Verbal and non-verbal recognition memory assessment: validation of a computerized version of the Recognition Memory Test.

BACKGROUND: The use of computerized devices for neuropsychological assessment (CNADs) as an effective alternative to the traditional pencil-and-paper modality has recently increased exponentially, both in clinical practice and research, especially due to the pandemic. However, several authors underline that the computerized modality requires the same psychometric validity as "in-presence" tests. The current study aimed at building and validating a computerized version of the verbal and non-verbal recognition memory test (RMT) for words, unknown faces and buildings. METHODS: Seventy-two healthy Italian participants, with medium-high education and ability to proficiently use computerized systems, were enrolled. The sample was subdivided into six groups, one for each age decade. Twelve neurological patients with mixed aetiology, age and educational level were also recruited. Both the computerized and the paper-and-pencil versions of the RMT were administered in two separate sessions. RESULTS: In healthy participants, the computerized and the paper-and-pencil versions of the RMT showed statistical equivalence for words, unknown faces and buildings. In the neurological patients, no statistical difference was found between the performance at the two versions of the RMT. A moderate-to-good inter-rater reliability between the two versions was also found in both samples. Finally, the computerized version of the RMT was perceived as acceptable by both healthy participants and neurological patients at System Usability Scale (SUS). CONCLUSION: The computerized version of the RMT can be used as a reliable alternative to the traditional version.

Cognitive Reserve Proxies Do Not Differentially Account for Cognitive Performance in Patients with Focal Frontal and Non-Frontal Lesions.

OBJECTIVE: Cognitive reserve (CR) suggests that premorbid efficacy, aptitude, and flexibility of cognitive processing can aid the brain's ability to cope with change or damage. Our previous work has shown that age and literacy attainment predict the cognitive performance of frontal patients on frontal-executive tests. However, it remains unknown whether CR also predicts the cognitive performance of non-frontal patients. METHOD: We investigated the independent effect of a CR proxy, National Adult Reading Test (NART) IQ, as well as age and lesion group (frontal vs. non-frontal) on measures of executive function, intelligence, processing speed, and naming in 166 patients with focal, unilateral frontal lesions; 91 patients with focal, unilateral non-frontal lesions; and 136 healthy controls. RESULTS: Fitting multiple linear regression models for each cognitive measure revealed that NART IQ predicted executive, intelligence, and naming performance. Age also significantly predicted performance on the executive and processing speed tests. Finally, belonging to the frontal group predicted executive and naming performance, while membership of the non-frontal group predicted intelligence. CONCLUSIONS: These findings suggest that age, lesion group, and literacy attainment play independent roles in predicting cognitive performance following stroke or brain tumour. However, the relationship between CR and focal brain damage does not differ in the context of frontal and non-frontal lesions.

Feeling physical pain while depressed: The effect of alexithymia.

BACKGROUND: In the literature, depression and alexithymia are associated with greater pain perception. It is unknown whether depression and alexithymia have additive effects on perceived pain. METHODS: The present study examined 152 participants (96 women, 56 men). Participants completed the 20-item Toronto Alexithymia Scale, the Hamilton Depression Rating Scale, the Brief Pain Inventory, and the NEO Personality Inventory. There were 49 participants in the active phase of depression with either definite (n = 15) or no alexithymia (n = 34). One hundred three participants showed no depression with either definite (n = 14) or no alexithymia (n = 89). RESULTS: Pain severity showed a small but significant relationship with alexithymia and depression. Pain was greater among without alexithymia individuals who were depressed and among with alexithymia individuals who were not depressed. Individuals with combined presence of depression and alexithymia did not report greater pain than participants with either condition alone. Alexithymia, depression, and pain were significantly correlated with greater neuroticism. CONCLUSIONS: We did not find a summative effect of depression and alexithymia on perceived pain. One interpretation of this result is that neuroticism (a shared personality factor in both depression and alexithymia) may be partially responsible for the effect on pain.

Early detection of memory impairments in older adults: standardization of a short version of the verbal and nonverbal Recognition Memory Test.

