Spanish normative studies (NEURONORMA-Plus project): norms for the Wisconsin Card Sorting Test, the Modified Taylor Complex Figure, and the Ruff-Light Trail Learning Test.

OBJECTIVE: The present study aims to provide norms and age-, education-, and sex-adjusted data for the Wisconsin Card Sorting Test (WCST), the Modified Taylor Complex Figure (MTCF), and the Ruff-Light Trail Learning Test (RULIT) as part of the NEURONORMA-Plus project. METHODS: We recruited 308 cognitively healthy individuals aged between 18 and 92 years. Tables are provided to convert raw scores to age-adjusted scaled scores, as well as adjustments for education and sex after applying independent regression models in 2 age groups (< 50 and ≥ 50 years). RESULTS: Older age had a negative effect on performance in both age groups. We observed a positive effect of education on WCST performance in the younger group (< 50 years), and on all MTCF measures (with the exception of the recognition task) in the older group (≥ 50 years). Education had no impact on performance in the RULIT, although sex did, with a small but significant effect whereby young men showed higher performance for one variable. CONCLUSION: The normative data provided can contribute to the clinical interpretation of performance in these tests in the Spanish population.

Spanish normative studies (NEURONORMA-Plus project): norms for the Delis Kaplan-Design Fluency Test, Color Trails Test, and Dual Task.

INTRODUCTION: Complex attention and non-verbal fluency tasks are used in neuropsychological assessments with the aim of exploring subdomains of executive function. The purpose of this study is to provide norms and age-, education-, and sex-adjusted data for the Delis Kaplan-Design Fluency Test (DK-DFT), Color Trails Test (CTT), and Dual Task (DT) as part of the NEURONORMA-Plus project. METHODS: The sample included 308 cognitively unimpaired individuals aged between 18 and 92 years. Raw scores were converted to age-adjusted scaled scores. These were further converted into education- and sex-adjusted scaled scores by applying linear regression, with 2 age groups (< 50 and ≥ 50 years). RESULTS: Overall, age had a negative impact on DK-DFT and CTT performance. We observed a positive effect of education on DK-DFT scores only in the older group (≥ 50 years). Moreover, younger men performed slightly better in the basic condition of this test. Education was positively associated with all CTT scores in both age groups, with the exception of the CTT-1 subtest in the younger group. Age and education did not influence DT performance, whereas sex did, with young women performing slightly better. CONCLUSIONS: These normative data may be useful in the interpretation of neuropsychological assessments in the Spanish population.

The CORCOBIA study: Cut-off points of Alzheimer's disease CSF biomarkers in a clinical cohort.

INTRODUCTION: The analysis of the core biomarkers of Alzheimer's Disease (AD) in the cerebrospinal fluid (CSF) is recommended in the clinical units where it is available. Because of the absence of universal validated values, the determination of specific cut-off points for each center and its population is recommended. The main objective of the CORCOBIA study was to determine the cut-off points of core AD CSF biomarkers for several centers (Parc de Salut Mar, Barcelona and Hospital General de Granollers), which work with the same reference laboratory (Laboratori de Referència de Catalunya). METHODS: Prospective study including cognitively unimpaired individuals (CU, n = 42), subjects with amnestic mild cognitive impairment (aMCI, n = 35) and patients with dementia due to Alzheimer's Disease (AD, n = 48), in whom clinical and neuropsychological assessment, neuroimaging, APOE genotyping and lumbar puncture to analyse amyloid beta peptides (Aß42, Aß40), total tau (tTau) and phosphorylated Tau (pTau181) using the Lumipulse G600II (Fujirebio) was performed. The values of sensitivity (SE), specificity (SP), predictive values and area under the curve (AUC) were calculated, determining the cut-off point according to the Youden index by comparing the CU and AD groups. RESULTS: The resulting cut-offs and their AUC were the following: Aß42 750 pg/mL (AUC 0.809); Aß42/Aß40 0.062 (AUC 0.78); pTau181 69.85 pg/mL (AUC 0.81); tTau 522.0 pg/mL (AUC 0.79); Aß42/tTau 1.76 (AUC 0.86); Aß42/pTau181 10.25 (AUC 0.86). CONCLUSIONS: The determination of cut-off points of core AD CSF biomarkers for the participating centers allows a better diagnostic accuracy. The ratio CSF Aß42/pTau181 shows the highest AUC and better balance between sensitivity and specificity.

