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Background and PurposeCognitive decline is a function of normal aging; however, the effect of age on various domains is differential. This study examined the effect of age on verbal fluency and showed how speed of processing modifies fluency performance in healthy older adults compared to younger individuals.MethodsThree age groups, 62 young (17–40 years), 30 middle-aged (41–59 years), and 38 older adults (60–78 years), were studied using the Controlled Oral Word Association Test, National Adult Reading Test, and speed-of-processing composite score. The study examined the effect of age on fluency before and after controlling for processing speed and intelligence quotient.ResultsThe young group performed better than the older group on category fluency as measured by animal category (p < .001) and on processing speed composite score (p < .001). However, the older group performed better than the young group on the National Adult Reading Test (p < .05) and on letter fluency after controlling for the decline in processing speed (p < .05). Processing speed had a significant effect on both category and letter fluency (p < .01) in older adults.ConclusionsThis study suggests that aging adversely affects some but not all cognitive domains and that age-related decline in processing speed contributes to age-related changes in fluency.

As part of a comprehensive league-wide study of concussion, the National Football League's Committee on Mild Traumatic Brain Injury sponsored a neuropsychological testing program from 1996 through 2001. Nearly 1,000 athletes participated voluntarily in the study. Traditional paper-and-pencil neuropsychological tests were used for baseline assessment. Neuropsychological tests used in the study included the Hopkins Verbal Learning Test-Revised, the Brief Visuospatial Memory Test-Revised, Trail-Making Tests (Parts A and B), and the Controlled Oral Word Association Test. We present a factor analysis of these baseline data on 513 athletes who completed all of the neuropsychological tests and present normative psychometric data on the multiple baseline tests employed.

Background and Purpose: We investigated the cognitive profiles in a large sample of pa tients with multiple system atrophy-cerebellar ataxia (MSA-C) and compared directly them in patients with clinical diagnosis of probable MSA-C without dementia and control subjects with intact cognition. Methods: We prospectively enrolled 26 patients with clinical diagnosis of probable MSA-C. All patients underwent a standardized neuropsychological test of the Seoul Neuropsychological Screening Battery. Results: The score of Korean version of the MiniMental State Examination was significantly lower in patients with MSA-C (27.2 ± 2.5) than in control subjects (28.9 ± 1.0, p = 0.003). Patients with MSA-C showed a significantly worse performance in visuospatial function, 3 words recall, verbal immediate, delayed and recognition memory, visual delayed memory, phonemic and sementic Controlled Oral Word Association Test, and ideomotor praxis (p < 0.05). Conclusions: Patients with MSA-C show more severe and more widespread cognitive dysfunctions than controls. Our results also indicate that cognitive dysfunction in patients with MCA-C is suggestive of disruption of the cerebellocortical circuits. Journal of Movement Disorders 2011;4:41-45 Key Word: Multiple system atrophy.

Neuroimaging studies of normative human brain development indicate that the brain matures at differing rates across time and brain regions, with some areas maturing into young adulthood. In particular, changes in cortical thickness may index maturational progressions from an overabundance of neuropil toward efficiently pruned neural networks. Developmental changes in structural MRI measures have rarely been examined in relation to discrete neuropsychological functions. In this study, healthy right-handed adolescents completed MRI scanning and the Controlled Oral Word Association Test (COWAT). Associations of task performance and cortical thickness were assessed with cortical-surface-based analyses. Significant correlations between increasing COWAT performances and decreasing cortical thickness were found in left hemisphere language regions, including perisylvian regions surrounding Wernicke's and Broca's areas. Task performance was also correlated with regions associated with effortful verbal processing, working memory, and performance monitoring. Structure–function associations were not significantly different between older and younger subjects. Decreases in cortical thicknesses in regions that comprise the language network likely reflect maturation toward adult-like cortical organization and processing efficiency. The changes in cortical thicknesses that support verbal fluency are apparent by middle childhood, but with regionally separate developmental trajectories for males and females, consistent with other studies of adolescent development.

BACKGROUND AND PURPOSE Using high-field magnetic resonance imaging (MRI), we investigated the relationships between white matter (WM) lesion volume (LV), normal-appearing WM (NAWM) normalized volume, WM-lesion and NAWM magnetization transfer ratios (MTRs), brain parenchyma fraction (BPF), and cognitive impairment (CI) in multiple sclerosis (MS). METHODS Twenty-four patients and 24 healthy volunteers (age, sex, and years of education–matched) underwent a 3.0 Tesla (3T) scan and evaluation of depression, fatigue, and CI using the Minimal Assessment of Cognitive Function in MS (MACFIMS) battery. RESULTS In this clinically relatively well-preserved cohort of patients (median score on the Expanded Disability Status Scale = 1.5), CI was detected on Symbol Digit Modalities Test (SDMT), California Verbal Learning Test-II (CVLT-II), and Controlled Oral Word Association Test. MT data were available in 19 pairs on whom correlation analyses were performed. Associations were seen between SDMT and normalized NAWM volume (P= .034, r= .502), CVLT-II long delay and normalized NAWM volume (P= .012, r= .563), WM-LV (P= .024, r= .514), and BPF (P= .002, r= .666). CONCLUSIONS The use of 3T MRI in a sample of clinically stable MS patients shows the importance of WM disease in hampering processing speed and word retrieval.

Overgeneral autobiographical memory (OGM) is an important cognitive phenomenon in depression, but questions remain regarding the underlying mechanisms. The CaR-FA-X model (Williams et al., 2007) proposes three mechanisms that may contribute to OGM, but little work has examined the possible additive and/or interactive effects among them. We examined two mechanisms of CaR-FA-X: capture and rumination, and impaired executive control. We analysed data from undergraduates (N=109) scoring high or low on rumination who were presented with cues of high and low self-relevance on the Autobiographical Memory Test (AMT). Executive control was operationalised as performance on both the Stroop Colour-Word Task and the Controlled Oral Word Association Test (COWAT). Hierarchical generalised linear modelling was used to predict whether participants would generate a specific memory on a trial of the AMT. Higher COWAT scores, lower rumination, and greater cue self-relevance predicted a higher probability of a specific memory. There was also a rumination×cue self-relevance interaction: Higher (vs lower) rumination was associated with a lower probability of a specific memory primarily for low self-relevant cues. We found no evidence of interactions between these mechanisms. Findings are interpreted with respect to current autobiographical memory models. Future directions for OGM mechanism research are discussed.

