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What factors are important in the calibration of mental representations of auditory space? A substantial body of research investigating the audiospatial abilities of people who are blind has shown that visual experience might be an important factor for accurate performance in some audiospatial tasks. Yet, it has also been shown that long-term experience using click-based echolocation might play a similar role, with blind expert echolocators demonstrating auditory localization abilities that are superior to those of people who are blind and who do not use click-based echolocation by Vercillo et al. (Neuropsychologia 67: 35–40, 2015). Based on this hypothesis we might predict that training in click-based echolocation may lead to improvement in performance in auditory localization tasks in people who are blind. Here we investigated this hypothesis in a sample of 12 adult people who have been blind from birth. We did not find evidence for an improvement in performance in auditory localization after 10 weeks of training despite significant improvement in echolocation ability. It is possible that longer-term experience with click-based echolocation is required for effects to develop, or that other factors can explain the association between echolocation expertise and superior auditory localization. Considering the practical relevance of click-based echolocation for people who are visually impaired, future research should address these questions. Supplementary Information The online version contains supplementary material available at 10.1007/s00221-021-06230-5.

The ventral prefrontal cortex (vPFC) is a major focus of investigation in neuroscience, particularly in the studies of emotion and emotion-cognition integration. A crucial question concerning the regulatory function of vPFC is how it is recruited, especially how the function maps onto the structure and determines appropriate behavior. In social exclusion studies, mediation model analyses suggest that vPFC regulates distress by disrupting anterior cingulate cortex (ACC) activities, whereas I recently report (Hu, 2018; Neuropsychologia) that ventral medial prefrontal cortex appears to defend the organism from acute stress by activating ACC. In this review, I synthesize and highlight functional imaging research with mediation analysis that over the past decades has begun to offer new insights into the brain mechanisms underlying vPFC. Toward this end, the first section of the paper outlines a model of the processes and neural systems involved in the interaction of emotion and cognition. The second and third sections survey recent research on emotional regulation with negative and positive pathways, respectively, emanating from vPFC. The fourth section summarizes the current dynamic network findings. Functional mediation analysis helps to identify signals within vPFC and others that are common and/or specific to particular information processing. Finally, I provide a personal perspective of the adoption of mediation model analysis in the investigations into vPFC.

The amino acid tyrosine is the precursor of dopamine and norepinephrine and can be administered as a dietary supplement. Previous studies have demonstrated that the intake of tyrosine can enhance both working memory performance and response inhibition (e.g., Colzato et al., Frontiers in Behavioral Neuroscience, 72013; Colzato et al., Neuropsychologia, 62, 398–402, 2014). In this study, we tested whether the consumption of tyrosine improved the performance of female participants in the Attention Network Test (ANT; Fan et al., Journal of Cognitive Neuroscience, 14, 340–347 2002) and the Stroop task (Stroop, Journal of Experimental Psychology, 18, 643–662 1935). Tyrosine marginally improved the resolution of interference in the Stroop task and had some impact on average reaction times. We conclude that more research is required as to understand the mechanisms through which tyrosine influences cognitive functioning. At this point in time, it remains unclear at best whether the consumption of tyrosine can be advised as a dietary supplement to support cognition.

Some early studies of people with aphasia reported strikingly better performance on lexical than on sublexical speech perception tasks. These findings challenged the claim that lexical processing depends on sublexical processing and suggested that acoustic information could be mapped directly to lexical representations. However, Dial and Martin (Neuropsychologia 96: 192-212, 2017) argued that these studies failed to match the discriminability of targets and distractors for the sublexical and lexical stimuli and showed that when using closely matched tasks with natural speech tokens, no patient performed substantially better at the lexical than at the sublexical processing task. In the current study, we sought to provide converging evidence for the dependence of lexical on sublexical processing by examining the perception of synthetic speech stimuli varied on a voice-onset time continuum using eye-tracking methodology, which is sensitive to online speech perception processes. Eight individuals with aphasia and ten age-matched controls completed two visual world paradigm tasks: phoneme (sublexical) and word (lexical) identification. For both identification and eye-movement data, strong correlations were observed between the sublexical and lexical tasks. Critically, no patient within the control range on the lexical task was impaired on the sublexical task. Overall, the current study supports the claim that lexical processing depends on sublexical processing. Implications for inferring deficits in people with aphasia and the use of sublexical tasks to assess sublexical processing are also discussed.

Stuss considered the human PFC as a “cognitive globe” [Stuss, D. T., & Benson, D. F. Neuropsychological studies of the frontal lobes. Psychological Bulletin, 95, 3–28, 1984] on which functions of the frontal lobe could be mapped. Here, we discuss classic and recent findings regarding the evolution, development, function, and cognitive role of shallow indentations or tertiary sulci in PFC, with the goal of using tertiary sulci to map the “cognitive globe” of PFC. First, we discuss lateral PFC (LPFC) tertiary sulci in classical anatomy and modern neuroimaging, as well as their development, with a focus on those within the middle frontal gyrus. Second, we discuss tertiary sulci in comparative neuroanatomy, focusing on primates. Third, we summarize recent findings showing the utility of tertiary sulci for understanding structural–functional relationships with functional network insights in ventromedial PFC and LPFC. Fourth, we revisit and update unresolved theoretical perspectives considered by C. Vogt and O. Vogt (Allgemeinere ergebnisse unserer hirnforschung. Journal für Psychologie und Neurologie, 25, 279–462, 1919) and F. Sanides (Structure and function of the human frontal lobe. Neuropsychologia, 2, 209–219, 1964) that tertiary sulci serve as landmarks for cortical gradients. Together, the consideration of these classic and recent findings indicate that tertiary sulci are situated in a unique position within the complexity of the “cognitive globe” of PFC: They are the smallest and shallowest of sulci in PFC, yet can offer insights that bridge spatial scales (microns to networks), modalities (functional connectivity to behavior), and species. As such, the map of tertiary sulci within each individual participant serves as a coordinate system specific to that individual on which functions may be further mapped. We conclude with new theoretical and methodological questions that, if answered in future research, will likely lead to mechanistic insight regarding the structure and function of human LPFC.