In several neurological conditions, in elderly and cognitively impaired subjects, memory functioning must be evaluated to early detect the cognitive deterioration processes. In particular, recognition memory assessment is an essential step in the clinical and neuropsychological evaluation of early memory impairments. The Recognition Memory Test (RMT) developed by Smirni et al. (G Ital Psicol XXXVII(1):325-343, 2010) is an effective instrument to assess verbal and nonverbal recognition memory in the Italian population. The current study provides a new, brief, and reliable RMT format to evaluate recognition memory on elderly subjects and it reports normative data in an older adult Italian population sample (including 100 participants well distributed across sex, education, and age categories). The shortened version of RMT keeps the administration procedures and materials of the original Italian RMT constant, i.e., words, faces, and buildings. Multiple regression analysis revealed significant effects of age and educational level on performance but no effect of sex. Inferential cutoffs have been determined and equivalent scores computed. The availability of equivalent scores for the Recognition Memory Test will prove useful in the clinical evaluation of patients' memory profiles.

Emotional Awareness and Cognitive Performance in Borderline Intellectual Functioning Young Adolescents.

According to DSM-5 and ICD-10, borderline intellectual functioning (BIF) should not be classified properly as a disorder. However, BIF people may present relevant problems of adaptive functioning in several areas of daily activities, and they seem to be more vulnerable to mental diseases. Young adolescence may be considered a particular period for emotional information processing. The "own and others' emotions" awareness can play a crucial role in many daily life situations, such as decision making, interpersonal relationships, and decoding of facial expressions. On this background, a BIF young adolescents group underwent a neuropsychological assessment including emotional and cognitive domains, and was compared with a healthy young adolescents control group (HC). In the overall sample, a significant negative correlation between general intellectual abilities and emotional awareness was found. The BIF group showed a significantly greater level of alexithymia and a poorer performance in higher cognitive tasks than HC group. As hypothesized, a border cognitive functioning influences mentalization processes as ability to discriminate and monitor emotions, as well as higher domains of cognition.

Benton visual form discrimination test in healthy children: normative data and qualitative analysis.

The attention evaluation may be considered a crucial phase in neuropsychological assessment. It must take into account the systemic nature of the attentional functions and must use different reliable tests in relation to the neurological and attentional problems to be addressed. The aim of the study was to offer the clinician an effective tool for attention assessment and provide the normative data and performance analysis on the Benton Visual Form Discrimination Test on an Italian sample (number 323) of healthy school children, from ages 5 to 11. Performance on Visual Form Discrimination Test (VFDT) significantly increased with growing age. Performances were significantly different when the test was divided into four sets. All groups, especially the younger ones, showed some difficulty in maintenance and sustained attention. The correct answers were significantly more numerous when they were placed at the top quadrants. This effect was more marked in the younger groups. Sex was never a significantly influencing performance. Our data seem to indicate that the higher attentional frontoparietal network becomes more functionally organized around 9-10 years. VFDT appears as a discriminative task. In clinical practice, our normative data can be used both on complex visual attention skill evaluation in children and on the ability to maintain visual attention in time.

Standardization and validation of a parallel form of the verbal and non-verbal recognition memory test in an Italian population sample.

In the neuropsychological assessment of several neurological conditions, recognition memory evaluation is requested. Recognition seems to be more appropriate than recall to study verbal and non-verbal memory, because interferences of psychological and emotional disorders are less relevant in the recognition than they are in recall memory paradigms. In many neurological disorders, longitudinal repeated assessments are needed to monitor the effectiveness of rehabilitation programs or pharmacological treatments on the recovery of memory. In order to contain the practice effect in repeated neuropsychological evaluations, it is necessary the use of parallel forms of the tests. Having two parallel forms of the same test, that kept administration procedures and scoring constant, is a great advantage in both clinical practice, for the monitoring of memory disorder, and in experimental practice, to allow the repeated evaluation of memory on healthy and neurological subjects. First aim of the present study was to provide normative values in an Italian sample (n = 160) for a parallel form of a verbal and non-verbal recognition memory battery. Multiple regression analysis revealed significant effects of age and education on recognition memory performance, whereas sex did not reach a significant probability level. Inferential cutoffs have been determined and equivalent scores computed. Secondly, the study aimed to validate the equivalence of the two parallel forms of the Recognition Memory Test. The correlations analyses between the total scores of the two versions of the test and correlation between the three subtasks revealed that the two forms are parallel and the subtasks are equivalent for difficulty.