BACKGROUND: Traumatic brain injury (TBI) involves several aspects of a patient's condition, including physical, mental, emotional, cognitive, social, and functional changes. Therefore, a clinical trial with individuals with TBI should consider outcome measures that reflect their global status. METHODS: We present the work of the National Institute of Child Health and Development-sponsored Traumatic Brain Injury Clinical Trials Network Outcome Measures subcommittee and its choice of outcome measures for a phase III clinical trial of patients with complicated mild to severe TBI. RESULTS: On the basis of theoretical and practical considerations, the subcommittee recommended the adoption of a core of 9 measures that cover 2 different areas of recovery: functional and cognitive. These measures are the Extended Glasgow Outcome Scale; the Controlled Oral Word Association Test; the Trail Making Test, Parts A and B; the California Verbal Learning Test-II; the Wechsler Adult Intelligence Scale-III Digit Span subtest; the Wechsler Adult Intelligence Scale-III Processing Speed Index; and the Stroop Color-Word Matching Test, Parts 1 and 2. CONCLUSIONS: The statistical methods proposed to analyze these measures using a global test procedure, along with research and methodological and regulatory issues involved with the use of multiple outcomes in a clinical trial, are discussed. Language: en

In “Clinical outcomes of asleep vs awake deep brain stimulation for Parkinson disease,” authors Brodsky et al. aimed to compare motor and nonmotor outcomes at 6 months of asleep deep brain stimulation (DBS) for Parkinson disease (PD) using intraoperative imaging guidance to confirm electrode placement vs awake DBS using microelectrode recording to confirm electrode placement. They found that asleep DBS for PD was associated with improved motor outcomes over 6 months, on par with, or better than, awake DBS, and was superior with regard to speech fluency and quality of life. In the accompanying editorial, Drs. Aziz and Hariz point out that microelectrode recording (MER) should be reserved as a tool for scientific research on basal ganglia neuronal activity. The authors explain that well-visualized targets, such as the subthalamic nucleus and internal globus pallidus (GPi), can also be done while the patient is fully asleep and without MER. Commenting on the Brodsky et al. article, Dr. Sidiropoulos requests comparison between image-guided DBS surgery and MER-guided surgery and questions why the asleep group was more shifted towards GPi as a target compared to the awake cohort. Commenting on the editorial, Dr. Sidiropoulos also suggests that accurate thalamic targeting for tremor using image-guided techniques is more challenging. Dr. Aziz, author of the editorial, agrees that the subdivisions of the thalamus are not so clearly visualized. He explains, however, that using image-guided approaches is emerging and thalamic targets can be extrapolated from visualization of the red nucleus and the posterior subthalamic area. Dr. Troster also commented on the article. He asks for several clarifications regarding verbal fluency scores data, correlation between verbal fluency scores and 39-item Parkinson's Disease Questionnaire (PDQ-39) cognition and communication scores, and the effect on the Dementia Rating Scale (DRS). Brodsky et al. explain that Controlled Oral Word Association Test (COWAT) standard scores were used and that the longitudinal mixed-effects models were evaluated and confirmed previous findings. They clarify that statistical analysis of the correlation between the COWAT speech fluency scores and the cognition and communication subscores of the PDQ-39 was not performed, but that the improvement in both cohorts was significant. Finally, they explain that while the DRS is influenced by speech fluency, there were enough other factors in the DRS that counterbalanced the improvement in speech that was seen in the asleep DBS group. In “Clinical outcomes of asleep vs awake deep brain stimulation for Parkinson disease,” authors Brodsky et al. aimed to compare motor and nonmotor outcomes at 6 months of asleep deep brain stimulation (DBS) for Parkinson disease (PD) using intraoperative imaging guidance to confirm electrode placement vs awake DBS using microelectrode recording to confirm electrode placement. They found that asleep DBS for PD was associated with improved motor outcomes over 6 months, on par with, or better than, awake DBS, and was superior with regard to speech fluency and quality of life.

BackgroundIt is reported that executive functions are impaired in a variety of neuropsychiatric syndromes, including depressive disorders. Studies on executive functions in depressive disorders are inconclusive. MethodsA total of 50 drug naïve patients with major depressive disorder were included in the study. The severity of depression was measured using the Hamilton Depression Rating Scale (HAM-D), and executive functions were assessed using the Digit Symbol Substitution Test, Digit Vigilance Test, Controlled Oral Word Association Test, Animal naming test, Verbal N back (1&2) test, Trail making test A & B and Stroop test as per the NIMHANS Neuropsychology Battery 2004 manual. ResultsThe mean age of the sample was 31.9 years. Females constituted 60% of the sample. A majority were Hindus, nearly 75% were from semi-urban areas, 66% were married, and 58% had a college education. Depression was associated with poor performance on executive functions except for working memory and set shifting. Older age, greater severity of depression, a longer duration of illness and the duration of the present episode were associated with poor performance on executive functions. A higher level of education was associated with better performance on executive functions. ConclusionsThis cross-sectional assessment suggests that some aspects of executive functions are impaired in patients with major depressive disorder. Further studies in remitted patients, controlled for age, and education level are suggested.

Although their neurocognitive performance is one of the major concerns of patients with high-grade gliomas (HGG) and although neurocognitive deficits have been described to be associated with negative outcome, neurocognitive rehabilitation is usually not integrated into the routine care of patients with malignant gliomas. In this pilot trial, a weekly group training session for attention, verbal, and memory skills was offered to patients with HGG with pre and post-training evaluation. Eleven patients, six with glioblastoma multiforme and five with WHO grade III gliomas, median age 50 years, with a Karnofsky performance score of 80-100 participated in ten group training sessions of 90 min. For evaluation at baseline and after the training by a neuropsychologist not involved in care or training of the patients, Trail Making Tests A and B (TMTA and TMTB), Hopkins Verbal Learning Test (HVLT), and the Controlled Oral Word Association Test (COWA) were used. Comparison of mean group differences between baseline and at post-training evaluation after 12 weeks revealed improvement across all neurocognitive variables. The patients showed a great diversity in their performances, with worsening, improvement, and stabilization. However, a significant group difference was detected only for the HVLT (score 19.6 +/- 8.9 at baseline, 23.6 +/- 8.8 after 12 weeks, P = 0.04). This pilot study shows that neurocognitive training in patients with HGG is feasible as group training with weekly sessions and might be able to induce improvements in attention and memory skills.

The Mayo Cognitive Factor Scores were derived from a “core battery” consisting of the WAIS-R, WMS-R, and Auditory Verbal Learning Test. The present study sought to clarify the factor structure of an expanded neuropsychological battery in normal elderly controls. Confirmatory factor analysis was performed on the WAIS-III, WRAT-3 Reading, Boston Naming Test, Controlled Oral Word Association Test, Category Fluency, Rey-Osterrieth Complex Figure, Visual Form Discrimination, and Trail Making Test A & B. A base four-factor model consistent with the WAIS-III factor structure was utilized. Only one novel five factor model differentiating processing and motor speed tests improved upon this base model. Other models did not, including a factor for executive function, division of construction/visuospatial ability, or “hold”/“no hold” language abilities.

This study was conducted to find out the association of diabetes mellitus with cognitive functioning and depressive features. We included 50 diabetic and 30 control subjects who were screened on the basis of various inclusion and exclusion criteria. Then, a history of variables under study was taken and respective laboratory investigations were noted. First, the Becks Depression Inventory (BDI) was administrated to the patients. The cognitive function was then assessed using the digit span test, stroop Test, controlled oral word association test, visual target cancellation test, digit symbol substitution test, and visuospatial working memory matrix. The composite score on all tests was used to make cognitive index. The data was compiled and appropriate statistical methods were used. We found that 48% of elderly diabetic patients showed cognitive impairment. Poor metabolic control (hyperglycemia) was associated significantly and negatively with cognitive index in diabetic patients. Hyperglycemia was significantly and negatively correlated with immediate memory and attention, verbal memory, psychomotor functioning (DSST), and visuospatial memory. In conclusion, genesis of cognitive deficits in diabetic patients is complex. However, it appears from the study that such deficits do exist and may be associated with chronically poorly controlled diabetes.