Expert readers have been repeatedly reported to misperceive the centre of visual stimuli, shifting systematically to the left the bisection of any lines (pseudoneglect) while showing a cross-over effect while bisecting different types of orthographic strings (Arduino etal., 2010, Neuropsychologia, 48, 2140). This difference has been attributed to asymmetrical allocation of attention that visuo-verbal material receives when lexical access occurs (e.g., Fischer, 2004, Cognitive Brain Research, 4, 163). The aim of this study was to further examine which visual features guide recognition of potentially orthographic materials. To disentangle the role of orthography, heterogeneity, and visuo-perceptual discreteness, we presented Italian unimpaired adults with four experiments exploiting the bisection paradigm. The results showed that a cross-over effect emerges in most discrete strings, especially when their internal structure, that is being composed of heterogeneous elements, is suggestive of orthographically relevant material. Interestingly, the cross-over effect systematically characterized the processing of letter strings (Experiment 2) and words (Experiments 3 and 4), whether visually discrete or not. Overall, this pattern of results suggests that neither discreteness nor heterogeneity per se are responsible for activating visual scanning mechanisms implied in text exploration, although both contribute to increasing the chance of a visual stimulus undergoing a perceptual analysis dedicated to pre-lexical processing

In view of the advances in neuroimaging, it is very important for health providers involved in caring for subjects with cognitive disorders to have a basic knowledge of imaging in their curriculum. Today, neuroimaging is an essential part of the complementary investigation in cognitive and behavioral neurology and neuropsychiatry. Imaging allows inferences to be drawn on which brain regions or cognitive networks are affected, while new developments in imaging biomarkers enable the assessment of perfusion, metabolism and protein deposition patterns. Thus, neuroimaging is a new area of interface between clinicians and radiologists. However, as for all fields of knowledge, it is sometimes difficult to stay abreast, especially in fields undergoing constant development. With these premises, we are introducing a new section in Dementia & Neuropsychologia entitled “Neuroimaging through clinical cases” focusing on short case reports (maximum of 750 words, without abstract, no more than 10 references) with interesting imaging features. This will cover not only rare imaging cases, but also include typical or emblematic imaging features of several diseases along with cognitive repercussions and biomarker images in healthy and pathological states. The section will also focus on teaching neuroimaging through discussion of clinical cases and help readers to become familiarized with neuroimaging. The editors of this new section are Leandro Tavares Lucato and Fabio Henrique de Gobbi Porto. We began this section with a case of Korsakoff syndrome that presented as a rapidly progressive dementia with contrast enhancement in both mammillary bodies on magnetic resonance imaging, which proved essential to confirm the etiology. We hope this section will inform readers interested in learning neuroimaging and widen the spectrum of the journal.

Carthery-Goulart, M. T., da Silveira, A. D. C., Machado, T. H., Mansur, L. L., Parente, M. D. M., Senaha, M. L. H., ... & Nitrini, R. (2013). Nonpharmacological interventions for cognitive impairments following primary progressive aphasia. Dementia & Neuropsychologia, 7, 121–131.Source of funding and declaration of interests: The authors report no conflicts of interest.

Mild Traumatic Brain Injury (mTBI), also known as concussion, has become a growing public health concern, prevalent in both athletic and military settings. Many researchers have examined post-mTBI neuropsychological outcomes, leading to multiple meta-analyses amalgamating individual study results. Objective: Considering the plethora of meta-analytic findings, the next logical step stands as a systematic review of meta-analyses, effectively reporting key moderators that predict post-mTBI neuropsychological outcomes. Method: A systematic review of reviews yielded 11 meta-analyses meeting inclusion criteria (i.e., English-language systematic reviews/meta-analyses covering post-mTBI observational cognitive research on late adolescents/adults), with their findings qualitatively synthesized based on moderator variables (i.e., cognitive domain, time since injury, past head injury, participant characteristics, comparison group, assessment technique, and persistent symptoms). Results: The overall effect sizes ranged for both general (range: .07–.61) and sports-related mTBI (range: .40–.81) and differed both between and within cognitive domains, with executive functions appearing most sensitive to multiple mTBI. Cognitive domains varied in recovery rates, but overall recovery occurred by 90 days postinjury for most individuals and by 7 days postinjury for athletes. Greater age/education and male gender produced smaller effects sizes, and high school athletes suffered the largest deficits post-mTBI. Controlgroup comparisons yielded larger effects than within-person designs, and assessment techniques had limited moderating effects. Conclusions: Overall, meta-analytic review quality remained low with few studies assessing publication or study quality bias. Meta-analyses consistently identified adverse acute mTBI-related effects and fairly rapid symptom resolution. Future meta-analyses should better operationally define cognitive constructs to produce more consistent effect estimates across domains.

The case series approach in cognitive neuropsychology provides a means to test theories that make quantitative predictions about associations between different components of the cognitive system [Schwartz, M. F.,Dell, G. S. (2010). Case series investigations in cognitive neuropsychology. Cognitive Neuropsychology, 27, 477-494]. However, even when the predicted association is borne out the study may include outliers-observations that deviate significantly from the rest of the data. These outliers may reveal individual cases whose cognitive impairments dissociate from other cases included in the study. These dissociating cases can pose a significant challenge to the theory being tested. Using a recent case series that investigated the underlying causes of letter perseveration in spelling [Fischer-Baum, S.,Rapp, B. (2012). Underlying cause(s) of letter perseveration errors. Neuropsychologia, 50, 305-318], I discuss statistical and theoretical issues that arise when using outlier detection techniques to identify dissociating cases in a case series study.

BackgroundAcute tryptophan depletion (ATD) results in a transient lowering of mood in patients recovered from depression and in healthy volunteers with a family history of affective disorders. The personality trait of neuroticism is strongly associated with depression.AimsTo assess whether neuroticism predicts mood change in response to ATD in healthy volunteers.MethodHealthy volunteers who scored at the top and bottom fifth percentiles of neuroticism scores (17 and 15 respectively) were selected. In a double-blind, crossover study they received a tryptophan-free or a control drink. Mood and cognition were assessed.ResultsNeuroticism did not predict the amount of mood change following ATD but did moderate performance on the verbal fluency test. A family history of affective disorder (n=5) predicted mood change but not cognitive function following ATD.ConclusionsNeuroticism moderates aspects of cognitive function, but in this study it was not strongly related with mood change via serotonin.

RATIONALE: A number of studies have compared ecstasy users to control groups on various measures of neuropsychological function in order to determine whether ecstasy use results in lasting cognitive deficits. However, few of those studies controlled adequately for non-ecstasy illicit drug use. OBJECTIVE: The aim of this study was to investigate neuropsychological function in chronic ecstasy users while controlling for polydrug use. METHODS: Neuropsychological function was assessed in four groups-30 current 3,4-methylenedioxymethamphetamine (MDMA) users with a little history of illicit drug use other than ecstasy and cannabis, 30 polydrug controls, 30 drug-naïve controls and 20 ex-MDMA users-using a battery of well-validated, computerized neuropsychological tests. The battery focused on memory, executive function, impulsivity and risk-taking. RESULTS: Few differences were apparent between the groups, and on no measure were the current MDMA users impaired significantly relative to the polydrug controls. However, within the current MDMA users, questionnaire-measured impulsivity correlated with performance on a number of tests-a relationship that was not apparent in the controls. CONCLUSIONS: These data highlight the complexity in understanding the current ecstasy literature and suggest that some individuals may be particularly vulnerable to cognitive impairment following chronic use. Although no differences were identified between the current MDMA users and the controls, trait impulsiveness was significantly correlated with impairment on a number of neuropsychological outcome measures in the MDMA users, but not in the controls. These data suggest that impulsive individuals may be those most at risk for the development of cognitive impairment following chronic ecstasy use.