Assessment of aphasia: dialectal and cultural considerations in neurology.

INTRODUCTION: In the context of neurological disorders, language assessment is traditionally based on the use of the standard language of the community in which the assessment is performed. Dialectal variables constitute a "forgotten" topic. This review aims to provide resources and working guidelines to overcome this limitation. DEVELOPMENT: The study was conducted as follows: 1) review of basic concepts of dialectology (language, dialect, isogloss line, idiolect, register, "standard variant," bilingualism); 2) characterisation of Spanish and Catalan dialectologies and search for online resources for the development of neurological assessment tools; 3) ad hoc search on the PubMed database (keywords: "dialect," "aphasia," and "multilingual"). CONCLUSIONS: We provide online resources to promote adequate development of assessment tools in Spanish and Catalan, accounting for dialectal considerations. We propose a set of working guidelines for the introduction of dialectal variables in language tests to ensure their ultimate objective: to evaluate the real use of the language, and not cultural knowledge of the standard language.

Development, equivalence study, and normative data of version B of the Spanish-language Free and Cued Selective Reminding Test.

INTRODUCTION: The Free and Cued Selective Reminding Test (FCSRT) is widely used for the assessment of verbal episodic memory, mainly in patients with Alzheimer disease. A Spanish-language version of the FCSRT and normative data were developed within the NEURONORMA project. Availability of alternative, equivalent versions is useful for following patients up in clinical settings. This study aimed to develop an alternative version of the original FCSRT (version B) and to study its equivalence to the original Spanish-language test (version A), and its performance in a sample of healthy individuals, in order to develop reference data. METHODS: We evaluated 232 healthy participants of the NEURONORMA-Plus project, aged between 18 and 90. Thirty-three participants were assessed with both test versions using a counterbalanced design. RESULTS: High intra-class correlation coefficients (between 0.8 and 0.9) were observed in the equivalence study. While no significant differences in performance were observed in total recall scores, free recall scores were significantly lower for version B. CONCLUSIONS: These preliminary results suggest that the newly developed FCSRT version B is equivalent to version A in the main variables tested. Further studies are necessary to ensure interchangeability between versions. We provide normative data for the new version.

Spanish normative studies (NEURONORMA-Plus project): norms for the Delis Kaplan-Design Fluency Test, Color Trails Test, and Dual Task. / Estudios normativos españoles (Proyecto NEURONORMA Plus): normas para las pruebas Delis Kaplan-Design Fluency Test (DK-DFT), Color Trails Tests (CTT) y Dual Task (DT).

INTRODUCTION: Complex attention and non-verbal fluency tasks are used in neuropsychological assessments with the aim of exploring subdomains of executive function. The purpose of this study is to provide norms and age-, education-, and sex-adjusted data for the Delis Kaplan-Design Fluency Test (DK-DFT), Color Trails Test (CTT), and Dual Task (DT) as part of the NEURONORMA-Plus project. METHODS: The sample included 308 cognitively healthy individuals aged between 18 and 92 years. Raw scores were converted to age-adjusted scaled scores. These were further converted into education- and sex-adjusted scaled scores by applying linear regression, with 2 age groups (< 50 and ≥ 50 years). RESULTS: Overall, age had a negative impact on DK-DFT and CTT performance. We observed a positive effect of education on DK-DFT scores only in the older group (≥ 50 years). Moreover, younger men performed slightly better in the basic condition of this test. Education was positively associated with all CTT scores in both age groups, with the exception of the CTT-1 subtest in the younger group. Age and education did not influence DT performance, whereas sex did, with young women performing slightly better. CONCLUSIONS: These normative data may be useful in the interpretation of neuropsychological assessments in the Spanish population.