The effects of interrupting an event-based prospective memory (PM) task and its associated ongoing task were compared for two groups of children: 8- to 9-year-olds (n = 35) and 12- to 13-year-olds (n = 28). Additionally, PM performance was examined as a function of attainment on a battery of tests of executive functioning (viz., Controlled Oral Word Association Test, Letter Number Sequencing Test, Stroop Color and Word Test, and Trail Making Test). A significant main effect of age indicated that the older children correctly carried out intended actions more often than the younger children. Consistent with the prefrontal model of PM, interruption had no impact on PM accuracy in the older group but produced reliable decrements to the accuracy of the younger group. Whereas IQ showed no association with PM performance, reliable relations between PM skills and aspects of their executive functioning were found.

Previous research has documented the impact of time of day on vigilance and memory and the moderating influence of circadian typology (morningness-eveningness) on the relationship between time of testing and cognitive processes. This study examined the impact of circadian typology and time of testing on executive functions. Morning-type and evening-type people were randomly assigned to a morning or afternoon testing time, and their performance on neuropsychological tests, including the Conners Continuous Performance Test (CPT), the Digit Span test, the Controlled Oral Word Association Test (COWAT), and the Wisconsin Card Sorting Test (WCST) was compared. No interactions between circadian typology and time of day were observed on the CPT or Digit Span test. A time of day effect was found on the letter generation portion of the COWAT. More words were generated in the afternoon than in the morning. In contrast, performance on the WCST was best when morning-type participants were tested at their optimal time of day. These findings suggest that circadian typology should be considered when scheduling neuropsychological assessments, rehabilitation training, and critical job tasks.

Previous studies have established that prospective memory is commonly affected following traumatic brain injury (TBI). This study examines whether demographic factors, injury severity and site, executive function, and metacognitive factors predict prospective memory performance in adults with TBI, using a cross-sectional multivariate correlational model. Prospective memory of 44 adults (mean age = 30 years) with severe TBI was measured by the Cambridge Prospective Memory Test (CAMPROMPT) time-based and event-based scores. Using stepwise multiple regression, the time-based score was predicted by the Controlled Oral Word Association Test (COWAT) Animals subtest score, length of post-traumatic amnesia (PTA) and use of note-taking on the CAMPROMPT. The event-based score was predicted by length of PTA and COWAT Animals score. Therefore, patients with longer periods of PTA and executive function impairment may be expected to display poorer prospective memory. Note-taking was associated with improved performance on time-based prospective memory tasks. (JINS, 2008,14, 823–831.)

Objective. This preliminary study aimed to investigate the effects of long-term frequent ketamine treatment on cognitive function in [AQ-A] CRPS patients. Design. A total of 30 CRPS patients were divided into two groups based on both the duration and frequency of ketamine treatment; the long-term frequent ketamine treatment (LF) group (N = 14) and the Non-LF group (N = 16). Participants were asked to complete a questionnaire packet including demographic and clinical characteristics and potential variables affecting cognitive function. Then, they performed the neuropsychological test. Results. Results indicated that the LF group performed significantly poorer than the Non-LF group on the digit span, digit symbol, Controlled Oral Word Association Test, and Trail Making Test, but not the Stroop task. Conclusions. Patients with CRPS receiving long-term frequent ketamine treatment showed impairment in cognitive function (specifically executive function) compared with those who do not. These findings may have implications for clinical assessment and rehabilitation of cognitive function in CRPS patients.

Objective: We describe the implementation of cognitive measures within the Canadian Longitudinal Study on Aging (CLSA), a nationwide, epidemiological study of aging, and relate CLSA Tracking cohort data (n over 20,000) to previous studies using these measures.Method: CLSA participants (aged 45–85, n over 50,000) provided demographic, social, physical/clinical, psychological, economic, and health service utilization information relevant to health and aging through telephone interviews (Tracking cohort, n over 20,000) or in-person (i.e. Comprehensive cohort, n over 30,000) in both official languages (i.e. English, French). Cognitive measures included: the Rey Auditory Verbal Learning Test (RAVLT) – Trial 1 and five-minute delayed recall; Animal Fluency (AF), the Mental Alternation Test (MAT) (both cohorts); Controlled Oral Word Association Test, Stroop Test, Prospective Memory Test, and Choice reaction times (Comprehensive Cohort).Results: Performance on the RAVLT Trial 1 and AF were very similar to comparable groups studied previously; CLSA sample sizes were far larger. Within the CLSA Tracking cohort, main effects of age and language were observed for all cognitive measures except RAVLT delayed recall. Interaction effects (language × age) were observed for AF.Conclusion: This preliminary examination of the CLSA Tracking cognitive measures lends support to their use in large studies of aging. The CLSA has the potential to provide the ‘best’ comparison data for adult Canadians generated to date and may also be applicable more broadly. Future studies examining relations among the psychological, biological, health, lifestyle, and social measures within the CLSA will make unique contributions to understanding aging.

Our objective was to establish a valid and reliable battery of measures to evaluate frontotemporal dementia (FTD) in patients with ALS over the telephone. Thirty-one subjects were administered either in-person or by telephone-based screening followed by the opposite mode of testing two weeks later, using a modified version of the UCSF Cognitive Screening Battery. Equivalence testing was performed for in-person and telephone based tests. The standard ALS Cognitive Behavioral Screen (ALS-CBS) showed statistical equivalence at the 5% significance level compared to a revised phone version of the ALS-CBS. In addition, the Controlled Oral Word Association Test (COWAT) and Center for Neurologic Study-Lability Scale (CNS-LS) were also found to be equivalent at the 5% and 10% significance level, respectively. Similarly, the Mini-Mental State Examination (MMSE) and the well-established Telephone Interview for Cognitive Status (TICS) were also statistically equivalent. Equivalence could not be claimed for the ALS-Frontal Behavioral Inventory (ALS-FBI) caregiver interview and the Written Verbal Fluency Index (WVFI). In conclusion, our study suggests that telephone-based versions of the ALS-CBS, COWAT, and CNS-LS may offer clinicians valid tools to detect frontotemporal changes in the ALS population. Development of telephone based cognitive testing for ALS could become an integral resource for population based research in the future.

Voxel-based morphometry (VBM) was used to examine the relationship between gray matter (GM) volume and performance on two commonly used clinical neuropsychological measures of frontal lobe or executive function, the Trail Making Test part B (TrailsB) and the Controlled Oral Word Association Test (COWAT) in 221 cognitively healthy adults between the ages of 18 and 84. We hypothesized that these measures would be associated with GM volume in the dorsolateral frontal lobes. Voxel-based multiple regression was used to correlate cognitive function with modulated GM probability maps while controlling for age, education, gender, and total intracranial volume. A relationship with TrailsB was found in bilateral lateral inferior frontal gyri and left basal ganglia. A relationship with COWAT was found in the left lateral inferior and middle frontal gyri. Lesion studies have long implicated the importance of these regions for executive function. The present results confirm and extend those prior findings to healthy adults.