BackgroundRecovery in bipolar disorder is central to its definition but is rarely complete. Previous work has suggested that neuropsychological impairment persists during the euthymic state but has been confounded partly by mild affective symptoms in remitted patients.AimsTo characterise neuropsychological functioning in the euthymic phase of bipolar disorder with an emphasis on tasks of executive functioning.MethodThirty euthymic patients with bipolar disorder were compared with thirty healthy controls on neuropsychological tasks differentially sensitive to damage within prefrontal cortex.ResultsBipolar I patients were impaired on tasks of attentional set shifting, verbal memory and sustained attention. Only sustained attention deficit survived controlling for mild affective symptoms. This deficit was related to progression of illness, but was none the less present in a subgroup of patients near illness onset.ConclusionsSustained attention deficit may represent a neuropsychological vulnerability marker for bipolar disorder, providing a focus for further understanding of the phenotype and analysis of the neuronal networks involved.

Background: Bipolar affective disorder patients often show cognitive deficits that are similar to those found in schizophrenia patients. Theory of mind (the ability to understand others’ mental states) is compromised in currently ill schizophrenia patients. This study aimed to establish whether similar deficits are found in bipolar patients. Methods: We measured theory of mind ability in 20 bipolar-manic patients, 15 bipolar-depressed patients, 13 bipolar patients in remission and 15 normal controls. The task, which controlled for memory and comprehension, had previously been used in a study of schizophrenia patients. Results: Impaired performance on theory of mind was found for both bipolar-depressed and bipolar-manic patients, even when memory was controlled for. No impairment was observed in the remitted patients. Limitations: The manic patients scored lower than the remitted patients on a brief measure of intelligence; no other group differences in IQ were significant. Conclusions: Theory of mind deficits are found in currently symptomatic bipolar patients. These findings add to growing evidence that common mechanisms may contribute to bipolar affective disorder and schizophrenia.

We investigated cognitive and affective Theory of Mind (ToM) and empathy in patients with premanifest and manifest Huntington’s disease (HD). The relationship between ToM performance and executive skills was also examined. Sixteen preclinical and 23 clinical HD patients, and 39 healthy subjects divided into 2 control groups were given a French adaptation of the Yoni test (Shamay-Tsoory, S.G., Aharon-Peretz, J. (2007). Dissociable prefrontal networks for cognitive and affective theory of mind: a lesion study. Neuropsychologia, 45(3), 3054–67) that examines first- and second-order cognitive and affective ToM processing in separate conditions with a physical control condition. Participants were also given questionnaires of empathy and cognitive tests which mainly assessed executive functions (inhibition and mental flexibility). Clinical HD patients made significantly more errors than their controls in the first- and second-order cognitive and affective ToM conditions of the Yoni task, but exhibited no empathy deficits. However, there was no evidence that ToM impairment was related to cognitive deficits in these patients. Preclinical HD patients were unimpaired in ToM tasks and empathy measures compared with their controls. Our results are consistent with the idea that impaired affective and cognitive mentalizing emerges with the clinical manifestation of HD, but is not necessarily part of the preclinical stage. Furthermore, these impairments appear independent of executive dysfunction and empathy.

Empirical evidence indicates that cognitive consequences of cerebellar lesions tend to be mild and less important than the symptoms due to lesions to cerebral areas. By contrast, imaging studies consistently report strong cerebellar activity during tasks of action observation and action understanding. This has been interpreted as part of the automatic motor simulation process that takes place in the context of action observation. The function of the cerebellum as a sequencer during executed movements makes it a good candidate, within the framework of embodied cognition, for a pivotal role in understanding the timing of action sequences. Here, we investigated a cohort of eight patients with chronic, first-ever, isolated, ischemic lesions of the cerebellum. The experimental task consisted in identifying a plausible sequence of pictures from a randomly ordered group of still frames extracted from (a) a complex action performed by a human actor ("biological action" test) or (b) a complex physical event occurring to an inanimate object ("folk physics" test). A group of 16 healthy participants was used as control. The main result showed that cerebellar patients performed significantly worse than controls in both sequencing tasks, but performed much worse in the "biological action" test than in the "folk physics" test. The dissociation described here suggests that observed sequences of simple motor acts seem to be represented differentially from other sequences in the cerebellum.

Both vision and cognitive problems are commonplace in multiple sclerosis. Previous research suggests that MS patients with compromised near vision perform more poorly on visually mediated cognitive tests. Consequently it has been recommended that neuropsychologists who evaluate MS patients with poor corrected near vision should rely primarily on auditory neuropsychological tests. However, no research has examined the association between vision problems and performance on non-visual neuropsychological tests in MS. Moreover, little if any research has examined the association between more sensitive measures of vision impairment and cognitive difficulties in MS. The objective of this study was to examine the relationship between visual acuity and cognition in MS. A total of 65 MS patients were administered a visual and neuropsychological evaluation. Visual examination included an assessment of visual acuity, low-contrast visual acuity (5%, 2.5%, and 1.25% illuminated charts) and near visual acuity. Poorer high-contrast, near, and low-contrast visual acuity were significantly associated with poorer performance on visual, non-visual, and motor-based neuropsychological tests. Neuropsychologists should be aware that poor corrected vision in MS is associated with poor performance in all cognitive and motor domains. Results suggest the need for further exploration of visual acuity biomarkers of disease progression in MS.

The current study examined the relation between attention, rapid automatized naming (RAN), and reading fluency among typically developing children. A total of 104 third- and fourth-grade children (8-11 years of age) completed RAN measures consisting of four stimuli (letter, digit, color, and object) and an oral reading fluency measure from the Gray Oral Reading Test-Fourth Edition. Correlational and hierarchical regression analyses revealed that all four RAN stimuli, particularly letter RAN, were significant predictors of reading fluency. Additionally, parent and teacher ratings of inattention from the Swanson, Nolan and Pelham-Version Four rating scale predicted RAN after controlling for gender, working memory, and estimated IQ. Further analyses indicated that RAN performance mediated the relation between inattention and reading fluency. Results support the need to consider attentional variables when assessing reading performance, even among typically developing children.