Spanish normative studies (NEURONORMA-Plus project): norms for the Wisconsin Card Sorting Test, the Modified Taylor Complex Figure, and the Ruff-Light Trail Learning Test. / Estudios normativos españoles (proyecto NEURONORMA-Plus): Normas para el Wisconsin Card Sorting Test (WCST), la Figura Compleja Modificada de Taylor (FCMT) y el Ruff-Light Trail Learning Test (RULIT).

OBJECTIVE: The present study aims to provide norms and age-, education-, and sex-adjusted data for the Wisconsin Card Sorting Test (WCST), the Modified Taylor Complex Figure (MTCF), and the Ruff-Light Trail Learning Test (RULIT) as part of the NEURONORMA-Plus project. METHODS: We recruited 308 cognitively healthy individuals aged between 18 and 92 years. Tables are provided to convert raw scores to age-adjusted scaled scores, as well as adjustments for education and sex after applying independent regression models in 2 age groups (<50 and ≥50 years). RESULTS: Older age had a negative effect on performance in both age groups. We observed a positive effect of education on WCST performance in the younger group (<50 years), and on all MTCF measures (with the exception of the recognition task) in the older group (≥50 years). Education had no impact on performance in the RULIT, although sex did, with a small but significant effect whereby young men showed higher performance for one variable. CONCLUSION: The normative data provided can contribute to the clinical interpretation of performance in these tests in the Spanish population.

Assessment of aphasia: dialectical and cultural considerations in neurology. / Evaluación de las afasias: consideraciones dialectales y culturales en neurología.

INTRODUCTION: In the context of neurological disorders, language assessment is traditionally based on the use of the standard language of the community in which the assessment is performed. Dialectical variables constitute a 'forgotten' topic. This review aims to provide resources and working guidelines to overcome this limitation. DEVELOPMENT: The study was conducted as follows: 1) review of basic concepts of dialectology (language, dialect, isogloss line, idiolect, register, 'standard variant', bilingualism); 2) characterisation of Spanish and Catalan dialectologies and search for online resources for the development of neurological assessment tools; 3) ad hoc search on the PubMed database (keywords 'dialect', 'aphasia' and 'multilingual'). CONCLUSIONS: We provide online resources to promote adequate development of assessment tools in Spanish and Catalan, accounting for dialectical considerations. We propose a set of working guidelines for the introduction of dialectical variables in language tests to ensure their ultimate objective: to evaluate the real use of the language, and not cultural knowledge of the standard language.

[The effect of traumatic brain injury on social decision making]. / Efecto del traumatismo craneoencefalico en la toma de decisiones sociales.

INTRODUCTION: Patients with traumatic brain injury (TBI) can present difficulties in making decisions of a social nature. Such difficulties condition complicate their personal relationships. AIMS: To assess social decision-making in a sample of patients with moderate and severe TBI, and to empirically contrast if, as Ochsner's social-emotional processing model proposes, the ability to recognize and respond to socio-affective stimuli is related to the ability to regulate sensitive responses to the context based on the proposed assessment tests. SUBJECTS AND METHODS: Twenty-one patients with a moderate and severe TBI (experimental group) matched by gender, age and years of education with 24 healthy subjects (control group). Social decision making was measured through the Social Decision Making Test (SDMT), and the ability to recognize and respond to socio-affective stimuli through the Pictures of Facial Affect (PoFA) test. RESULTS: Statistically significant differences in the SDMT were obtained between the experimental group and the control group. Regarding PoFA, the performance of the control group was also significantly better than that of the experimental group. However, no relationship was observed between the performance in the SDMT and the PoFA for any of the groups. CONCLUSIONS: The SDMT seems to be a sensitive test to detect alterations in social decision making in patients with moderate or severe TBI. No relationship was observed between the results in the SDMT and the PoFA.

