: difference of memory profile in subjects who converted or did not convert to Alzheimer's disease

Episodic long-term, short-term, and implicit memory were investigated in 79 elderly subjects who fulfilled criteria for the amnestic form of mild cognitive impairment (a-MCI; i.e., by having an idiopathic amnestic disorder with absence of impairment in cognitive areas other than memory and without confounding medical or psychiatric conditions) and who developed Alzheimer's disease (AD) after 2 years as well as in 111 subjects affected by a-MCI who did not develop dementia. Results document a memory profile in a-MCI subjects characterized by preserved short-term and implicit memory and extensive impairment of episodic long-term memory. In virtually all episodic memory indexes examined (learning, forgetting, recognition abilities), a-MCI subjects who converted to AD were more severely impaired than were subjects who did not become demented. This memory profile, which closely resembles that exhibited by amnestic patients with bilateral mesial-temporal lobe lesions, confirms a precocious phase in preclinical AD characterized by selective involvement of mesial-temporal areas and worsening of the memory impairment as atrophic changes progress in hippocampal structures. In this context of pervasive episodic memory impairment, tests assessing the free recall of verbal material following a delay interval demonstrated the greater sensitivity to memory deficits of a-MCI subjects who developed AD.     

Impact of peripheral glucoregulation on memory

Impaired glucoregulation is associated with neuropsychological deficits, particularly for tests that measure verbal declarative memory performance in older diabetic patients. The performances of 74 undergraduate students (mean age = 21 years) on several verbal declarative measures, including immediate and delayed paragraph recall, verbal free recall, and order reconstruction tasks, were correlated with glucoregulatory indices. The indices were obtained from glucose and insulin levels after a 75-g glucose load. In general, higher blood glucose levels were associated with poorer performance on all memory tests. Glucose ingestion did not interact with performance except on the most difficult task. Subjects with poorer glucoregulation showed higher evoked glucose and insulin, suggestive of a mild glucose intolerance accompanied by mild insulin insensitivity. Results suggest that poor peripheral glucoregulation has an impact on central nervous system functions.     

听觉词语学习测验的社区老人常模

目的:编制汉语的听觉词语学习测验(AVLT)在社区老人中的常模。方法:对上海城区360名55岁至85岁、初中及以上教育程度的健康老人完成AVLT、简明精神状态量表(MMSE)、词语阅读能力、执行功能测验及自行编制的一般情况调查表。结果:正常老人有记忆减退感受的占70%;AVLT分析指标与MMSE总分有显著相关性、与记忆自评相关性较低、在躯体疾病中仅与高血压病有显著相关性。70岁和80岁是听觉词语记忆减退的2个转折点;AVLT分析指标与年龄成正相关而与教育程度的相关性较低,根据不同年龄层次制定了短时记忆、延迟回忆和AVLT总分与的划界分。结论:AVLT的社区老人常模将为老年人记忆减退检测提供参照数据。     

成功老龄者听觉词汇学习特征初步研究

目的:探索成功老龄者的记忆特征。方法:采用中国老年成套神经心理测验中听觉词汇学习测验评估65岁以上社区老人421名,其中成功老龄(SA)组230名,常态老龄(UA)组137名,轻度认知损害(MCI)组54名。结果:(1)控制年龄、性别、教育程度后,SA 与MCI、UA 与MCI 组间即刻记忆、延迟回忆保持率、倒摄抑制有显著性差异(P<0.01);但三组间学习效应指数、前摄抑制无显著性差异。(2)对三组间七次回忆正确数进行重复测量协方差分析:SA 与UA 组组别及时间与组别交互作用均无显著性差异,但时间*组别变化趋势有显著性差异(P<0.05)。SA 与MCI、UA 与MCI 比较,组别及时间与组别交互作用、变化趋势均有显著性差异(P<0. 05)。结论:(1)延迟回忆可能是鉴别SA 较敏感的指标。(2)UA、MCI 仍具一定的学习能力,为进行成功老龄化干预提供了相关理论依据。     

Patterns of subjective memory impairment in the elderly: association with memory performance