Although cognitive deficits are recognized as a core feature in schizophrenia, their evolution over the course of the illness is still debated. Longitudinal studies of cognition in patients after a first episode of psychosis (FEP) provide extremely useful information, in that they include an adequate and realistic baseline measure of cognitive performance, while at the same time minimizing the effect of confounding variables associated with chronicity. The aim of this systematic review was to summarize findings of studies assessing the longitudinal course of neuropsychological deficits in patients with FEP for durations of at least one year. Overall, the neuropsychological deficits that are present following a first episode of psychosis appeared to remain stable over time for periods of up to ten years, the only possible exception being verbal memory deficits, where there is some evidence of further deterioration over the long term. However, further studies are needed to confirm this conclusion, especially in the (somewhat inconsistently defined) domain of executive function. Improvements in psychopathology appear to positively influence the course of cognitive deficits, although the effects of antipsychotic medication are not as clear.

Objective To examine the differential impact of depressive symptom clusters on neuropsychological functioning in a rural-dwelling, multi-ethnic cohort. Methods Data were analyzed for 184 participants (70% female, 46% Hispanic) who are part of an ongoing rural healthcare study, Project FRONTIER. Previously published factor scores of dysphoria, meaninglessness, apathy, and cognitive impairment from the GDS-30 were entered as predictor variables in linear regression models with RBANS Index raw scores as outcome variables. Results In the total sample, Dysphoria, Meaninglessness, and Cognitive Impairment were significantly associated with Immediate Memory, Language, Attention and Delayed Memory; Dysphoria was also significantly related to Visuospatial skills. When examined by gender and ethnicity, however, the findings varied with dysphoria being most related to cognitive status among men and dysphoria, meaninglessness, and cognitive impairment being most significantly related to cognitive status among women. When examined by ethnicity, dysphoria, meaninglessness, and cognitive impairment were most strongly associated with immediate and delayed memory in Hispanics. Conclusions In this study of rural-dwelling adults and elders, depressive symptom clusters were differentially associated with poorer cognition with the most consistent findings being between depressive symptoms of dysphoria and meaninglessness and the cognitive domains of immediate and delayed memory. Copyright © 2010 John Wiley & Sons, Ltd.

This study is one of very few that has investigated the neuropsychological functioning of both familial and clinical high risk subjects for psychosis. Participants (N = 164) were members of the Northern Finland 1986 Birth Cohort in the following four groups: familial risk for psychosis (n = 62), clinical risk for psychosis (n = 20), psychosis (n = 13), and control subjects (n = 69). The neurocognitive performance of these groups was compared across 19 cognitive variables. The two risk groups did not differ significantly from controls, but differed from the psychosis group in fine motor function. Neuropsychological impairments were not evident in a non-help-seeking high-risk sample.

Introduction The current criteria for detecting a Clinical High-Risk (CHR) state for psychosis do not address cognitive impairment. A first step for identifying cognitive markers of psychosis risk would be to determine which aspects of neurocognitive performance are related with more severe psychotic-like symptoms. This study assessed cognitive impairment associated with prodromal symptoms in adolescents receiving public psychiatric treatment. Methods 189 adolescents were recruited from consecutive new patients aged 15–18 attending mainly outpatient adolescent psychiatric units in Helsinki. They had been screened for prodromal symptoms using the Prodromal Questionnaire, and all screen-positives as well as a random sample of screen-negatives were interviewed using the Structured Interview for Prodromal Symptoms (SIPS) and underwent testing using a large, standardized neurocognitive test battery. The sample included 62 adolescents who met the CHR criteria (CHR) and 112 who did not (non-CHR). A healthy control sample ( n = 72) was also included to provide age- and gender-matched norms. Results The CHR group performed worse on visuospatial tasks than the non-CHR group. Among CHR adolescents, negative symptoms were associated with slower processing speed and poorer performance on verbal tasks. Among non-CHR adolescents, positive symptoms were associated with poorer performance on visuospatial tasks, and negative symptoms with poorer performance on verbal tasks. Conclusion Clinical high-risk status is associated with impaired visuospatial task performance. However, both positive, psychotic-like symptoms and negative symptoms are associated with lower levels of neurocognitive functioning among adolescents in psychiatric treatment regardless of whether CHR criteria are met. Thus, even mild positive and negative symptoms may have clinical relevance in adolescents in psychiatric care. Adolescents with both psychotic-like symptoms and neurocognitive deficits constitute a group requiring special attention.

Background: Most studies reporting cognitive deficits in chronic alcoholics have relied on treatment samples (predominantly men) from inpatient or outpatient treatment facilities. However, the majority of chronic alcoholics have never been in treatment and there is increasing evidence that treated and non-treatment-seeking alcoholic samples come from different populations with regard to alcohol use and other factors related to the severity of disease. Accordingly, in the present study, we assessed a broad range of cognitive functions in 55 treatment-naive alcohol-dependent (TNAD) individuals and 55 nonalcoholic controls (NAC) matched for age and education. In addition, a goal of the present study was to assess potential differential effects of alcohol dependence on cognitive performance in TNAD men and women. Methods: Comprehensive neuropsychological assessment was conducted on TNAD and NAC. The following 9 performance domains, each consisting of multiple measures, were examined: attention, auditory working memory, verbal processing, abstraction/cognitive flexibility, psychomotor function, immediate memory, delayed memory, reaction time, and spatial processing. Results: Analysis revealed no cognitive deficits in TNAD, relative to NAC, in any of the 9 cognitive domains. TNAD performed better than NAC in the attention domain. In addition, while men performed better than women in the spatial domain, there were no TNAD versus NAC group by gender interactions for any domain. Conclusions: Our results extend findings that TNAD show minimal behavioral effects of chronic heavy alcohol use and are consistent with the contention that TNAD are relatively cognitively intact. Differences between our findings and those often reported for alcoholics recruited from treatment settings may be understood in terms of differences in alcohol use, along with genetic, psychiatric, and nutritional factors. In addition, the lack of differential effects of alcohol dependence on male and female cognitive performance in our study suggests that TNAD men and women do not differ in the severity of cerebral consequences of alcohol dependence.

Alcohol dependence (AD) in developmentally vulnerable adolescents is ubiquitous and confers a risk for long-term neurocognitive sequelae, yet comorbid substance use disorders and psychopathology can complicate interpretations. Here, we compare cognitive functioning in adolescents with and without AD, who are free from comorbid disorders.English- and Afrikaans-speaking adolescents (13-15 years) of mixed ancestry and low socio-economic status were recruited from the Cape Town region of South Africa. Adolescents with psychiatric, developmental, or other substance use disorders (SUDs) were excluded. AD (n=26) and control (n=26) groups were matched on age, gender, language, and level of education. Neuropsychological testing in participants' home language followed detailed medical/psychiatric evaluation.Although our sample included participants who smoked tobacco, lifetime dosage of other drugs was negligible. When tobacco and other drug use as well as demographic variables were controlled, adolescents with AD performed more poorly on measures of Verbal Story Memory, Self-Monitoring, and Psychomotor Speed and Coordination.These preliminary results, although relatively subtle, suggest that adolescents with AD may be at increased risk for failure to reach optimal levels of neuromaturation, and may be susceptible to cognitive problems associated with protracted alcohol consumption.