TITLE: Efecto del traumatismo craneoencefalico en la toma de decisiones sociales.Introduccion. Los pacientes con traumatismo craneoencefalico (TCE) pueden presentar dificultades para tomar decisiones de tipo social. Tales dificultades condicionan un deterioro en sus relaciones personales. Objetivos. Valorar la toma de decisiones de tipo social en una muestra de pacientes con TCE moderado y grave y contrastar empiricamente si, como defiende el modelo de procesamiento socioemocional de Ochsner, la capacidad para reconocer y responder a estimulos socioafectivos se relaciona con la capacidad para regular respuestas sensibles al contexto basandose en las pruebas de valoracion propuestas. Sujetos y metodos. Muestra de 21 pacientes con TCE moderado y grave (grupo experimental), emparejados por sexo, edad y años de escolaridad con 24 sujetos sanos (grupo control). La toma de decisiones de tipo social se valoro mediante el Social Decision Making Test (SDMT), y la capacidad para reconocer y responder a estimulos socioafectivos, mediante el Pictures of Facial Affect (PoFA). Resultados. Se obtuvieron diferencias estadisticamente significativas entre el grupo experimental y el grupo control en el SDMT. Respecto al PoFA, el rendimiento del grupo control tambien fue sensiblemente mejor que el del grupo experimental. Sin embargo, no se observo relacion entre el rendimiento en el SDMT y el PoFA para ninguno de los grupos. Conclusiones. El SDMT parece ser una prueba sensible para detectar alteraciones en la toma de decisiones sociales en pacientes con TCE moderado o grave. No se ha observado relacion entre los resultados del SDMT y el PoFA.

[Barcelona Test for Intellectual Disability: a new instrument for the neuropsychological assessment of adults with intellectual disability]. / Test Barcelona para discapacidad intelectual: un nuevo instrumento para la valoracion neuropsicologica clinica de adultos con discapacidad intelectual.

INTRODUCTION: Neuropsychological assessment in individuals with intellectual disability is of utmost importance in order to determine the cognitive deficits underlying brain dysfunction and limiting intellectual functioning and adaptive behavior. However, no neuropsychological batteries in Spanish language have been created and validated for this population. AIM: To adapt the 'programa integrado de exploracion neuropsicologica-test Barcelona' and to validate the new version, the Barcelona Test for Intellectual Disability (TB-DI). To create normative data for its clinical use. SUBJECTS AND METHODS: The original test was modified based on data from a pilot sample of 65 individuals with intellectual disability. In order to study the psychometric properties of the TB-DI, it was administered to a sample of 170 individuals with intellectual disability and to a group of 60 individuals without it. The relevant variables for stratification of normative data were determined by means of regression models. RESULTS: The TB-DI was finally composed by 67 subtests grouped in eight cognitive domains and it showed good psychometric properties. Normative data were created for five groups taking into account intellectual disability level, age and acquired curricular competence. These data were organized in percentiles in a way that allows the creation of cognitive profiles in the clinical and experimental fields. CONCLUSION: The TB-DI constitutes a tool of high applicability in the population with intellectual disability. It shows adequate validity and reliability, and it has good psychometric properties. The cognitive profiles obtained by the TB-DI will provide valuable information for the treatment of adult adults with mild and moderate intellectual disability.

TITLE: Test Barcelona para discapacidad intelectual: un nuevo instrumento para la valoracion neuropsicologica clinica de adultos con discapacidad intelectual.Introduccion. La evaluacion neuropsicologica en las personas con discapacidad intelectual es importante para determinar los deficits cognitivos especificos que subyacen a la afectacion cerebral, limitan el funcionamiento intelectual y afectan al comportamiento adaptativo. A pesar de ello, no existen baterias neuropsicologicas en castellano adaptadas y validadas para esta poblacion. Objetivo. Adaptar el programa integrado de exploracion neuropsicologica-test Barcelona y validar la nueva version, el test Barcelona para discapacidad intelectual (TB-DI), estableciendo datos normativos para el empleo clinico. Sujetos y metodos. A partir de los datos obtenidos en una muestra piloto de 65 personas con discapacidad intelectual, se realizaron cambios en el test original. Para estudiar las propiedades psicometricas del TB-DI, se administro a una muestra de 170 personas con discapacidad intelectual y a un grupo de 60 personas sin ella. Mediante modelos de regresion, se determino que variables eran importantes para la estratificacion de los datos normativos. Resultados. El TB-DI, compuesto de 67 subtests agrupados en ocho dominios cognitivos, muestra unas buenas propiedades psicometricas. Se crean datos normativos para cinco grupos en funcion del nivel de discapacidad intelectual, la edad y la competencia curricular. Estos datos se organizan en percentiles, lo que permite trazar perfiles cognitivos en el ambito clinico y experimental. Conclusion. El TB-DI es un instrumento de alta aplicabilidad para la poblacion con discapacidad intelectual, y muestra una validez y una fiabilidad adecuadas, y con buenas propiedades psicometricas. Los perfiles cognitivos determinados mediante el TB-DI proporcionaran informacion valiosa para el tratamiento integral de las personas adultas con discapacidad intelectual leve y moderada.

