Self-Reference Effect and Self-Reference Recollection Effect for Trait Adjectives in Amnestic Mild Cognitive Impairment.

OBJECTIVES: The self-reference effect (SRE), enhanced memory for self-related information, has been studied in healthy young and older adults but has had little investigation in people with age-related memory disorders, such as amnestic mild cognitive impairment (aMCI). Self-referential encoding may help to improve episodic memory in aMCI. Additionally, self-referential processing has been shown to benefit recollection, the vivid re-experiencing of past events, a phenomenon that has been termed the self-reference recollection effect (SRRE; Conway & Dewhurst, 1995). Furthermore, it remains unclear whether the valence of stimuli influences the appearance of the SRE and SRRE. METHODS: The current study investigated the SRE and SRRE for trait adjective words in 20 individuals with aMCI and 30 healthy older adult controls. Ninety trait adjective words were allocated to self-reference, semantic, or structural encoding conditions; memory was later tested using a recognition test. RESULTS: While healthy older adults showed a SRE, individuals with aMCI did not benefit from self-referential encoding over and above that of semantic encoding (an effect of "deep encoding"). A similar pattern was apparent for the SRRE; healthy controls showed enhanced recollection for words encoded in the self-reference condition, while the aMCI group did not show specific benefit to recollection for self-referenced over semantically encoded items. No effects of valence were found. CONCLUSIONS: These results indicate that while memory for trait adjective words can be improved in aMCI with deep encoding strategies (whether self-reference or semantic), self-referencing does not provide an additional benefit. (JINS, 2018, 24, 821-832).

A re-examination of Montreal Cognitive Assessment (MoCA) cutoff scores.

OBJECTIVE: The Montreal Cognitive Assessment (MoCA; Nasreddine et al., 2005) is a cognitive screening tool that aims to differentiate healthy cognitive aging from Mild Cognitive Impairment (MCI). Several validation studies have been conducted on the MoCA, in a variety of clinical populations. Some studies have indicated that the originally suggested cutoff score of 26/30 leads to an inflated rate of false positives, particularly for those of older age and/or lower education. We conducted a systematic review and meta-analysis of the literature to determine the diagnostic accuracy of the MoCA for differentiating healthy cognitive aging from possible MCI. METHODS: Of the 304 studies identified, nine met inclusion criteria for the meta-analysis. These studies were assessed across a range of cutoff scores to determine the respective sensitivities, specificities, positive and negative predictive accuracies, likelihood ratios for positive and negative results, classification accuracies, and Youden indices. RESULTS: Meta-analysis revealed a cutoff score of 23/30 yielded the best diagnostic accuracy across a range of parameters. CONCLUSIONS: A MoCA cutoff score of 23, rather than the initially recommended score of 26, lowers the false positive rate and shows overall better diagnostic accuracy. We recommend the use of this cutoff score going forward. Copyright © 2017 John Wiley & Sons, Ltd.

Older adults show a self-reference effect for narrative information.

The self-reference effect (SRE), enhanced memory for information encoded through self-related processing, has been established in younger and older adults using single trait adjective words. We sought to examine the generality of this phenomenon by studying narrative information in these populations. Additionally, we investigated retrieval experience at recognition and whether valence of stimuli influences memory differently in young and older adults. Participants encoded trait adjectives and narratives in self-reference, semantic, or structural processing conditions, followed by tests of recall and recognition. Experiment 1 revealed an SRE for trait adjective recognition and narrative cued recall in both age groups, although the existence of an SRE for narrative recognition was unclear due to ceiling effects. Experiment 2 revealed an SRE on an adapted test of narrative recognition. Self-referential encoding was shown to enhance recollection for both trait adjectives and narrative material in Experiment 1, whereas similar estimates of recollection for self-reference and semantic conditions were found in Experiment 2. Valence effects were inconsistent but generally similar in young and older adults when they were found. Results demonstrate that the self-reference technique extends to narrative information in young and older adults and may provide a valuable intervention tool for those experiencing age-related memory decline.

Self-referential processing improves memory for narrative information in healthy aging and amnestic Mild Cognitive Impairment.

The Self-Reference Effect (SRE), enhanced memory for self-related information, has been established in healthy young and older adults but has had limited study in age-related memory disorders such as amnestic Mild Cognitive Impairment (aMCI). Additionally, the majority of SRE studies have been conducted using trait adjective paradigms, which lack ecological validity; memory for narrative information has real-world importance and has been shown to decline in healthy aging and, to a greater extent, in aMCI. The present study investigated whether self-referential processing promotes memory for narrative information in healthy aging and, for the first time, in aMCI. The promotion of recollection (vivid re-experiencing of an event) through self-referential processing, termed the Self-Reference Recollection Effect (SRRE; Conway and Dewhurst, 1995), was also examined, as was the potential impact of material valence on the SRE. Twenty individuals with aMCI and thirty healthy older controls encoded short narratives under self-reference, semantic, and structural conditions. Memory for narrative details was subsequently tested. Results indicated a SRE for narrative information in both aMCI and healthy control groups on a recognition memory test. The SRRE was found in healthy controls and individuals with aMCI. Material valence did not impact the SRE in either group. The SRE appears to be powerful enough to circumvent loss of hippocampal function in aMCI, possibly due to the multimodal nature of narrative information. Findings from this study highlight the potential of the SRE as an effective intervention tool for improving memory for narrative information in aMCI.