Background: Recently attention has been addressed to the role of 5-HT in cognition and several experimental studies revealed that manipulations of the central 5-HT system can produce quite specific changes in cognitive functioning. These results may suggest new treatment strategies to improve cognition in psychiatric conditions characterized by neuropsychological impairments, such as schizophrenia. It is possible to investigate the involvement of 5-HT in cognition by examining the impact of genetic variation in key regulators of serotoninergic neurotransmission. Among these, the serotonin transporter (5-HTT) presents a functional polymorphism in the transcriptional control region of the gene (5-HTTLPR) affecting transcriptional efficiency. In the present study, we aimed to analyze the effect of 5-HTTLPR polymorphism on specific cognitive functions, known to be affected by 5-HT manipulation and altered in schizophrenia. Methods: 223 schizophrenia patients were tested with Wisconsin Card Sorting Test (WCST), for the evaluation of cognitive flexibility, Continuous Performance Test (CPT), for the evaluation of attention, and genotyped for the 5-HTTLPR. Results: We found a significant association between HTT polymorphism and executive functions and inversely with sustained attention. The presence of the high-activity long (L) allele in homozygosis was a predictor of better executive performances and poorer performances of attention. Conclusions: Our findings suggest that factors affecting serotonin availability may play a specific role in cognitive processes, probably through complex modulation of the different performance components. (C) 2009 Elsevier Inc. All rights reserved. Background: Recently attention has been addressed to the role of 5-HT in cognition and several experimental studies revealed that manipulations of the central 5-HT system can produce quite specific changes in cognitive functioning. These results may suggest new treatment strategies to improve cognition in psychiatric conditions characterized by neuropsychological impairments, such as schizophrenia. It is possible to investigate the involvement of 5-HT in cognition by examining the impact of genetic variation in key regulators of serotoninergic neurotransmission. Among these, the serotonin transporter (5-HTT) presents a functional polymorphism in the transcriptional control region of the gene (5-HTTLPR) affecting transcriptional efficiency. In the present study, we aimed to analyze the effect of 5-HTTLPR polymorphism on specific cognitive functions, known to be affected by 5-HT manipulation and altered in schizophrenia. Methods: 223 schizophrenia patients were tested with Wisconsin Card Sorting Test (WCST), for the evaluation of cognitive flexibility, Continuous Performance Test (CPT), for the evaluation of attention, and genotyped for the 5-HTTLPR. Results: We found a significant association between HTT polymorphism and executive functions and inversely with sustained attention. The presence of the high-activity long (L) allele in homozygosis was a predictor of better executive performances and poorer performances of attention. Conclusions: Our findings suggest that factors affecting serotonin availability may play a specific role in cognitive processes, probably through complex modulation of the different performance components. (C) 2009 Elsevier Inc. All rights reserved.

Ancin I, Santos JL, Teijeira C, Sanchez-Morla EM, Bescos MJ, Argudo I, Torrijos S, Vazquez-Alvarez B, De La Vega I, Lopez-Ibor JJ, Barabash A, Cabranes-Diaz JA. Sustained attention as a potential endophenotype for bipolar disorder. Objective: Nowadays, it is accepted that to identify the biological basis of psychiatric illnesses it would be useful to deconstruct them into the most basic manifestations, such as cognitive deficits. The aim of this study was to set attention deficit as a stable vulnerability marker of bipolar disorder. Method: Sustained attention was evaluated by the Continuous Performance Test (DS-CPT) in 143 euthymic bipolar patients and 105 controls. To estimate the influence of clinical profile in attention, patients completed a semi-structured interview. Results: Bipolar patients showed a deficit in attention during euthymic periods. This disturbance correlated with years of evolution, age of onset and age of first hospitalisation; and was not influenced by other clinical data. Conclusion: Sustained attention may be considered as an endophenotype of the illness.

The purpose of this review is to gain more insight in the neuropathology of pathological gambling (PG) and problem gambling, and to discuss challenges in this research area. Results from the reviewed PG studies show that PG is more than just an impulse control disorder. PG seems to fit very well with recent theoretical models of addiction, which stress the involvement of the ventral tegmental-orbito frontal cortex. Differentiating types of PG on game preferences (slot machines vs. casino games) seems to be useful because different PG groups show divergent results, suggesting different neurobiological pathways to PG. A framework for future studies is suggested, indicating the need for hypothesis driven pharmacological and functional imaging studies in PG and integration of knowledge from different research areas to further elucidate the neurobiological underpinnings of this disorder.

We compared the frequency of life stress and coping styles using self-report measures in patients with systemic lupus erythematosus (SLE) and healthy controls. We also explored the relationship between cognition, life stress and coping. Thirty-one SLE patients with overt neuropsychiatric (NPSLE) symptoms, 22 SLE patients without overt neuropsychiatric (non-NPSLE) symptoms and 25 healthy controls completed measures of cognition, life events and coping skills. SLE patients (NP and non-NP) showed greater use of negative, disengaging coping scales (p = 0.002) and more negative life stress events over the past 6 months (p = 0.018) and past 6–12 months (p = 0.004) compared with controls. NPSLE and non-NPSLE subjects were higher on a cognitive impairment index (CII) than controls (p < 0.001). Only the NPSLE subjects had significant correlations between CII and negative life events 0–6 months (p < 0.001), negative life events 0–12 months (p < 0.001) and negative coping styles (p = 0.007). SLE patients demonstrated greater negative life events over the past 12 months and tend to utilise greater negative disengaging coping skills. NPSLE patients demonstrate a potential relationship between negative life events, negative coping and cognitive dysfunction. The associations between cognitive changes and life stress and coping suggest the need for integrated behavioural strategies for treatment. Copyright © 2009 John Wiley & Sons, Ltd.

Tourette syndrome (TS) is assumed to result from frontostriatal dysfunction, which would be expected to result in impairments in neuropsychological functions. This possibility has been explored in a number of studies that have assessed the performance of patients with TS within major cognitive domains and on tests involving executive functioning. We aim to summarize the main findings of these studies while evaluating the influence of task limitations and potentially critical confounding factors such as the presence of comorbidity. Although there is clearly a need for improved study design, we tentatively suggest that there is considerable evidence for cognitive impairment in a subgroup of patients, and that some difficulties seem to be intrinsic to TS. These impairments may reflect dysfunction of the anterior cingulate network within the frontostriatal pathway.