Practical application of brief cognitive tests.

INTRODUCTION: Brief cognitive tests (BCT) may help detect cognitive impairment (CI) in the clinical setting. Several BCT have been developed and/or validated in our country, but we lack specific recommendations for use. DEVELOPMENT: Review of studies on the diagnostic accuracy of BCT for CI, using studies conducted in Spain with BCT which take less than 20 min. We provide recommendations of use based on expert consensus and established on the basis of BCT characteristics and study results. CONCLUSION: The Fototest, the Memory Impairment Screen (MIS) and the Mini-Mental State Examination (MMSE) are the preferred options in primary care; other BCT (Clock Drawing Test [CDT], test of verbal fluency [TVF]) may also be administered in cases of negative results with persistent suspected CI or concern (stepwise approach). In the specialised care setting, a systematic assessment of the different cognitive domains should be conducted using the Montreal Cognitive Assessment, the MMSE, the Rowland Universal Dementia Assessment, the Addenbrooke's Cognitive Examination, or by means of a stepwise or combined approach involving more simple tests (CDT, TVF, Fototest, MIS, Memory Alteration Test, Eurotest). Associating an informant questionnaire (IQ) with the BCT is superior to the BCT alone for the detection of CI. The choice of instruments will depend on the patient's characteristics, the clinician's experience, and available time. The BCT and IQ must reinforce - but never substitute - clinical judgment, patient-doctor communication, and inter-professional dialogue.

Diagnostic validity of the Alzheimer's disease functional assessment and change scale in mild cognitive impairment and mild to moderate Alzheimer's disease.

BACKGROUND: The Alzheimer's Disease Functional Assessment and Change Scale (ADFACS) is a functional assessment instrument widely used in clinical research. AIMS: To test the diagnostic and concurrent validity of the Spanish version of this scale and to describe the functional deficit pattern for mild cognitive impairment (MCI) and Alzheimer's disease (AD) dementia. METHODS: The ADFACS, the Interview for Deterioration in Daily Living Activities in Dementia (IDDD), and the Mini Mental State Examination (MMSE) were administered to 146 control subjects (CS) and 165 patients (67 MCI and 98 AD). Nonparametric tests were used to compare the diagnostic groups. Cronbach's α and correlations with the MMSE and the IDDD were calculated. Sensitivity, specificity and predictive values were studied. RESULTS: The ADFACS had a high internal consistency (α = 0.95). Three cutoff points of 1, 4, and 17 were provided to separate CS and MCI patients, MCI and mild AD patients, and mild AD and moderate AD patients, respectively. The ADFACS strongly correlated with functional (IDDD, 0.927) and cognitive (MMSE, 0.747) measures. A similar pattern of dysfunction, but in different grades, was found for the MCI and AD groups. CONCLUSION: The ADFACS is a reliable, valid, and sensitive instrument to assess functional abilities; it is useful in dementia assessment for elderly populations.

Spanish normative studies in young adults (NEURONORMA young adults project): norms for Stroop Color-Word Interference and Tower of London-Drexel University tests.