An Initial Study of Alexithymia and Its Relationship With Cognitive Abilities Among Mild Cognitive Impairment, Mild Alzheimer's Disease, and Healthy Volunteers.

The present study examined the degree to which alexithymia is greater in mild Alzheimer's disease (AD) and mild cognitive impairment (MCI) relative to healthy volunteers (healthy comparison [HC]), and investigated relationships between alexithymia and cognition. Eighty-five participants (MCI = 30, AD = 21, HC = 34) underwent a comprehensive neuropsychological examination and completed the 20-item Toronto Alexithymia Scale (TAS-20). Relative to HC, MCI and AD reported greater alexithymia total scores and higher scores on the TAS factor difficulty in identifying feelings (DIF). The remaining two factors, difficulty in describing feelings (DDF) and externally oriented thinking showed no significant group differences. In MCI, TAS-20 and DIF were negatively correlated with working and long-term verbal memory. In AD, TAS-20 was negatively correlated with general cognition, attention, memory, and visual spatial constructive and executive abilities. Also in AD, DIF was negatively correlated with general cognition, memory, and executive abilities. The correlation between DIF and long-term verbal memory in both MCI and AD suggests a potential common mechanism for alexithymia in these neurocognitive disorders. Declines in verbal memory may hinder a patient's ability to recall an association between a given sensation and the episodic experience of that sensation, thus leading to difficulty identifying feelings, as measured by the DIF factor of the TAS-20.

Premorbid Personality Traits as Risk Factors for Behavioral Addictions: A Systematic Review of a Vulnerability Hypothesis.

The debate on personality structure and behavioral addictions is an outstanding issue. According to some authors, behavioral addictions could arise from a premorbid personality, while for others, it could result from a pathological use of technological tools. The current study aims to investigate whether, in the latest literature, personality traits have been identified as predictors of behavioral addictions. A literature search was conducted under the PRISMA methodology, considering the most relevant studies of the five-factor model from the past 10 years. Overall, most studies on addiction, personality traits, and personality genetics proved that behavioral addiction may be an epiphenomenon of a pre-existing personality structure, and that it more easily occurs in vulnerable subjects with emotional instability, negative affects, and unsatisfactory relationships with themselves, others, and events. Such neurotic personality structure was common to any addictive behavior, and was the main risk factor for both substance and behavioral addictions. Therefore, in clinical and educational contexts, it becomes crucial to primarily focus on the vulnerability factors, at-risk personality traits, and protective and moderating traits such as extroversion, agreeableness, conscientiousness, and openness to experience; meanwhile, treatment of behavioral addictions is frequently focused on overt pathological behaviors.

Epilepsy: A Multifaced Spectrum Disorder.

Epilepsy is one of the most widespread chronic conditions, affecting about 50 million people worldwide [...].

Manual dexterity in school-age children measured by the Grooved Pegboard test: Evaluation of training effect and performance in dual-task.