BACKGROUND: The association of subjective memory impairment (SMI) with cognitive performance in healthy elderly subjects is poor because of confounds such as depression. However, SMI is also a predictor for future dementia. Thus, there is a need to identify subtypes of SMI that are particularly related to inferior memory performance and may represent at-risk stages for cognitive decline.METHOD: A total of 2389 unimpaired subjects were recruited from the German Study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe), as part of the German Competence Network on Dementia. Clusters of SMI according to patterns of response to SMI questions were identified. Gender, age, depressive symptoms, apolipoprotein E (apoE) genotype, delayed recall and verbal fluency were included in a Classification and Regression Tree (CART) analysis to identify discriminators between the clusters. RESULTS: We identified three clusters. Cluster 1 contained subjects without memory complaints. Cluster 2 contained subjects with general memory complaints, but mainly without memory complaints on individual tasks of daily living. Cluster 3 contained subjects with general memory complaints and complaints on individual tasks of daily living. Depressive symptoms, as the first-level discriminator, distinguished between clusters 1 and 2 versus cluster 3. In subjects with only a few depressive symptoms, delayed recall discriminated between cluster 1 versus clusters 2 and 3. CONCLUSIONS: In SMI subjects with only a minor number of depressive symptoms, memory complaints are associated with delayed recall. As delayed recall is a sensitive predictor for future cognitive decline, SMI may be the first manifestation of future dementia in elderly subjects without depression.     

Neuropsychological functioning in HIV-positive African-American women with a history of drug use.

This preliminary investigation examined neuropsychological performance in a sample of human immunodeficiency virus (HIV)-positive and HIV-negative African-American women with a history of drug use. The study population was comprised of 10 HIV-negative, 9 asymptomatic HIV-positive, 13 symptomatic HIV-positive, and 10 acquired immunodeficiency virus (AIDS) patients. A neuropsychological battery designed to assess attention, psychomotor processing, verbal memory, and visual memory was administered to participants. No evidence of HIV-related cognitive impairment was found in patients in the early stages of HIV infection. Multivariate analyses of variance revealed significant deficits in psychomotor processing and verbal recall in persons with AIDS. These individuals showed greater difficulty in tasks requiring maintained attention and performed poorly on measures of immediate and delayed verbal recall. In contrast, HIV status was not related to visual memory, verbal recognition, or the number of errors made during a verbal recall task. The pattern of cognitive deficits observed in persons with AIDS resembles that commonly associated with subcortical pathology. The cognitive deficits observed were not related to depression or recentness of drug use.     

Verbal learning and memory among heterozygous fragile X females.

In this paper we report the results of a brief examination of verbal learning and memory in 20 heterozygous fragile X [fra(X)] positive females and in 2 control groups of 20 subjects each. One control group was composed of fra(X)-negative mothers (obligate carriers) and sisters of male probands with fra(X) syndrome, while the other consisted of 14 head injured and 6 learning disabled females. Intellectual functioning was assessed by means of the Wechsler scales, and learning was assessed by several different clinical memory tests. Significant differences were found between groups on measures of short-term memory and learning efficiency. Groups did not differ on measures of cued recall or delayed recall. The findings are consistent with other data and suggest the possibility that central information processing and/or specific encoding processes are defective in persons with fra(X).     

Reconsidering the Gospel According to Group Studies: A Neuropsychological Case Study Approach to Schizophrenia

Individual patterns of performance on tests of: visual perception, language, executive function, memory, and face-processing, were examined in 10 schizophrenic patients who were preselected for having current WAIS IQ and premorbid NART IQ scores in the normal range. Although the patients showed some heterogeneity in the type, pervasiveness, and degree of cognitive impairment, a majority had severely impaired verbal recall and familiar face-naming. This contrasted with the low incidence and severity of impairment on tests of executive function, visual recall, recognition memory, naming, and unfamiliar faceprocessing. Contrasts between individual patients indicated that verbal recall and executive performance are independent in some patients and that memory appears to be the core deficit. The profile of impaired and preserved cognitive function revealed some important dissimilarities from the pattern that has emerged from group studies. Finally, face-naming correlated highly with the learning of unrelated paired associates, confirming a similarity with neurological patients who have person name anomia. It is suggested that both deficits might reflect a problem with learning ''meaninglessness'' associations; this interpretation is discussed with reference to a deficit at the level of the Supervisory Attentional System (Shallice, 1988).     

The role of the frontal lobes in memory: evidence from unilateral frontal resections for relief of intractable epilepsy.