INTRODUCTION: The Stroop Color-Word Interference Test (Stroop) measures cognitive flexibility, selective attention, cognitive inhibition and information processing speed. The Tower of London-Drexel University version test (TOL) assesses higher-order problem solving and executive planning abilities. OBJECTIVE: In this study, as part of the Spanish normative studies project in young adults (NEURONORMA young adults), we present normative data for the Stroop and young adults TOL tests. MATERIAL AND METHODS: The sample consisted of 179 participants who are cognitively normal and range in age from 18 to 49 years. Tables are provided to convert raw scores to scaled scores. Scores adjusted for sociodemographic factors were obtained by applying linear regression techniques. RESULTS: No effects were found for age and sex in either test. Educational level impacted most of the Stroop test variables and some of the TOL scores (Total Moves score and Total Initiation Time score). CONCLUSIONS: The norms obtained will be extremely useful in the clinical evaluation of young Spanish adults.

Spanish normative studies in young adults (NEURONORMA young adults project): norms for the Rey-Osterrieth Complex Figure (copy and memory) and Free and Cued Selective Reminding Test.

INTRODUCTION: The Rey-Osterrieth Complex Figure (ROCF) and the Free and Cued Selective Reminding Test (FCSRT) are widely used in clinical practice. The ROCF assesses visual perception, constructional praxis, and visuo-spatial memory. The FCSRT assesses verbal learning and memory. OBJECTIVE: In this study, as part of the Spanish normative studies project in young adults (NEURONORMA young adults), we present age- and education-adjusted normative data for both tests obtained by using linear regression techniques. MATERIAL AND METHODS: The sample consisted of 179 healthy participants ranging in age from 18 to 49 years. We provide tables for converting raw scores to scaled scores in addition to tables with scores adjusted by socio-demographic factors. RESULTS: The results showed that education affects scores for some of the memory tests and the figure-copying task. Age was only found to have an effect on the performance of visuo-spatial memory tests, and the effect of sex was negligible. CONCLUSIONS: The normative data obtained will be extremely useful in the clinical neuropsychological evaluation of young Spanish adults.

Spanish normative studies in young adults (NEURONORMA young adults project): norms for the Visual Object and Space Perception Battery and Judgment of Line Orientation tests.

INTRODUCTION: The Visual Object and Space Perception Battery (VOSP) and Judgment of Line Orientation tests (JLO) are used in clinical practice to assess visuoperceptual and visuospatial abilities. OBJECTIVE: In this study, as part of the Spanish normative studies project in young adults (NEURONORMA young adults), we present normative data for a short version of the VOSP test and for the JLO test. MATERIAL AND METHODS: The sample consisted of 179 participants who are cognitively normal and range in age from 18 to 49 years. Tables are provided to convert raw scores to scaled scores. Education- and sex-adjusted scores were obtained by applying linear regression techniques. RESULTS: Our results show that education and sex only affect scores on the JLO test, and that age has no effect. CONCLUSIONS: The normative data obtained will be extremely useful in the clinical evaluation of young Spanish adults.

Spanish normative studies in young adults (NEURONORMA young adults project): norms for verbal fluency tests.

INTRODUCTION: Lexical fluency tests are frequently used in clinical practice to assess language and executive function. OBJECTIVE: As part of the Spanish normative studies project in young adults (NEURONORMA young adults project), we provide age- and education-adjusted normative data for 3 semantic fluency tasks (animals, fruits and vegetables, and kitchen tools), three formal lexical fluency tasks (words beginning with P, M and R), three excluded-letter fluency tasks (words excluding A, E and S) and a verb fluency task. MATERIAL AND METHODS: The sample consisted of 179 participants who are cognitively normal and range in age from 18 to 49 years. Tables are provided to convert raw scores to scaled scores. Age- and education-adjusted scores are provided by applying linear regression techniques. RESULTS: The results show that education impacted most of the verbal fluency test scores, with no effects related to age and only minimal effects related to sex. CONCLUSIONS: The norms obtained will be extremely useful in the clinical evaluation of young Spanish adults.

Spanish normative studies in a young adult population (NEURONORMA young adults Project): norms for the Boston Naming Test and the Token Test.