Background: Manual dexterity is the ability to manipulate objects using the hands and fingers for a specific task. Although manual dexterity is widely investigated in the general and special population at all ages, numerous aspects still remain to be explored in children. The aim of this study was to assess the presence of the training effect of the execution of the Grooved Pegboard test (GPT) and to measure the performance of the GPT in dual-task (DT), i.e., during a motor task and a cognitive task. Methods: In this observational, cross-sectional study manual dexterity was assessed in children aged between 6 and 8. The procedure consisted of two phases: (1) the execution of five consecutive trials of the GPT to evaluate the training effect; (2) the execution of one trial of the GPT associated with a motor task (finger tapping test, GPT-FTT), and one trial of the GPT associated with a cognitive task (counting test, GPT-CT) to evaluate the performance in DT. Results: As for the training effect, a significant difference (p < 0.001) between the five trials of the GPT (i.e., GPT1, GPT2, GPT3, GPT4, GPT5) was detected. In particular, we found a significant difference between GPT1 and GPT3 (p < 0.05), GPT1 and GPT4 (p < 0.001), and GPT1 and GPT5 (p < 0.001), as well as between GPT2 and GPT4 (p < 0.001), and GPT2 and GPT5 (p < 0.001).As for the performance in DT, no differences between the best trial of the GPT (i.e., GPT5) and both the GPT-FTT and GPT-CT was found. Conclusion: Our findings suggest that the execution of the GPT in children has a training effect up to the third consecutive trial. Furthermore, the administration of the GPT in DT does not affect GPT performance.

Current and Potential Cognitive Development in Healthy Children: A New Approach to Raven Coloured Progressive Matrices.

In clinical practice and research, Raven's Coloured Progressive Matrices (RCPMs) continue to be used according to a single procedure that aims to evaluate a single overall score of the current general intelligence level. This study aimed to examine potential cognitive development in a sample of 450 typically developing children, aged from 6 to 10 years, by administering RCPMs according to the standard procedure followed immediately by a standardized interview on incorrect items. In addition, the study aimed to analyze how performance differed across age groups. The results analysis was examined on the basis of three different factors in which the items were grouped in previous factorial studies. The results found that performance improved markedly and significantly after the interview; however, the improvement was not homogeneous in the three factors across age groups or within each age group. The age groups showed a different development potential in relation to the nature of the task: the younger ones showed a greater increase on items requiring figure completion, and the older ones showed a greater increase on analogical reasoning items. Finally, the children who showed the greatest improvement were those with the best performance in standard RCPM administration. The procedure described in the present research could represent a useful tool in clinical practice and in the research for a broader cognitive assessment focused on potential cognitive development, as well as on real cognitive development, and to favor the planning of more adequate rehabilitation and educational treatments.

Noli Timere: The Role of Reassuring Adults in Dealing with COVID-19 Anxiety in Pediatric Age.

Since the earliest stages of the Corona Virus Disease-19 (COVID-19) spread, the elderly has been identified as the most vulnerable and health authorities have rightly focused on that population. Minor attention was paid to pediatric populations and their emotional reactions. Actually, children and adolescents faced severe anxiety, fear and stress conditions. An efficient management of the pandemic, therefore, must take into account the pediatric population which cannot be neglected as a minor matter compared to the elderly, the economy and health care. Since the lockdown time is over, children and adolescents must recover sociality, return to living in the open air, rediscover playing, free time, aiming for the beauty of their everyday life. In order to mitigate the long-term impact of COVID-19, the key response is the reassuring presence of the adult as 'a secure base'. The current study aimed to collect an overview of the recent references that report evidence on the role of adults in containing pandemic anxiety COVID-19 in pediatric populations, suggesting the need to ensure a reassuring presence of the adult, an effective child-parent communication, a child-friendly day and a long-lasting shared time with parents.

Pediatric Chronic Migraine Severity and Maternal Stress.

Primary headache is an increasing phenomenon in pediatric age, and very often, it causes disabling limitations in children's daily activities, negatively affecting family well-being. There are conflicting data in the literature on the impact of children's migraines on parental experienced stress. This study aimed to evaluate maternal stress in a sample of school-aged children with a migraine without aura (MwoA) and its correlation with migraine intensity and frequency. A total of 474 mothers aged between 31 and 55 participated in the study: 237 were mothers of children with MwoA, and 237 were mothers of typical developing children. All participants were administered the Parent Stress Index-Short Form (PSI-SF) for the assessment of parental stress; the Pediatric Migraine Disability Assessment (PedMIDAS) was administered to children with MwoA to assess the presence of a related disability migraine. The results showed a significantly higher rate of stress in mothers of MwoA children (p < 0.001) in all the domains explored by the PSI-SF and a statistically significant correlation between the maternal stress total score and the intensity and frequency of migraine attacks (p < 0.0001). This study highlights the need for the holistic contribution of the family to be considered in the clinical management of pediatric migraines.