Nature and extent of person recognition impairments associated with Capgras syndrome in Lewy body dementia.

Patients with Capgras syndrome (CS) adopt the delusional belief that persons well-known to them have been replaced by an imposter. Several current theoretical models of CS attribute such misidentification problems to deficits in covert recognition processes related to the generation of appropriate affective autonomic signals. These models assume intact overt recognition processes for the imposter and, more broadly, for other individuals. As such, it has been suggested that CS could reflect the "mirror-image" of prosopagnosia. The purpose of the current study was to determine whether overt person recognition abilities are indeed always spared in CS. Furthermore, we examined whether CS might be associated with any impairments in overt affective judgments of facial expressions. We pursued these goals by studying a patient with Dementia with Lewy bodies (DLB) who showed clear signs of CS, and by comparing him to another patient with DLB who did not experience CS, as well as to a group of healthy control participants. Clinical magnetic resonance imaging scans revealed medial prefrontal cortex (mPFC) atrophy that appeared to be uniquely associated with the presence CS. We assessed overt person recognition with three fame recognition tasks, using faces, voices, and names as cues. We also included measures of confidence and probed pertinent semantic knowledge. In addition, participants rated the intensity of fearful facial expressions. We found that CS was associated with overt person recognition deficits when probed with faces and voices, but not with names. Critically, these deficits were not present in the DLB patient without CS. In addition, CS was associated with impairments in overt judgments of affect intensity. Taken together, our findings cast doubt on the traditional view that CS is the mirror-image of prosopagnosia and that it spares overt recognition abilities. These findings can still be accommodated by models of CS that emphasize deficits in autonomic responding, to the extent that the potential role of interoceptive awareness in overt judgments is taken into account.

Association of maternal and nutrient supply line factors with DNA methylation at the imprinted IGF2/H19 locus in multiple tissues of newborn twins.

Epigenetic events are crucial for early development, but can be influenced by environmental factors, potentially programming the genome for later adverse health outcomes. The insulin-like growth factor 2 (IGF2)/H19 locus is crucial for prenatal growth and the epigenetic state at this locus is environmentally labile. Recent studies have implicated maternal factors, including folate intake and smoking, in the regulation of DNA methylation at this locus, although data are often conflicting in the direction and magnitude of effect. Most studies have focused on single tissues and on one or two differentially-methylated regions (DMRs) regulating IGF2/H19 expression. In this study, we investigated the relationship between multiple shared and non-shared gestational/maternal factors and DNA methylation at four IGF2/H19 DMRs in five newborn cell types from 67 pairs of monozygotic and 49 pairs of dizygotic twins. Data on maternal and non-shared supply line factors were collected during the second and third trimesters of pregnancy and DNA methylation was measured via mass spectrometry using Sequenom MassArray EpiTyper analysis. Our exploratory approach showed that the site of umbilical cord insertion into the placenta in monochorionic twins has the strongest positive association with methylation in all IGF2/H19 DMRs (p<0.05). Further, evidence for tissue- and locus-specific effects were observed, emphasizing that responsiveness to environmental exposures in utero cannot be generalized across genes and tissues, potentially accounting for the lack of consistency in previous findings. Such complexity in responsiveness to environmental exposures in utero has implications for all epigenetic studies investigating the developmental origins of health and disease.

Imagining Other People's Experiences in a Person with Impaired Episodic Memory: The Role of Personal Familiarity.

Difficulties remembering one's own experiences via episodic memory may affect the ability to imagine other people's experiences during theory of mind (ToM). Previous work shows that the same set of brain regions recruited during tests of episodic memory and future imagining are also engaged during standard laboratory tests of ToM. However, hippocampal amnesic patients who show deficits in past and future thinking, show intact performance on ToM tests, which involve unknown people or fictional characters. Here we present data from a developmental amnesic person (H.C.) and a group of demographically matched controls, who were tested on a naturalistic test of ToM that involved describing other people's experiences in response to photos of personally familiar others ("pToM" condition) and unfamiliar others ("ToM" condition). We also included a condition that involved recollecting past experiences in response to personal photos ("EM" condition). Narratives were scored using an adapted Autobiographical Interview scoring procedure. Due to the visually rich stimuli, internal details were further classified as either descriptive (i.e., details that describe the visual content of the photo) or elaborative (i.e., details that go beyond what is visually depicted in the photo). Relative to controls, H.C. generated significantly fewer elaborative details in response to the pToM and EM photos and an equivalent number of elaborative details in response to the ToM photos. These data converge with previous neuroimaging results showing that the brain regions underlying pToM and episodic memory overlap to a greater extent than those supporting ToM. Taken together, these results suggest that detailed episodic representations supported by the hippocampus may be pivotal for imagining the experiences of personally familiar, but not unfamiliar, others.