The reliability and validity of two qualitative scoring systems for the Controlled Oral Word Association Test [Benton, A. L., Hamsher, de S. K., & Sivan, A. B. (1983). Multilingual aplasia examination (2nd ed.). Iowa City, IA: AJA Associates] were examined in 108 healthy young adults. The scoring systems developed by Troyer et al. [Troyer, A. K., Moscovich, M., & Winocur, G. (1997). Clustering and switching as two components of verbal fluency: Evidence from younger and older healthy adults. Neuropsychology, 11, 138–146] and by Abwender et al. [Abwender, D. A., Swan, J. G., Bowerman, J. T., & Connolly, S. W. (2001a). Qualitative analysis of verbal fluency output: Review and comparison of several scoring methods. Assessment, 8, 323–336] each demonstrated excellent interrater reliability (all indices at or above ricc = .9). Consistent with previous research [e.g., Ross, T. P. (2003). The reliability of cluster and switch scores for the COWAT. Archives of Clinical Psychology, 18, 153–164), test–retest reliability coefficients (N = 53; M interval 44.6 days) for the qualitative scores were modest to poor (ricc = .6 to .4 range). Correlations among COWAT scores, measures of executive functioning, verbal learning, working memory, and vocabulary were examined. The idea that qualitative scores represent distinct executive functions such as cognitive flexibility or strategy utilization was not supported. We offer the interpretation that COWAT performance may require the ability to retrieve words in a non-routine manner while suppressing habitual responses and associated processing interference, presumably due to a spread of activation across semantic or lexical networks. This interpretation, though speculative at present, implies that clustering and switching on the COWAT may not be entirely deliberate, but rather an artifact of a passive (i.e., state-dependent) process. Ideas for future research, most noticeably experimental studies using cognitive methods (e.g., priming), are discussed.

OBJECTIVES: To evaluate the effect of ultra-low-dose (0.25 mg/d) micronized 17β-estradiol on cognitive function in older postmenopausal women. DESIGN: Randomized, placebo-controlled trial conducted for 3 years. SETTING: Academic health center in greater Hartford, Connecticut. PARTICIPANTS: Fifty-seven healthy, community-dwelling, older postmenopausal women. INTERVENTION: Women received 0.25 mg/d of micronized 17β-estradiol (estrogen therapy (ET), n=32) or placebo (n=25); all women who had not had a hysterectomy received 100 mg/d of oral micronized progesterone for 2-week periods every 6 months. MEASUREMENTS: Neuropsychological measures of memory, language, mood, and executive function were collected at baseline, 3 months, and 36 months. Measures of executive function included the Controlled Oral Word Association Test, the Trail Making Test, and the Wisconsin Card Sorting Test. The Boston Naming Test was used to measure language skills. The Symbol Digit Modalities Test was used as a measure of sustained attention. Measures of memory included the Complex Figure Test, Fuld Object Memory Test, and a selected subtest from the Wechsler Memory Scale. Scores from the Geriatric Depression Scale and the Beck Anxiety Inventory were used to assess symptoms of depression. RESULTS: No differences were found between ET and placebo on any of the neurocognitive measures or depression instruments, nor were there any differences when the groups were stratified according to age. CONCLUSION: This small study, which had adequate power to detect change in some but not all domains of cognition tested, revealed that low-dose estrogen neither benefits nor harms cognitive function in older women after 3 years of treatment, but confirmation is needed from larger trials.

Introduction: This paper reports on the development of a national recruitment and clinical assessment strategy by the Australian Schizophrenia Research Bank (ASRB). The aim of this strategy is to ensure a representative sample of people with schizophrenia and to collect comprehensive, cross-referenced clinical, cognitive, genetic, brain imaging and linked data. Method: The ASRB recruitment targets are 2000 people with schizophrenia and 2000 healthy, non-psychiatric controls. Using a three pronged approach, schizophrenia subjects will be recruited from various settings. To recruit people in the community, a successful TV and radio community service advertisement campaign was developed and a national 1800 telephone number established. The assessment battery includes the Diagnostic Interview for Psychosis (DIP: Castle et al, 2005), Neurological Evaluation Scale (Buchanan & Heinrichs, 1989), Wechsler Test of Adult Reading (WTAR-Wechsler, 2001), Wechsler Abbreviated Scale of Intelligence (WASI-Wechsler, 1999), Repeatable Battery for Assessment of Neuropsychological Status (RBANS Randolph et al, 1998), Letter Number Sequencing (Wechsler, 1997), Controlled Oral Word Association Test (Spreen & Benton, 1969), Global Assessment of Functioning (GAF-American Psychiatric Association, 2000), and the Schizotypal Personality Questionnaire (Raine et al., 1991). In addition, a blood sample and structural MRI scan are collected. Results: Over 2000 people have registered with the ASRB using the 1800 number. A proportion of these people have been assessed using the ASRB assessment battery. Conclusion: The ASRB is the first Australian research facility to develop a national recruitment and clinical assessment strategy in schizophrenia.

Measures of phonemic and semantic verbal fluency, such as FAS and Animal Fluency (Benton, Hamsher, & Sivan, 1989), are often thought to be measures of executive functioning (EF). However, some studies (Henry & Crawford, 2004a , 2004b , 2004c ) have noted there is also a language component to these tasks. The current exploratory factor-analytic study examined the underlying cognitive structure of verbal fluency. Participants were administered language and EF measures, including the Controlled Oral Word Association Test (FAS version), Animal Fluency, Boston Naming Test (BNT), Vocabulary (Wechsler Adult Intelligence Scale-III), Wisconsin Card-Sorting Test (WCST, perseverative responses), and Trail-Making Test-Part B (TMT-B). A 2-factor solution was found with the 1st factor, language, having significant loadings for BNT and Vocabulary, while the second factor was labeled EF because of significant loading from the WCST and TMT-B. Surprisingly, FAS and Animal Fluency loaded exclusively on to the language factor and not EF. The current results do not exclude EF as a determinant of verbal fluency, but they do suggest that language processing is the critical component for this task, even without significant aphasic symptoms. Thus, the results indicated that both letter (phonemic) and category (semantic) fluency are related to language, but the relationship to EF is not supported by the results.

The construct validity of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was investigated in a sample of 210 acute ischemic stroke patients seen on an inpatient rehabilitation unit. Intercorrelations between the six index scores were found to be relatively consistent with previously published work. A principal components analysis yielded a two-factor (Language/Verbal Memory and Visuospatial/Visual Memory) solution that accounted for 61% of the variance. Correlations generated between the resulting factor scores, the Controlled Oral Word Association Test (COWA), the Visual Form Discrimination Test (VFD), Boston Diagnostic Aphasia Examination (BDAE) Complex Ideational Material Test (CIM), the presence of neglect as determined by Line Bisection Test performance, and the Mini Mental Status Examination (MMSE) supported the validity of these factors. A comparison of the obtained factor scores in a subgroup of 111 left and right hemispheric stroke patients showed that the left hemispheric stroke patients performed more poorly on the Language/Verbal Memory factor score than did right hemispheric stroke patients while the converse was true for the Visuospatial/Visual Memory factor score. Implications for the construct validity of the RBANS and its use and interpretation in clinical assessment are discussed.