The Playing Brain. The Impact of Video Games on Cognition and Behavior in Pediatric Age at the Time of Lockdown: A Systematic Review.

A growing number of children and adolescents play video games (VGs) for long amounts of time. The current outbreak of the Coronavirus pandemic has significantly reduced outdoor activities and direct interpersonal relationships. Therefore, a higher use of VGs can become the response to stress and fear of illness. VGs and their practical, academic, vocational and educational implications have become an issue of increasing interest for scholars, parents, teachers, pediatricians and youth public policy makers. The current systematic review aims to identify, in recent literature, the most relevant problems of the complex issue of playing VGs in children and adolescents in order to provide suggestions for the correct management of VG practice. The method used searches through standardized search operators using keywords related to video games and the link with cognition, cognitive control and behaviors adopted during the pandemic. Ninety-nine studies were reviewed and included, whereas twelve studies were excluded because they were educationally irrelevant. Any debate on the effectiveness of VGs cannot refer to a dichotomous approach, according to which VGs are rigidly 'good' or 'bad'. VGs should be approached in terms of complexity and differentiated by multiple dimensions interacting with each other.

Transcranial Magnetic Stimulation Trains at 1 Hz Frequency of the Right Posterior Parietal Cortex Facilitate Recognition Memory.

Neuroimaging, neuropsychological, and brain stimulation studies have led to contrasting findings regarding the potential roles of the lateral parietal lobe in episodic memory. Studies using brain stimulation methods reported in the literature do not offer unequivocal findings on the interactions with stimulation location (left vs. right hemisphere) or timing of the stimulation (encoding vs. retrieval). To address these issues, active and sham 1 Hz repetitive transcranial magnetic stimulation (rTMS) trains of 600 stimuli were applied over the right or left posterior parietal cortex (PPC) before the encoding or before the retrieval phase of a recognition memory task of unknown faces in a group of 40 healthy subjects. Active rTMS over the right but not the left PPC significantly improved non-verbal recognition memory performance without any significant modulation of speed of response when applied before the retrieval phase. In contrast, rTMS over the right or the left PPC before the encoding phase did not modulate memory performance. Our results support the hypothesis that the PPC plays a role in episodic memory retrieval that appears to be dependent on both the hemispheric lateralization and the timing of the stimulation (encoding vs. retrieval).

Improvement of phonemic fluency following leftward prism adaptation.

Anatomo functional studies of prism adaptation (PA) have been shown to modulate a brain frontal-parieto-temporal network, increasing activation of this network in the hemisphere ipsilateral to the side of prism deviation. This effect raises the hypothesis that left prism adaptation, modulating frontal areas of the left hemisphere, could modify subjects' performance on linguistic tasks that map on those areas. To test this hypothesis, 51 healthy subjects participated in experiments in which leftward or rightward prism adaptation were applied before the execution of a phonemic fluency task, i.e., a task with strict left hemispheric lateralization onto frontal areas. Results showed that leftward PA significantly increased the number of words produced whereas rightward PA did not significantly modulate phonemic fluency. The present findings document modulation of a language ability following prism adaptation. The results could have a huge clinical impact in neurological populations, opening new strategies of intervention for language and executive dysfunctions.

Verbal Fluency in Mild Alzheimer's Disease: Transcranial Direct Current Stimulation over the Dorsolateral Prefrontal Cortex.