The current investigation explored processes associated with memory deficits in patients with frontal lobe dysfunction. Specifically, we examined deficits associated with the encoding, consolidation, and retrieval of information in memory in 53 patients who underwent either a unilateral frontal (N=13) or temporal (N=40) lobe resection for relief of intractable epilepsy. Post-surgical memory scores indicated that the frontal group and the temporal group did not differ in consolidation of information, as defined by the information forgotten between immediate and delayed recall. Instead, the temporal group evidenced significantly poorer recall of verbal information at both immediate and delayed recall. This effect was especially strong in the left temporal group for the recall of verbal information. Although no group differences were observed in the degree to which patients semantically organized information or made recency discriminations, the frontal group exhibited significantly weaker release from proactive interference than the temporal group, suggesting some impairment in encoding and retrieval processes associated with frontal lobe dysfunction.     

The effect of response modality on immediate serial recall in dementia of the Alzheimer type

Objective: Contrary to traditional models of verbal short-term memory (STM), psycholinguistic accounts assume that temporary retention of verbal materials is an intrinsic property of word processing. Therefore, memory performance will depend on the nature of the STM tasks, which vary according to the linguistic representations they engage. The aim of this study was to explore the effect of response modality on verbal STM performance in individuals with dementia of the Alzheimer Type (DAT), and its relationship with the patients' word-processing deficits. Method: Twenty individuals with mild DAT and 20 controls were tested on an immediate serial recall (ISR) task using the same items across two response modalities (oral and picture pointing) and completed a detailed language assessment. Results: When scoring of ISR performance was based on item memory regardless of item order, a response modality effect was found for all participants, indicating that they recalled more items with picture pointing than with oral response. However, this effect was less marked in patients than in controls, resulting in an interaction. Interestingly, when recall of both item and order was considered, results indicated similar performance between response modalities in controls, whereas performance was worse for pointing than for oral response in patients. Picture-naming performance was also reduced in patients relative to controls. However, in the word-to-picture matching task, a similar pattern of responses was found between groups for incorrectly named pictures of the same items. Conclusion: The finding of a response modality effect in item memory for all participants is compatible with the assumption that semantic influences are greater in picture pointing than in oral response, as predicted by psycholinguistic models. Furthermore, patients' performance was modulated by their word-processing deficits, showing a reduced advantage relative to controls. Overall, the response modality effect observed in this study for item memory suggests that verbal STM performance is intrinsically linked with word processing capacities in both healthy controls and individuals with mild DAT, supporting psycholinguistic models of STM. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

The differentiation of semantic dementia and frontal lobe dementia (temporal and frontal variants of frontotemporal dementia) from early Alzheimer's disease: a comparative neuropsychological study

The authors compared age-matched groups of patients with the frontal and temporal lobe variants of frontotemporal dementia (FTD; dementia of frontal type [DFT] and semantic dementia), early Alzheimer's disease (AD), and normal controls (n = 9 per group) on a comprehensive neuropsychological battery. A distinct profile emerged for each group: Those with AD showed a severe deficit in episodic memory with more subtle, but significant, impairments in semantic memory and visuospatial skills; patients with semantic dementia showed the previously documented picture of isolated, but profound, semantic memory breakdown with anomia and surface dyslexia but were indistinguishable from the AD group on a test of story recall; and the DFT group were the least impaired and showed mild deficits in episodic memory and verbal fluency but normal semantic memory. The frontal and temporal presentations of FTD are clearly separable from each other and from early AD.     

Sex differences in the association of the apolipoprotein E epsilon 4 allele with incidence of dementia,cognitive impairment,and decline

We examined longitudinal associations between the apolipoprotein E ε4 allele (ApoE4⁺ status) and several cognitive outcomes and tested effect modification by sex. Data on 644 non-Hispanic Caucasian adults, from the Baltimore Longitudinal Study of Aging (BLSA) were used. Dementia onset, cognitive impairment and decline were assessed longitudinally. After 27.5 years median follow-up, 113 participants developed dementia. ApoE4⁺ predicted dementia significantly (hazard ratio [HR] = 2.89; 95% confidence interval [CI], 1.93–4.33), with nonsignificant sex differences. Taking all time points for predicting cognition, women had significantly stronger positive associations than men between ApoE4⁺ status and impairment or decline on the California Verbal Learning Test (CVLT; delayed recall and List A total recall) and on Verbal Fluency Test-Categories. This ApoE4 × sex interaction remained significant with Bonferroni correction only for CVLT-delayed recall. Taking time points prior to dementia for cognitive predictions, the positive association between impairment in CVLT-delayed recall and ApoE4⁺ status remained stronger among women, though only before Bonferroni correction. While ApoE4+ status appears to be a sex neutral risk factor for dementia, its association with verbal memory and learning decline and impairment was stronger among women.     