The equivalence of forms CFL and PRW of the Controlled Oral Word Association Test (COWAT; Benton, de Hamsher, & Sivan; 1994) was examined in samples of healthy college students. Both novel words and qualitative scores (e.g., clusters, switches) were examined using null hypothesis statistical testing (NHST) and inferential confidence intervals (Tryon, 2001). Study 1 used a within-subjects design (n = 66) to examine form equivalence in persons who completed versions CFL and PRW. No mean differences were found for any index, and only one (mean cluster size) differed when examining the standard deviations across forms. Inferential confidence intervals were constructed and Rg (maximum probable difference) values were small and, when compared to prior research, less than the standard error of measure associated with using a single form. In Study 2, we employed a between-subjects design (n = 208) and found that the use of each version generated comparable normative data and correlations among scores. These studies suggest that versions CFL and PRW are best viewed as alternate (rather than parallel) forms at this time; however, they are likely to produce comparable results for most purposes. We discuss the use of inferential confidence intervals to examine form equivalence and directions for future work.

This study examined the utility of baseline psychomotor speed, measured with neuropsychological tests, to predict fluoxetine response in moderately depressed outpatients. The authors hypothesized that since psychomotor slowing in depressed patients has been linked to reduced dopaminergic neurotransmission, patients with slowing would be unresponsive to fluoxetine, a selective serotonin reuptake inhibitor.After baseline neuropsychological testing, patients were treated openly with fluoxetine for 12 weeks. Thirty-seven patients completed the trial.Compared to the 25 patients who responded, the 12 patients who did not respond to fluoxetine exhibited significantly poorer performance in verbal fluency on the Controlled Oral Word Association Test FAS and in color naming on the Stroop Color and Word Test. In addition, the nonresponders tended to perform worse than the responders on the Stroop Color and Word Test reading subtest and the WAIS-III digit symbol subtest. Differential treatment response was specific to psychomotor speed because responders and nonresponders did not perform differently on tasks of executive functioning, attention, visuospatial functioning, or verbal intelligence.Psychomotor slowing may identify a subgroup of depressed patients who have a dopaminergic deficit that is unresponsive to fluoxetine monotherapy and who should therefore receive an alternative treatment.

This study examined the impact of instructional changes on the temporal stability of cluster and switch scores for the Controlled Oral Word Association Test [COWAT; Benton, A. L., Hamsher, K., & Sivan, A. B. (1994). Multilingual Aphasia Examination (3rd ed.). Iowa City, IA: AJA Associates]. Healthy undergraduates were assigned randomly into experimental ( N = 60) and control ( N = 60) groups. Experimental group participants were administered three letters as customary, then informed about clustering strategies prior to completing three additional letters. Control group participants received the original instructions only for all six letters. All participants were examined on two separate occasions. The mean inter-assessment interval was 38.6 days (ranging from 29 to 47 days). Stability coefficients for cluster and switch scores on the last set of letters differed significantly between groups, as higher coefficients were observed for the experimental group. In contrast, stability coefficients for the total words produced and mean cluster size did not differ between groups. Although the temporal stability improved, the resulting coefficients were modest (e.g., r icc = .76 for clusters; r icc = .79 for switches). We present implications of these findings and considerations for future research.

The transtheoretical model of Prochaska and DiClemente [ Psychother. Theory Res. Prac. 19 (1982) 276] postulates that cognitive skills are critical for drinking behavior change. Memory and executive cognitive function likely influence the execution of skills that are implicated for both motivating and sustaining drinking behavior change. Participants who met criteria for alcohol abuse or dependence ( N =117) were administered a battery of standardized memory and executive cognitive function tests that included the Wechsler Memory Scale-Revised (WMS-R), Controlled Oral Word Association Test (COWAT), Ruff Figural Fluency Test (RFFT), and Wisconsin Card Sort Test (WCST). Lower verbal and higher delayed recall memory score at baseline significantly predicted precontemplation, higher verbal memory scores predicted contemplation, and better attention–concentration at baseline significantly predicted reduced drinking at 3-month follow-up, after controlling for baseline alcohol consumption. The study findings indicate that explicit memory processes may have utility for predicting readiness to change drinking behavior.

Background The subjectively assessed quality of life of schizophrenia patients is mostly lower than healthy subjects, and cognitive impairment is an integral feature of schizophrenia. The aims of the present study were to compare the quality of life and neurocognitive functioning between the patients with schizophrenia and the healthy subjects, and to examine the relationships between quality of life and neurocognitive functions among the patients with schizophrenia. Methods Thirty-eight patients with schizophrenia (15 women and 23 men) and 31 healthy individuals (18 women and 13 men) were included in the study. All participants were administered World Health Organization Quality of Life–Brief Form (WHOQOL-BREF) to assess their quality of life, and Digit Span Test (DST) and Controlled Oral Word Association Test (COWAT) for cognitive functions. Results The patients with schizophrenia demonstrated lower scores in physical ( F =25.6, p =0.0001), psychological ( F =15.85, p =0.0001) and social ( F =37.7, p =0.0001) domains compared to control group. The patients with schizophrenia showed significantly lower scores on COWAT compared to healthy subjects ( F =4.22, p =0.04). The social domain scores of WHOQOL correlated to DST total scores ( r =0.45, p =0.007), DST forwards scores ( r =0.54, p =0.001) and COWAT total scores ( r =0.40, p =0.04) in patients with schizophrenia but not in the control group. The patients with lower level of cognitive functioning had lower scores on social domain of WHOQOL-BREF ( z =−2.01, p =0.04). Conclusion Our results confirm that the cognitive deficits in executive function and working memory appear to have direct impact on the patients’ perceived quality of life especially in social domain which can either be a cause or a consequence of social isolation of patients with schizophrenia.

Background Deep brain stimulation (DBS) is commonly used in the treatment of Parkinson’s disease (PD). Various research groups have reported that DBS is associated with decreased verbal fluency. We investigated the possible confounding effects of patients’ age, disease duration and levodopa equivalent daily dose (LEDD) on verbal fluency performance after DBS in patients with PD. Methods 43 patients with PD and without major psychiatric illness (according to DSM-IV) were enrolled in the study, median age 63.4 years, range 39–76. Subjects were allocated to two groups: the first were scheduled to bilateral DBS-STN (n = 21), the second comprised patients without DBS surgery (n = 22). Verbal fluency performance in both groups was assessed with Controlled Oral Word Association Test at baseline and eight months later. Results Decline in semantic fluency performance was found in the DBS group (p = 0.03). No confounding effect of age, disease Duration and LEDD was found in relation to this decline. Conclusions This restrospective observation confirms previous findings showing a decline in verbal fluency after DBS-STN in PD patients when compared with PD patients without surgery. Verbal fluency decline is unrelated to age, disease duration and LEDD.

This study aimed to evaluate the influence of cognitive demand on prospective-memory in individuals with traumatic brain injury (TBI) using a dual-task paradigm. Fourteen individuals with severe TBI and 14 matched controls were required to undertake two tasks. A lexical-decision task was used as an ongoing task and had two levels of cognitive demand (viz., low and high). The event-based prospective-memory task involved performing a specific action whenever a target stimulus appeared during the ongoing task. The Letter-Number Sequencing Test, the Tower of London and the Controlled Oral Word Association Test were also administered to assess the relationship between prefrontal lobe functions and prospective memory. As hypothesised, participants in the TBI group performed more poorly than participants in the control group on the prospective-memory task in the high but not in the low demand condition. There were significant correlations between prospective-memory task performance and scores on the Letter-Number Sequencing Test and the Controlled Oral Word Association Test. These findings help to clarify the nature of prospective-memory impairment in individuals with TBI and support the involvement of prefrontal processes in prospective remembering.