BACKGROUND: Recent studies showed that in healthy controls and in aphasic patients, inhibitory trains of repetitive transcranial magnetic stimulation (rTMS) over the right prefrontal cortex can improve phonemic fluency performance, while anodal transcranial direct current stimulation (tDCS) over the left prefrontal cortex can improve performance in naming and semantic fluency tasks. OBJECTIVE: This study aimed at investigating the effects of cathodal tDCS over the left or the right dorsolateral prefrontal cortex (DLPFC) on verbal fluency tasks (VFT) in patients with mild Alzheimer's disease (AD). METHODS: Forty mild AD patients participated in the study (mean age 73.17±5.61 years). All participants underwent cognitive baseline tasks and a VFT twice. Twenty patients randomly received cathodal tDCS to the left or the right DLPFC, and twenty patients were assigned to a control group in which only the two measures of VFT were taken, without the administration of the tDCS. RESULTS: A significant improvement of performance on the VFT in AD patients was present after tDCS over the right DLPFC (p = 0.001). Instead, no difference was detected between the two VFTs sessions after tDCS over the left DLPFC (p = 0.42). Furthermore, these results cannot be related to task learning effects, since no significant difference was found between the two VFT sessions in the control group (p = 0.73). CONCLUSION: These data suggest that tDCS over DLPFC can improve VFT performance in AD patients. A hypothesis is that tDCS enhances adaptive patterns of brain activity between functionally connected areas.

Neuropsychological Profile, Emotional/Behavioral Problems, and Parental Stress in Children with Neurodevelopmental Disorders.

BACKGROUND: The aim of our study was to trace a specific neuropsychological profile, to investigate emotional-behavioral problems and parental stress in children with Autism Spectrum Disorder Level 1/High functioning (ASD-HF), Specific Learning Disorders (SLD) and Attention Deficit/Hyperactivity Disorder (ADHD) disorders and to highlight similarities and differences among the three groups. METHODS: We retrospectively collected the data from a total of 62 subjects with ASD-HF (n = 19) ADHD (n = 21), SLD (n = 22) and 20 typical development. All the participants underwent neuropsychological standardized test for the evaluation of cognitive profile (Wechsler Intelligence Scale for Children Fourth Edition-WISC-IV), behavioral and emotional problems (Child Behavior CheckList CBCL), and parental stress (Parental Stress Index Short Form-PSI-SF). The scores of the ASD-HF, ADHD, and SLD groups were compared using non-parametric statistic methods (Kruskall-Wallis H test and U Mann-Whitney for post-hoc analysis). RESULTS: The ASD-HF group were significantly higher in all areas of the WISC-IV than the other two clinical groups. The SLD group performed significantly lower than ASD-HF in Working Memory Index. The SLD group showed lower scores on the somatic problems subscale than the other two groups. In the Difficult Child subscale of the PSI-SF, parents of ADHD children scored lower than the mothers of SLD subjects and higher than the fathers of SLD subjects. In all three groups there are specific deficiencies compared to the control group in the cognitive profile, behavioral and emotional problems, and parental stress. CONCLUSIONS: Our comparative analysis highlighted similarities and differences in three groups of children with different neurodevelopmental disorders, helping to better define cognitive, behavioral, and emotional characteristics of these children and parental stress of their parents.

Childhood Obesity and Maternal Personality Traits: A New Point of View on Obesity Behavioural Aspects.

The epidemic spread of childhood obesity in Western society has interested many researchers, who agree in defining it as a multifactorial disease in which not only eating habits and sedentary lifestyle play a role, but also genetic predisposition. The aim of this study was to analyze the personality profile of a group of mothers of children with obesity and to compare this profile to that of a group of mothers of children without obesity. A total of 258 mothers participated in the study (126 mothers of children with obesity and 132 mothers of children without obesity). Weight and height were measured and the body mass index was calculated. The Minnesota Multiphasic Personality Inventory second edition (MMPI-2), evaluating personality and psychological disorders, was used to evaluate the personality profile. The results suggested that mothers of children with obesity score higher than the mothers of children without obesity in all MMPI-2 subscales. In most of these subscales, the differences between the two groups of mothers were statistically significant and with a medium to high effect size. These data suggest a new perspective on childhood obesity, identifying it as a multifactorial pathology that requires a multimodal and multidisciplinary approach that also takes care of caregivers to ensure optimal therapeutic efficacy.