Verbal and nonverbal short‐term memory in patients with Alzheimer's disease and in healthy elderly subjects

Short‐term memory (STM) deteriorates with the progression of Alzheimer's disease (AD). The purpose of the present study was to characterize this decline by examining component processes of STM. Accordingly, AD patients whose dementia ranged from mild to severe and healthy, age‐matched subjects received the Brown‐Peterson distractor task, in which class of material (verbal and nonverbal), number of memoranda (one, two, and three), and agent of forgetting (time and distraction) were manipulated. Healthy elderly subjects showed the expected pattern of performance: When distraction was present, forgetting was greater with longer retention intervals and larger memory loads; when distraction was absent, recall was perfect. AD patients showed significant forgetting at shorter intervals and with smaller memory loads than healthy elderly subjects when distraction was present; without distraction, AD patients' recall of nonverbal (but not verbal) material was impaired, which may be attributable to the greater difficulty of the nonverbal task over the verbal one and to a diminished rehearsal capacity of AD patients for nonverbal material. Data from individual patients suggest that the verbal and nonverbal systems can deteriorate independently.     

Inhibition of hippocampal function in mild cognitive impairment: targeting the cholinergic hypothesis

Mild cognitive impairment (MCI) is a condition with an increased risk of developing Alzheimer's disease. Chief complaint and diagnostic criterion in subjects with mild cognitive impairment is memory failure. We hypothesized that cholinergic malfunction may underlie memory impairment in these subjects and applied a low dosage of an acetylcholinesterase inhibitor and modulator of nicotinic acetylcholine receptors, galantamine (4 mg bid), for 7 days. We used neuropsychological tests to investigate attention, cognitive flexibility, verbal and visual short-term and working memory, susceptibility to interference and episodic memory and functional magnetic resonance imaging to assess spatial navigation both prior to and after treatment. Late episodic learning and delayed recall improved on treatment as did recruitment of the hippocampal region during spatial navigation. Performance in all other neuropsychological measures remained unchanged. We show that an increase of cholinergic neurotransmission in subjects with MCI specifically improves hippocampal function and thus that a cholinergic deficit is functionally relevant in subjects with MCI. Malfunction of the cholinergic system may be tackled pharmacologically via the inhibition of acetylcholinesterase even when the impairment is slight.     

Changes in cognition

The clinical hallmark of Alzheimer's disease (AD) is a gradual decline in cognitive function. For the majority of patients the initial symptom is an impairment in episodic memory, i.e., the ability to learn and retain new information. This is followed by impairments in other cognitive domains (e.g., executive function, language, spatial ability). This impairment in episodic memory is evident among individuals with mild cognitive impairment (MCI) and can be used to predict likelihood of progression to dementia, particularly in association with AD biomarkers. Additionally, cognitively normal individuals who are likely to progress to mild impairment tend to perform more poorly on tests of episodic memory than do those who remain stable. This cognitive presentation is consistent with the pathology of AD, showing neuronal loss in medial temporal lobe structures essential for normal memory. Similarly, there are correlations between magnetic resonance imaging (MRI) measures of medial temporal lobe structures and memory performance among individuals with mild cognitive impairment. There are recent reports that amyloid accumulation may also be associated with memory performance in cognitively normal individuals.     

Comprehensive assessment of memory functioning following traumatic brain injury in children

This study examined specific memory functions in 52 children with mild‐moderate or severe traumatic brain injury (TBI) and 29 noninjured controls using the Wide Range Assessment of Memory and Learning (WRAML). Children's recall varied as a function of injury severity and task demands. The participants with severe brain injuries performed worse than controls on global measures of visual memory, learning, and general memory functioning, as well as on specific subtests measuring recall of contextual verbal information. Children with mild‐moderate brain injuries performed similarly to controls except for poorer performance on 2 subtests measuring sound‐symbol learning and recall of geometric designs. Results suggest that the WRAML provides clinically useful information and that specific aspects of memory processing need to be evaluated following childhood TBI.