Apathy and executive cognitive dysfunction (ECD) are important though conceptually different aspects of late-life depression. The primary objective of this study was to evaluate the relationship of apathy to ECD. The authors also evaluated the relationship of apathy and ECD to global cognitive impairment and word generation. Fifty-two elderly subjects with major depression and MMSE scores of 15 or greater were evaluated with apathy-related items from the Hamilton rating scale for depression (ApHRSD), the Executive Interview (EXIT), the Dementia Rating Scale (DRS), and the Controlled Oral Word Association test (COWA). ApHRSD scores were not significantly correlated with any of these variables. EXIT scores were correlated significantly with DRS and COWA. The results suggest that apathy and ECD may be independent of each other in some samples of elderly with late-life depression. Correlations may have been reduced by low variance for the variables of interest and by psychometric limitations of the ApHRSD. ( J Geriatr Psychiatry Neurol 2003; 16:112-116)

The outcome of patients with brain metastases is generally poor. Survival alone is not necessarily a good measure of clinical outcome. Measures of neurocognitive function and the impact of the disease and treatments on functional status also need to be considered. Although these parameters have been measured in patients with primary brain tumors, they have not been as thoroughly evaluated in patients with brain metastases. The Mini-Mental State Examination provides limited assessment of neurocognitive domains impaired in brain tumor patients. It is less sensitive to mild impairment, does not avoid memorized learning from repeat administration, and does not have validated alternative forms necessary for non-English speaking patients. To determine the feasibility of using a more comprehensive neurocognitive test battery, motor, verbal, executive, and daily functions were assessed in 30 patients with brain metastases. The test battery included the Hopkins Verbal Learning Tests, Controlled Oral Word Association Test, Grooved Pegboard Test, Trailmaking Tests A and B, and the Barthel Index. In this study, there was complete patient compliance, with average test completion time of 23 +/- 6 minutes. Despite high functional status, most patients demonstrated impairment in memory and fine motor domains. Neurocognitive test batteries can and should be used in patients with brain metastases enrolled in clinical trials.

This study examined the interrater reliability and temporal stability of a scoring system developed by Troyer, Moscovich, and Winocur [Neuropsychologia 11 (1997) 138] to measure clustering and switching on verbal fluency (VF) tasks such as the Controlled Oral Word Association Test (COWAT) [Benton, A.L., Hamsher, K., & Sivan, A.B. (1983). Multilingual aphasia examination (3rd ed.). Iowa City, IA: AJA Associates]. Seven independent raters scored COWAT protocols of 125 healthy participants in accordance with the rules proposed by Troyer et al. Intraclass coefficients were near perfect, ranging from.96 for total number of clusters to.99 for total number of switches. Test-retest reliability coefficients (n=55) were poor to modest (r=.47 for clusters, r=.58 for switches, and r=.70 for total words). Significant improvement in performance was observed across most COWAT indices, suggesting a practice effect. Modifications to test administration are suggested to improve the stability of cluster and switch scores, as well as other variables for further study.

OBJECTIVES: To determine whether a tape recorder can be used to administer cognitive tests efficiently and yield valid results. DESIGN: Convenience sample. Administration of cognitive test materials by tape recorder and conventional technique. SETTING: Outpatient clinic. PARTICIPANTS: Subjects from memory disorder clinic, hostel accommodation, and community. MEASUREMENTS: Responses to Hopkins Verbal Learning Test–revised, verbal fluency items from the controlled oral word association test, 10-item naming task, a construction task, and speed writing task. RESULTS: Performances on the tape- and clinician-administered battery of tests were highly correlated. Memory impairment was accurately detected using the tape battery. Data from 30 minutes of testing via tape were obtained at the cost to the clinician of 2 to 3 minutes of scoring time. CONCLUSION: Tape-administration of cognitive test material warrants further study as an efficient means of cognitive screening.

This study provides preliminary norms and test-retest indices on a brief battery of neuropsychological tests administered to a sample of 60 male and 40 female high school athletes. Forty-eight subjects completed retesting 8 weeks later. Analyses of baseline scores indicate that girls outperform boys on selected measures of processing speed and executive functions [Wechsler Adult Intelligence Scale-III (WAIS-III) Digit Symbol, Trails B, and Controlled Oral Word Association Test (COWAT)]. Test-retest reliability was low and varied widely among the tests. There were no gender differences in test-retest reliability. Reliable Change Indices (RCIs) were computed on the test-retest data for use in clinical interpretation. These preliminary results indicate that caution should be used in interpreting neuropsychological test data from high school athletes. The current findings indicate that separate norms for boys and girls are warranted. Caution should be used in interpreting discrepancies from baseline scores as a result of what may turn out to be poor test-retest reliability in this population.

Social engagement provides dynamic stimulation for older individuals that influences cognition. Grandparenting is an increasingly popular form of childcare that provides social activity for older adults. Objective: To investigate the relationship between grandparenting, as a form of social engagement, and cognitive function in adults aged over 65, a decade after our previous work. Study design: Participants were 224 Australian women (mean age = 70) from the longitudinal prospective Women's Healthy Ageing Project (WHAP). Cognitive function was assessed using a neuropsychological battery consisting of previously validated measures including the California Verbal Learning Test, Digit Span task, and Controlled Oral Word Association Test. Individual test scores were combined using factor analysis into executive function and episodic memory scores. Results: Grandmothers minding grandchildren had higher executive function than those who were not minding grandchildren or who did not have grandchildren (p < 0.05). Minding grandchildren for one day per week predicted better executive function performance than more frequent grandparenting (p < 0.05), consistent with previous findings. Conclusions: While grandparenting is associated with better executive function overall, highly frequent grandparenting is associated with lower executive function, which may be due to demands. Social engagement comprises various aspects which need to be taken into consideration when studying cognition.

IntroductionThe Executive Interview (EXIT25) is an effective measure of executive dysfunction, but may be inefficient due to the time it takes to complete 25 interview-based items. The current study aimed to examine psychometric properties of the EXIT25, with a specific focus on determining whether a briefer version of the measure could comprehensively assess executive dysfunction.MethodThe current study applied a graded response model (a type of item response theory model for polytomous categorical data) to identify items that were most closely related to the underlying construct of executive functioning and best discriminated between varying levels of executive functioning. Participants were 660 adults ages 40 to 96 years living in West Texas, who were recruited through an ongoing epidemiological study of rural health and aging, called Project FRONTIER. The EXIT25 was the primary measure examined. Participants also completed the Trail Making Test and Controlled Oral Word Association Test, among other measures, to examine the convergent validity of a brief form of the EXIT25.ResultsEight items were identified that provided the majority of the information about the underlying construct of executive functioning; total scores on these items were associated with total scores on other measures of executive functioning and were able to differentiate between cognitively healthy, mildly cognitively impaired, and demented participants. In addition, cutoff scores were recommended based on sensitivity and specificity of scores.ConclusionA brief, eight-item version of the EXIT25 may be an effective and efficient screening for executive dysfunction among older adults.