INTRODUCTION: The Boston Naming Test (BNT) and the Token Test (TT) are frequently used in clinical practice to assess naming and comprehension. OBJECTIVE: The aim of this paper is to present normative data for the BNT and for the TT as part of the NEURONORMA young adults Project. MATERIAL AND METHODS: A total of 179 Spanish healthy subjects from 18 to 49 years old were evaluated. Tables to convert raw scores to scaled scores are provided. Age- and education- adjusted scores are obtained by applying linear regressions. RESULTS: The results show an effect of education in both tests, and a minimal effect of age and sex. CONCLUSIONS: The normative data obtained will be useful in the clinical evaluation of young Spanish adults.

[Spanish normative studies in a young adult population (NEURONORMA young adults Project): norms for the verbal span, visuospatial span, Letter-Number Sequencing, Trail Making Test and Symbol Digit Modalities Test]. / Estudios normativos españoles en población adulta joven (Proyecto NEURONORMA jóvenes): normas para las pruebas span verbal, span visuoespacial, Letter-Number Sequencing, Trail Making Test y Symbol Digit Modalities Test.

INTRODUCTION: Verbal and visuospatial span, Letter-Number Sequencing, Trail Making Test, and Symbol Digit Modalities Test are frequently used in clinical practice to assess attention, executive functions and memory. OBJECTIVE: In the present study, as part of the Spanish normative studies of NEURONORMA young adults Project, normative data adjusted by age and education are provided for digits, Corsi Block-Tapping Task, Letter-Number Sequencing, Trail Making Test, and Symbol Digit Modalities Test. MATERIAL AND METHODS: The sample consisted of 179 participants from 18 to 49 years old, who were cognitively normal. Tables to convert raw scores to scaled scores are provided. Age and education adjusted scores are provided by applying linear regressions. RESULTS: Education affected scores in most of the attention tests; age was found to be related to the visuospatial span and to speed of visuomotor tracking, and there was no relationship as regards sex. CONCLUSIONS: The data obtained will be useful in the clinical evaluation of young Spanish adults.

[Spanish normative studies in a young adult population (NEURONORMA young adults Project): methods and characteristics of the sample]. / Estudios normativos españoles en población adulta joven (Proyecto NEURONORMA jóvenes): métodos y características de la muestra.

INTRODUCTION: In clinical neuropsychology, normative data are necessary to relate the performance of a subject to a reference group. These normative data should be collected from a pertinent population taking into account sociodemographic and cultural factors. OBJECTIVE: This paper describes the methods and sample characteristics of a series of Spanish normative studies on young adults (NEURONORMA young adults Project). The normative information was based on a series of selected, commonly used, neuropsychological tests covering attention, language, visual-perceptual abilities, constructional tasks, memory, and executive functions. MATERIAL AND METHODS: A sample of 179 cognitively normal subjects from 18 to 49 years was studied. Demographics, socio-cultural, and medical data were collected. The statistical procedure used in the normative studies is described. RESULTS: Sociodemographic, family background, health habits, medical history and use of drugs are presented. CONCLUSIONS: The use of these norms should improve neuropsychological diagnostic accuracy in young Spanish subjects. These data may also be of considerable use for comparisons with other normative studies.

Problem-solving abilities and frontal lobe cortical thickness in healthy aging and mild cognitive impairment.

Mild cognitive impairment (MCI) is considered a transitional state between normal aging and Alzheimer disease. Most MCI subjects present disturbances in multiple neuropsychological domains, including executive function. This study aimed at exploring frontal lobe cortical thinning in MCI and healthy controls, and its relationship with problem-solving abilities. Twenty-three MCI patients and 30 elderly controls underwent MRI and neuropsychological assessment. Cortical thickness was measured by means of FreeSurfer. Problem-solving was assessed by means of the Tower of London (TOL) task. MCI showed a global thinning of the cortex. With regard to specific regions of interest, a thinning in the left frontal lobe and the bilateral posterior cingulate gyri was found. Partial correlations, after controlling for age, education, Mini-Mental Status Examination, and non-frontal mean thickness revealed negative significant correlations between frontal lobe thickness and executive outcomes in the control group. This counterintuitive relationship was not observed in the MCI group, suggesting that the frontal cortical atrophy observed in MCI entails a specific pathology-related relationship with high-level executive outcomes that is qualitatively different from that observed in healthy aging.