Patients with borderline personality disorder show various neuropsychological dysfunctions. However, the exact pattern of this dysfunction and its severity in comparison with other personality disorders are not known. The purpose of this study was to compare the neuropsychological performance of borderline patients (n = 50) with that of patients with other personality disorders (n = 30) and healthy controls (n = 30) using the Repeatable Brief Assessment of Neuropsychological Status (RBANS) test battery. Borderline patients showed deficient attention, immediate and delayed memory, and relatively spared visuospatial and language functions compared with controls (effect size range: 0.34-0.99). The neuropsychological deficit was less pronounced in patients with other personality disorders compared with controls (effect size range: 0.18-0.66). However, there was no statistically significant difference between patients with borderline and other personality disorders. The neuropsychological deficit significantly correlated with the impulsivity sector score of the Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD). These results suggest that borderline patients are impaired in neuropsychological domains sensitive for frontal and temporal lobe functioning, and this deficit is related to impulsivity.

Objective: Although it is established that euthymic bipolar patients have neurocognitive deficits, the influence of medication on their cognitive performance is uncertain and requires investigation. Method: Neuropsychological tests of executive function, memory and attention were performed on 44 prospectively verified, euthymic bipolar I patients, 22 of whom were drug-free. Residual mood symptom effects were controlled statistically using ancova. Results: Drug-free and medicated patients differed only in delayed verbal recall (Rey AVLT list A7, drug-free > medicated), and perseverations during the five-point test (drug-free > medicated). When residual mood symptoms were controlled statistically, differences between drug-free and medicated subjects became insignificant. Medication effect sizes were modest. Significant correlations were found between residual depression scores and measures of verbal learning. Conclusion: Medications did not have any significant influence on neurocognitive performance, suggesting that neurocognitive deficits are an integral part of bipolar disorder.

Background An aspect of neuropsychological impairment which has been linked specifically to depression is an abnormal response to failure. That is, a rapid deterioration of performance after receiving feedback that an error was made on the previous task. We aimed to examine this phenomenon in unmedicated, depressed outpatients. Methods Forty-four patients meeting DSM-IV criteria for major depression, all psychotropicmedication-free for at least six weeks, and 44 demographically matched, healthy control participants completed a computerised simultaneous/delayed matching-to-sample task (S/DMTS). Results Patients with depression were significantly less accurate than controls on the S/DMTS task. Both groups augmented their performance after an error had been made. The probability of making an error following an error was significantly greater in depressed compared with control participants, even when total number of errors was controlled for. Response latencies reduced significantly after an error had been made for both groups. Limitations Both groups made relatively few errors. This reduced the power of analysis particularly when examining the effect of delay. Conclusions The abnormal response to negative feedback previously identified in depressed samples was replicated in the current unmedicated, less severely depressed group. The impairment shown in the depressed sample may be due to a reduction in the motivating effect of an error compared with healthy controls. This has possible relevance to both neurobiological and psychological theories of depression.

Studies have identified generalized slowing in information processing speed as the primary cognitive deficit in multiple sclerosis (MS). Similar changes are also commonly observed in healthy cognitive aging. The present study is the first to examine the combined impact of aging and disease on the course of cognitive slowing. MS patients (N = 245) and healthy controls (N = 188) were assessed using two measures of processing speed (the preliminary word reading and color naming trials of the Stroop). Participants ranging in age from 18 to 74 were grouped into five age cohorts. Slowing in processing speed was evident for patients vs. controls and for older vs. younger cohorts. The age-related declines in performance were parallel for patients and controls, indicating that the disease process in MS does not interact with general cognitive aging to effect a more rapid decline in functioning.

The goal of the present investigation was to determine whether the anti-pointing task (i.e., pointing to a location 180 degrees from a visual cue [M. Heath, A. Maraj, A. Gradkowski, G. Binsted, Anti-pointing is mediated by a perceptual bias of target location in left and right visual space, Exp. Brain Res. 192 (2009) 275-286]) and a 90 degrees -rotated-pointing task are supported by a similar cognitive strategy. Previous work evaluating visuomotor mental rotation (MR) has reported a monotonic increase in reaction time (RT) as a function of the angle of rotation [A.P. Georgopoulos, G. Pellizzer, The mental and the neural: psychological and neural studies mental rotation and memory scanning, Neuropsychologia 33 (1995) 1531-1547]. Interestingly, however, anti-pointing movements have not been evaluated in concert with intermediary angles of rotation. We therefore examined RT for center-out pointing movements in four tasks: pro-pointing (PRO), anti-pointing (ANTI), and 90 degrees clockwise (CW90) and counter-clockwise (CCW90) pointing. We found that response latencies for PRO responses were faster than ANTI responses, which in turn were faster than CW90 and CCW90 responses. These findings counter the notion that the angle of rotation influences the speed of visuomotor MR. Instead, we posit that visuomotor MR is supported by a serial process requiring the suppression of a stimulus-driven response followed by voluntary response generation. Further, we suggest that preparation of the voluntary response is cognitively less demanding for the ANTI task because the sensorimotor transformations underlying such an action are completed within the same plane as the stimulus-driven response. In contrast, the cognitive demands associated with CW90 and CCW90 are more complex because the action requires the transformation of response parameters in a movement plane orthogonal to the original - and suppressed - stimulus-driven response.

Post-retrieval processes are engaged when the outcome of a retrieval attempt must be monitored or evaluated. Functional neuroimaging studies have implicated right dorsolateral prefrontal cortex (DLPFC) as playing a role in post-retrieval processing. The present study used fMRI to investigate whether retrieval-related neural activity in DLPFC is associated specifically with monitoring the episodic content of a retrieval attempt. During study, subjects were cued to make one of two semantic judgments on serially presented pictures. One study phase was followed by a source memory task, in which subjects responded 'new' to unstudied pictures, and signaled the semantic judgment made on each studied picture. A separate study phase was followed by a task in which the studied items were subjected to a judgment about their semantic attributes. Both tasks required that retrieved information be evaluated prior to response selection, but only the source memory task required evaluation of retrieved episodic information. In both tasks, activity in a common region of right DLPFC was greater for studied than for unstudied items, and the magnitude of this effect did not differ between the tasks. Together with the results of a parallel event-related potential study [Hayama, H. R., Johnson, J. D., & Rugg, M. D. (2008). The relationship between the right frontal old/new ERP effect and post-retrieval monitoring: Specific or non-specific? Neuropsychologia, 46(5), 1211-1223, doi:S0028-3932(07)00390-9], the present findings indicate that putative right DLPFC correlates of post-retrieval processing are not associated exclusively with monitoring or evaluating episodic content. Rather, the effects likely reflect processing associated with monitoring or decision-making in multiple cognitive domains.