Little is known about differences in human brain structures relating to sexual orientation. We can find sexual orientation differences among men and women in terms of function, human exhibit sex differences in reproduction, gonadotropin secretion, cognitive abilities and others. Research show strong similarities of gay man with brains of heterosexual women in hemisphere dominance and in many other respects; also brains of lesbian woman show similarities to those of heterosexual men. Our study will focus on differences in cognitive abilities among studied groups, which will be linked with theory of differences in brain structures and sexual dimorphism. In our study there will be included several heterosexualy and homosexualy oriented participants. First, to define sexual orientation our subjects will have to complete questionnaire. To determine the brain sex of participants we will give them a questionnaire relating to their brain dominance. For testing the differences in cognition we will use two tests. One for measuring spatial ability and other for testing the verbal fluency in tests subjects. English version is called COWAT – Controlled Oral word Association test, but we will use our own variation of it. The test will include words starting with letters N, O and S, because they are most frequent in Slovene. With given different sexual orientations in combination with known brain sex of every single subject we will test our hypothesis on how our subject will perform in different cognitive ability tasks. Hypothesis: 1. Heterosexual men will perform better than homosexual men and heterosexual women on test of spatial abilities. 2. On the verbal fluency test heterosexual women will perform better than homosexual women and heterosexual men. 3. Heterosexual woman will have equal results as homosexual men on questionnaire relating to the brain dominance. 4. Homosexual men will have equal results as heterosexual women on the questionnaire.

A neurocognitive model of thought disorder is proposed that links: (1) impaired ability to establish set with poverty of speech; (2) impaired ability to maintain set with positive thought disorder; and (3) impaired ability to shift sets with perseveration in speech. The aim of this study is to examine performance on tests sensitive to set ability in patients prone to thought disorder. Patients with schizophrenia (n = 36), mania (n = 18) and a well control group (n = 20) were assessed on two occasions separated by 4 weeks. Testing included: a free speech sample, Controlled Oral Word Association test, Stroop test, Wisconsin Card Sort test, and the Trail Making test. Impaired ability to maintain set in the face of interference was correlated with positive thought disorder, impaired ability to establish set was correlated with poverty of speech, and impaired ability to shift set was associated with perseveration in speech. The associations between impaired set ability and types of thought disorder support a neurocognitive model implicating impaired executive ability in the pathogenesis of thought disorder.

The objective of this study was to determine to what extent verbal fluency measures can be used as performance validity indicators during neuropsychological evaluation. Participants were clinically referred for neuropsychological evaluation in an urban-based Veteran's Affairs hospital. Participants were placed into 2 groups based on their objectively evaluated effort on performance validity tests (PVTs). Individuals who exhibited credible performance (n = 431) failed 0 PVTs, and those with poor effort (n = 192) failed 2 or more PVTs. All participants completed the Controlled Oral Word Association Test (COWAT) and Animals verbal fluency measures. We evaluated how well verbal fluency scores could discriminate between the 2 groups. Raw scores and T scores for Animals discriminated between the credible performance and poor-effort groups with 90% specificity and greater than 40% sensitivity. COWAT scores had lower sensitivity for detecting poor effort. A combination of FAS and Animals scores into logistic regression models yielded acceptable group classification, with 90% specificity and greater than 44% sensitivity. Verbal fluency measures can yield adequate detection of poor effort during neuropsychological evaluation. We provide suggested cut points and logistic regression models for predicting the probability of poor effort in our clinical setting and offer suggested cutoff scores to optimize sensitivity and specificity.

AIM: To investigate whether perceptions of task difficulty on neuropsychological tests predicted academic achievement after controlling for glucose levels and depression. METHODS: Participants were type 1 diabetic adolescents, with a mean age = 12.5 years (23 females and 16 males), seen at a northwest suburban Chicago hospital. The sample population was free of co-morbid clinical health conditions. Subjects completed a three-part neuropsychological battery including the Digit Symbol Task, Trail Making Test, and Controlled Oral Word Association test. Following each task, individuals rated task difficulty and then completed a depression inventory. Performance on these three tests is reflective of neuropsychological status in relation to glucose control. Blood glucose levels were measured immediately prior to and after completing the neuropsychological battery using a glucose meter. HbA1c levels were obtained from medical records. Academic performance was based on self-reported grades in Math, Science, and English. Data was analyzed using multiple regression models to evaluate the associations between academic performance, perception of task difficulty, and glucose control. RESULTS: Perceptions of difficulty on a neuropsychological battery significantly predicted academic performance after accounting for glucose control and depression. Perceptions of difficulty on the neuropsychological tests were inversely correlated with academic performance (r = -0.48), while acute (blood glucose) and long-term glucose levels increased along with perceptions of task difficulty (r = 0.47). Additionally, higher depression scores were associated with poorer academic performance (r = -0.43). With the first regression analysis, perception of difficulty on the neuropsychological tasks contributed to 8% of the variance in academic performance after controlling for peripheral blood glucose and depression. In the second regression analysis, perception of difficulty accounted for 11% of the variance after accounting for academic performance and depression. The final regression analysis indicated that perception of difficulty increased with peripheral blood glucose, contributing to 22% of the variance. Most importantly, after controlling for perceptions of task difficulty, academic performance no longer predicted glucose levels. Finally, subjects who found the cognitive battery difficult were likely to have poor academic grades. CONCLUSION: Perceptions of difficulty on neurological tests exhibited a significant association with academic achievement, indicating that deficits in this skill may lead to academic disadvantage in diabetic patients.

WOS: 000335016500001, PubMed ID: 25944978, Objective. The aim of our study was to investigate the frequency and pattern of cognitive impairment in patients with clinically isolated syndromes and definite diagnosis of multiple sclerosis within the last 2 years. Methods. We assessed the cognitive status of 46 patients aged 18-49 years with clinically isolated syndromes or definite diagnosis of multiple sclerosis who have onset of their symptoms within the last 2 years. Patients were matched with 40 healthy participants for age, sex, and educational level. Neuropsychological assessment was performed by stroop test, paced auditory serial addition test (PASAT), controlled oral word association test (COWAT), clock drawing test, trail making test (TMT), faces symbol test (FST). Hamilton Depression Scale and Modified Fatigue Impact Scale were used to quantify the severity of any depression and fatigue the subjects might suffer. Results. 19.6% of early MS/CIS group failed at 4 and more tests and had significant cognitive impairment focused on attention, executive functions, memory, and learning. No significant relationship was found between cognitive impairment and disability and fatigue scores. Discussion. Cognitive impairment can be present from the earliest stage of multiple sclerosis. It should be considered among the main manifestations of MS even in the earliest stages of the disease.

Background Cognitive symptoms are core symptoms with an impact on functioning in depression. Remission is considered as the main objective of the management and treatment of depression. This study was aimed to compare cognitive performance between melancholic (MelD) and non-melancholic depression (NMelD) and to determine whether these cognitive alterations remain after clinical remission. Methods We performed a 6 month follow-up study of 88 melancholic and non-melancholic depressive patients. Sociodemographic and clinical characteristics were recorded. Depression was examined using the Hamilton Depression Rating Scale and the CORE Index for Melancholia. Cognitive performance was assessed with the Trail Making Test (TMT), the Digit Span subtest of the WAIS-III, Stroop Colour Word Test (SCWT), the Tower of London (TOL DX), the Controlled Oral Word Association Test (FAS), Semantic Verbal Fluency and Finger Tapping Test (FTT). Results MelD patients show worse performance than N-MelD at baseline, with significant differences at Digit Span subtest of WAIS Part I and Part II, SCWT Part I and Part II, TOL DX, Total Problem Solving, Total Execution Time and FTT- Preferred hand. Cognitive impairment remains at six months follow-up after clinical remission in MelD. In the comparison between remitted and non-remitted patients, cognitive impairment in Trail Making Test Part B and Verbal and Semantic Fluency (Animals) remains after clinical remission in MelD group but not in non-melancholic patients. Limitations The use of psychopharmacological treatment and the small sample of melancholic patients. Conclusions Patients with MelD do not improve cognitive performance despite clinical remission compared with remitted NMelD patients. The persistence of some cognitive dysfunctions in MelD remitted patients could represent a trait marker of a different depressive subtype and not be secondary to disease severity.