This study examined the course of clinically significant cognitive change in hematopoietic stem cell transplant (HSCT), using a Reliable Change Index (RCI). Neuropsychological evaluations were administered to 117 patients before HSCT. Thirty-three received subsequent evaluations 6 and 28 weeks later. Of 117 patients, 39% were classified as impaired before HSCT. Of the 33 receiving subsequent evaluations, 47% showed reliable decline at 6-weeks; of these, 33% showed reliable decline again at 28-weeks. Mood and QOL did not account for declines. Verbal learning, psychomotor speed, and executive function showed greatest vulnerability to pre-HSCT impairment, and verbal learning showed greatest likelihood of further, subsequent decline. In conclusion, a subgroup of patients showed cognitive impairment before HSCT, indicating that factors other than HSCT contributed to cognitive deficits. Another subgroup showed further decline after HSCT. This study demonstrated the utility of the RCI in describing cognitive change in HSCT patients.

Objective Patients with mild cognitive impairment account for a significant number of referrals to old age psychiatry services and specialist memory clinics. The cognitive evaluation of such patients is commonly restricted to brief dementia screens, with no consideration to their suitability for assessing MCI. Here, we review the utility of such cognitive screens for MCI and provide an overview of validated instruments. Methods We identified papers published after Petersen and colleagues 1999 MCI criteria (Petersen et al., 1999) and examining face-to-face cognitive screening for MCI from publication databases using combinations of the search terms ‘mild cognitive impairment’ and ‘cognitive screening’. We also combined the former search with the names of 39 screening tests recently identified in a relevant review (Cullen et al., 2007). Results Fifteen cognitive screening instruments were identified, 11 cover a restricted range of cognitive domains. High sensitivity and specificity for MCI relative to healthy controls were reported for two comprehensive and two noncomprehensive screening instruments, adequate test-retest and inter-rater reliability for only one of these. With the exception of three studies, sample sizes were universally small (i.e. n ≤ 100), and prognostic values were reported for only two of the identified 15 screening measures. Sensitivities of the full domain measures were universally high, but information about their specificity against psychiatric and non-progressive neurological conditions and predictive validity is lacking. Conclusion Several cognitive screening instruments afford the clinician the ability to detect MCI, early AD, and in some cases non-AD dementia, but they cannot currently be used to make reliable inferences about the course and eventual outcome of MCI. Copyright © 2009 John Wiley & Sons, Ltd.

Although reviews concerning the neuropsychology of obsessive-compulsive disorder (OCD) put great emphasis on impaired executive functioning, the overall conclusions are notoriously divergent. The main goal of the present study was to use a battery of neuropsychological tasks to assess nine cognitive domains with a special focus on executive functions in 40 patients with OCD. A secondary objective was to examine the relationships between clinical or demographic variables and neuropsychological performances. The third goal was to separate executive functions in more homogeneous components to verify whether specific impairment might be found in persons with OCD. Confirming the main hypothesis, few neuropsychological differences emerged between the OCD and healthy participants when concomitant factors were controlled. Moreover, subclinical symptoms appeared to play a different and independent role on the cognitive results. Future studies should include more specific tasks of lower-order executive functions among persons with OCD to confirm this possibility.

Anxiety disorders are common in multiple sclerosis (MS). Chronic worry is the defining feature of generalized anxiety. Despite this, only one study has examined the impact of chronic worry in MS. The present investigation explored the relationship between excessive worry and common physical, emotional, and neuropsychological symptoms in a community-based sample of 50 patients with relapsing-remitting and secondary progressive MS. As expected, MS patients reported significantly more worry than a group of 45 healthy controls. Correlational analyses revealed that MS patients' elevated worry was associated with fatigue, sleep disturbance, problem-solving deficits, pain, and disability status. Follow-up analyses indicated that worry and anxiety may represent related but distinct constructs. Clinicians are urged to regularly monitor and treat pathological worry in MS.

Schizophrenia patients with first-rank (passivity) symptoms (FRS) report a loss of clear boundaries between the self and others and that their thoughts and actions are controlled by external forces. One of the more widely accepted explanatory models of FRS suggests a dysfunction in the 'forward model' system, whose role consists in predicting the sensory consequences of actions [Frith, C., 2006. The neural basis of hallucinations and delusions. Comptes Rendus Biologies 328, 169-175.]. There has been recent interest in the importance of timing precision underlying both the functioning of the forward model, and in processes contributing to the mechanisms of self-recognition [Haggard, P., Martin, F., Taylor-Clarke, M., Jeannerod, M., Franck, N., 2003. Awareness of action in schizophrenia. Neuroreport 14, 1081-1085.]. In the current study, we examined whether schizophrenia patients with FRS have a time perception impairment, using an auditory discrimination task requiring judgments of temporal intervals. Thirty-five schizophrenia patients (15 with, and 20 without, FRS), and 16 non-clinical controls completed the task. The results showed that patients with FRS experienced time differently by underestimating the duration of time intervals. Given the role of timing in shaping sensory awareness and in the formation of causal mental associations, a breakdown in timing mechanisms may affect the processes relating to the perceived control of actions and mental events, leading to disturbances of self-recognition in FRS.

Background Individuals with bipolar disorder have higher rates of cigarette smoking and cognitive deficits when compared to the general population. Emerging evidence indicates that both smoking and cognitive deficits are associated with more severe illness presentation and course. Methods The data were derived from a study evaluating a novel treatment for cognitive function in bipolar disorder. Smoking status was determined by self-report; cognitive function was evaluated with a comprehensive cognitive battery, which included measures of psychomotor speed, attention, memory, learning and executive function. The relations between smoking status and cognitive measures were evaluated with two independent-samples t -test and multiple regression. Results The sample comprised forty-three subjects with bipolar disorder (Type I/II). There were no consistent differences in neuropsychological performance between current smokers ( N = 16) and non-smokers ( N = 27) on most tasks. The occurrence of subjective cognitive failures, as measured with the Cognitive Functioning Questionnaire, was non-significantly lower for smokers compared to non-smokers. Lifetime “smoking load” was negatively associated with premorbid intelligence as estimated by the National Adult Reading Test. Conclusion This pilot study provides preliminary evidence that cigarette smoking may exert a salutary effect on subjective, but not objective, measures of cognitive function in euthymic bipolar patients. A larger sample size evaluating this hypothesis would be less vulnerable to type II error.