Norms for the Controlled Oral Word Association Test (COWAT; Benton & Hamsher, 1976) have been published as summary statistics from many relatively small samples. The purpose of this study was to combine statistics from these samples to produce metanorms broken down by age, gender, and level of education. Means and standard deviations of letters F, A, and S (FAS) totals from normative samples and samples of normal controls were gathered from a wide variety of research studies and then stringently selected based on factors such as adequacy of the sample and presence of the appropriate statistics. The resulting aggregate statistics for FAS totals suggest differences may exist in verbal fluency task performance, depending on a person 's age, gender, and level of education.

The present study aimed to examine the relationship between activation induced by an orthographic lexical retrieval (OLR) task and performance across time on the standard clinical version of OLR, the Controlled Oral Word Association Test (COWAT). The number of significantly activated pixels in a frontal lobe region of interest (encompassing middle and inferior frontal gyri) were measured for the left and right cerebral hemispheres in 20 volunteers. A relationship between the pixel count and the total number of words retrieved during the COWAT was found for the left but not the right hemisphere. Further examination of the left-sided relationship showed that the number of pixels in the left middle frontal region of interest correlated significantly with the second, but not the first, 30-s COWAT epoch. By contrast, the first epoch, but not the second, correlated significantly with the pixel count within the left inferior frontal region of interest. These relationships suggest differential involvement of dorsolateral and ventrolateral prefrontal cortex in specific cognitive processes fundamental to the production of language. Interindividual variation in activation levels may reflect underlying differences in cognitive processing capacity. This study is the first attempt to examine the relationship between fMRI activation and standard verbal fluency performance.

This study aimed to cross-validate the capacity of a computer software program to detect and measure, using a measurement method applied to the content and form analysis of 5-minute speech samples, cognitive impairment and associated comorbid neuropsychiatric psychobiological dimensions in drug-abusing patients. At the University of California-Irvine (UCI) Neuropsychiatric Center, 28 drug-abusing inpatients using illegal drugs were clinically evaluated. Their scores for cognitive impairment derived by the computerized content analysis method were compared with scores derived from selected tests from the Halstead-Reitan Neuropsychological Test Battery, the computerized Automated Neuropsychological Assessment Metric Battery (ANAM), the Alzheimer's Disease Assessment Scale-Cognitive Portion, the Stroop Color and Word Test, the Symbol Digit Modalities Test, and the Controlled Oral Word Association Test. The statistical significance ( P value) of the correlations of scores from these different measures with scores obtained from the computerized content analysis measures was less than .05 to .001. The comparative “hit rate,” detecting cognitive impairment above the norms for each measure administered to these drug-abusing patients, for the computerized content analysis measures and some of the ANAM neuropsychological measures was 75% to 89%, and for the other neuropsychological measures, 25% to 64%. In conclusion, the computerized content analysis methodology applied to 5-minute verbal samples is a valid, rapid, easily administered measurement instrument for assessing the magnitude of cognitive impairment and comorbid neuropsychiatric dimensions.

Adolescents meeting diagnostic criteria for schizotypal personality disorder (SPD) are presumed to be at risk for developing schizophrenia in adulthood, making them an important group for exploring the developmental trajectory of the disease. Deficits in executive functioning have been documented in schizophrenia patients and adults with SPD. The present study examined executive functions in adolescents with SPD. It was predicted that the SPD group would score below comparison groups (normals and adolescents with other disorders) on measures of executive function, and that those with greater 'negative' signs of SPD would show more pronounced performance deficits. Analyses revealed that the performance of the SPD subjects was impaired relative to the other groups on the modified Wisconsin Card Sorting Test (MCST), but not on the Tower of London or the Controlled Oral Word Association Test. Consistent with prediction, regression analyses indicated that MCST deficits were associated with greater negative signs of SPD, but not positive signs.

The Neuropsychological Screening Battery for Hispanics (NeSBHIS; Ponton et al., 1996) was developed to provide clinicians and researchers with appropriate tests and norms to assess the Latino population. However, the construct validity of the NeSBHIS is unclear, and its clinical utility is untested. This study provides data on the construct validity of this battery via factor analytic methodology. Five factors were identified: (a) a language factor, which included the Controlled Oral Word Association Test, the Ponton-Satz Boston Naming Test, and the Escala de Inteligencia Wechsler para Adultos (EIWA; Wechsler, Green, & Martinez, 1968) Digit Span; (b) a verbal learning factor, which included all the World Health Organization--University of California, Los Angeles Auditory Verbal Learning Test scores (Trials V, VII, and VIII); (c) an attentional-mental control factor, which included the EIWA Digit Symbol, Color Trails 1 and 2, and the EIWA Block Design; (d) a visuospatial factor, made up of the Rey-Osterrieth Complex Figure Test Copy and Memory and the Raven's Standard Progressive Matrices total score; and (e) a psychomotor factor, the Pin Test. This was a stable factor structure, suggesting that the NeSBHIS has a robust construct validity.

Objective: This study is the first systematic assessment of the impact of early-onset multiple sclerosis (MS) on youngsters’ cognitive abilities and social/emotional functioning. Background: Although adult-onset MS often is characterized by intellectual changes and challenges to psychosocial adaptation, no investigation of these MS-related problems has been done in early-onset MS. Methods: Nine subjects, aged 10 to 20, diagnosed with definite MS before age 18, were evaluated with neuropsychological and psychosocial measures. Results: Although cognitive test scores were generally within normal limits, they were characterized by considerable variability. Subjects scored significantly below the norm on the Wechsler Intelligence Scale for Children (WISC)-III Performance scale (probably indicative of incoordination, motor slowing, and/or perceptual motor difficulties) and on the Controlled Oral Word Association Test (COWAT) (reflecting the semantic verbal memory retrieval deficits reported in adults). They scored above the norm on the Wechsler Individual Achievement Test (WIAT) Oral Expression subtest, indicating heightened communication abilities. Self-Perception Profile scores generally were within normal limits; however, Social Acceptance subscale scores were above the norm, indicating a high level of perceived peer support/friendship. Conclusions: As with adults, some youngsters with MS experience an early cognitive decline that appears unrelated to degree of physical impairment. Such a decline can interfere with academic, social, and work endeavors. To identify deficits and implement appropriate interventions/accommodations, periodic neuropsychological assessments should be included in disease management from diagnosis onward. Contrary to expectations that MS would negatively impact self-concept, subjects did not view themselves as being different from peers, and showed little or no awareness of the potential impact of MS on their lives.