Background: Information provided by patients with schizophrenia and their respective carers is used to study the descriptive psychopathology and neuropsychology of formal thought disorder (FTD). Sampling and Methods: Relatively intellectually preserved schizophrenia patients (n = 31) exhibiting from no to severe positive FTD completed a self-report scale of FTD, a scale of insight as well as several tests of executive and semantic function. The patients’ carers completed another scale of FTD to assess the patients’ speech. Results: FTD as self-reported by patients was significantly associated with the synonyms test performance and severity of the reality distortion dimension. FTD as assessed by a clinician and by the patients’ carers was significantly associated with executive test performance and performance in a test of associative semantics. Overall insight was significantly associated with severity of the reality distortion dimension and graded naming test performance, but was not associated with self-reported FTD or severity of FTD as assessed by the clinician or carers. Conclusions: The self-reported experience of FTD has different clinical and neuropsychological correlates from those of FTD as assessed by clinicians and carers. The assessment of FTD by patients and carers used along with the clinician’s assessment may further the study of this group of symptoms.

This review includes 1) an explanation of what neuropsychology is, 2) a brief history of how developmental cognitive neuroscience emerged from earlier neuropsychological approaches to understanding atypical development, 3) three recent examples that illustrate the benefits of this approach, 4) issues and challenges this approach must face, and 5) a forecast for the future of this approach.

Hemispheric differences in the use of memory retrieval cues were examined in a continuous recognition design, using visual half-field presentation to bias the processing of test words. A speeded recognition task revealed general accuracy and response time advantages for items whose test presentation was biased to the left hemisphere. A second experiment recorded event-related brain potentials in the same design and replicated these behavioral effects, but found no electrophysiological support for the hypothesis that test words biased to the left hemisphere elicit superior recognition. Instead, successful retrieval was accompanied by memory components of identical strength regardless of test field. That robust visual field effects in response accuracy and speed were not mimicked in memory components that generally do correlate with such behavioral differences suggests that patterns in overt responses may be dominated by the left hemisphere's superior ability to apprehend words. Differences between the data pattern observed in the present study with lateralized retrieval and that in a prior study with lateralized encoding [Evans, K. M., & Federmeier, K. D. (2007). The memory that's right and the memory that's left: Event-related potentials reveal hemispheric asymmetries in the encoding and retention of verbal information. Neuropsychologia 45(8), 1777-1790.] support the notion that hemispheric processing is highly integrated in the intact brain, and highlight the need to treat lateralization at different stages as distinct.

Patients with schizophrenia and water imbalance may represent a subset of patients with distinct pathophysiological abnormalities and susceptibility to cognitive impairment. Specifically, patients with polydipsia and hyponatremia have been shown to have smaller anterior hippocampal volumes, which are also associated with various impairments in neuroendocrine function. To determine whether abnormalities in patients with water imbalance extend to the cognitive realm, the present study evaluated neuropsychological functioning in three groups of patients with schizophrenia: polydipsic hyponatremic, polydipsic normonatremic, and nonpolydipsic normonatremic. Participants were administered cognitive tests assessing intelligence, attention, learning/memory (verbal, nonverbal, emotional), and facial discrimination. Hyponatremic patients showed poorer overall neuropsychological functioning relative to all other patients, and polydipsic normonatremic patients performed intermediate to the other two groups. Results indicate that patients with schizophrenia and polydipsia, and particularly those with hyponatremia, show prominent cognitive deficits relative to patients without water imbalance. The clinical, neuroendocrine, and cognitive abnormalities in these patients may arise from pathology within the anterior hippocampus and associated prefrontal/limbic brain regions.

An extensive literature indicates that elevated blood pressure (BP) and hypertension are associated with decreased cognitive performance (Elias, Wolf, D'Agostino, Cobb, & White, 1993; Harrington, Saxby, McKeith, Wesnes, & Ford, 2000; Kilander, Nyman, Boberg, Hansson, & Lithell, 1998; Kuo, Sorond, Iloputaife, Gagnon, Milberg, & Lipsitz, 2004). Recent data suggest that, independent of resting BP levels, several BP indexes of autonomic dysregulation are related to lowered levels of cognitive function. In that regard, increased BP variability on ambulatory monitoring, nocturnal non-dipping, and stress-induced BP responses (or BP reactivity) have been associated with poorer cognitive performance or cognitive decline (Bellelli, Pezzini, Bianchetti, & Trabucchi, 2002; Bellelli et al., 2004; Waldstein & Katzel, 2005). In a recent investigation, we found that greater stress-induced BP reactivity in a laboratory setting was associated with lower levels of performance on tests of immediate verbal memory, delayed verbal memory, and executive function explaining 3–8% of the variance in performance in these measures (Waldstein & Katzel, 2005). Abnormal diurnal BP patterning, BP variability, and BP reactivity have also been associated with increased cerebral white matter disease and silent brain infarction on magnetic resonance imaging, thus offering a biologically plausible mechanism that may link measures of autonomic dysregulation to cognitive performance (Goldstein, Bartzokis, Hance, & Shapiro, 1998; Kario, Matsuo, Kobayashi, Imiya, Matsuo, & Shimada, 1996; Waldstein et al., 2004). In the present study, we examined the cross-sectional relations between BP reactivity and cognitive function in a stroke- and dementia-free sample of older adults to further understand what domains of cognitive function (Lezak, Howieson, & Loring, 2004) are most affected by enhanced BP reactivity. We have previously recommended use of comprehensive test batteries that tap multiple domains of cognitive function in studies of health and cognition in order to determine relevant patterns of performance difficulties (Waldstein, 2001). Here we specifically expanded upon prior assessment of attention, verbal and nonverbal memory, executive function and language skills. We hypothesized that, consistent with our prior work, increased BP reactivity would be associated with decreased performance on tests of verbal memory and executive function. Similar to the study of traditional cardiovascular risk factors and cognitive function, many variables may confound the relation of BP reactivity to cognitive performance. Here we evaluated as potential confounders a series of variables that could affect both BP reactivity and cognitive function. These included age, education, resting BP, history of hypertension or diabetes, use of antihypertensive medications, body mass index (BMI), and smoking status.

Cognitive dysfunction is a common feature of schizophrenia and deficits are present before the onset of psychosis, and are moderate to severe by the time of the first episode. Controversy exists over the course of cognitive dysfunction after the first episode. This study examined age-associated differences in performance on clinical neuropsychological (NP) and information processing tasks in a sample of geriatric community living schizophrenia patients (n=172). Compared to healthy control subjects (n=70), people with schizophrenia did not differ on NP tests across age groups but showed evidence for age-associated cognitive worsening on the more complex components of an information-processing test. Age-related changes in cognitive function in schizophrenia may be a function of both the course of illness and the processing demands of the cognitive measure of interest. Tests with fixed difficulty, such as clinical NP tests, may differ in their sensitivity from tests for which parametric difficulty manipulations can be performed.