Working memory and intelligence are associated with victoria symptom validity test hard item performance in patients with intractable epilepsy.

Loring et al. (Journal of clinical and experimental neuropsychology, 2005:27;610­617) observed relationships between VSVT hard item performance and IQ and memory indices in epilepsy surgical candidates, with a potential confound of low FSIQ on VSVT performance. The present study replicated the Loring et al. study in a larger sample and extended their findings by examining the relationships among VSVT performance, FSIQ, and working memory. A total of 404 patients with medically intractable epilepsy completed a comprehensive neuropsychological assessment. Differences in WAIS-III and WMS-III performance were examined as a function of VSVT hard score categories as determined by Grote et al. (2000)--that is, valid, > 20/24; questionable, 18­20; or invalid, < 18. Quantile regression models were constructed to compare the strength of the relationship between FSIQ and VSVT at various points of the FSIQ distribution. Linear regression analyses examined working memory as a potential mediator between FSIQ and VSVT performance. The invalid group performed more poorly than the valid and questionable groups on multiple measures of intelligence and memory. The strength of the relationship between FSIQ and VSVT hard item performance decreased as FSIQ increased, and working memory mediated this relationship. Results suggest VSVT hard item scores may be impacted by working memory difficulties and/or low intellectual functioning.

Reduced heart rate recovery is associated with poorer cognitive function in older adults with cardiovascular disease.

Cardiovascular disease (CVD) in older adults has been associated with varying degrees of cognitive dysfunction. Several mechanisms may explain this association, including impaired cardiovascular reactivity to autonomic nervous system (ANS) signaling. Reduced heart rate recovery following a stress test may be considered an indication of impaired ANS function (i.e., reduced parasympathetic activity). Participants were 47 older adults (53-83 years) who underwent a treadmill stress test and were administered a comprehensive neuropsychological battery upon entry to phase II cardiac rehabilitation. Reduced parasympathetic activity was associated with impaired cognitive performance on a measure of global cognitive function and on tasks of speeded executive function and confrontation naming. These relationships suggest that changes in autonomic function may be mechanistically related to the impaired cognitive function prevalent in CVD patients.

Women with posttraumatic stress disorder have larger decreases in heart rate variability during stress tasks.

The relationship between posttraumatic stress disorder (PTSD) and high frequency heart rate variability (HF-HRV) was investigated during a resting baseline period and two 4-minute laboratory speech tasks. Participants were 20 women with PTSD and 20 age- and gender-matched controls. Parasympathetic nervous system (PNS) cardiac control was measured as HF-HRV (0.12-0.40 Hz) using power spectrum analysis. Participants with PTSD had significantly greater reductions in HF-HRV during two speech tasks (trauma recall and mental arithmetic) than control. These results suggest that PTSD is related to the magnitude of decrease in parasympathetic cardiac control during stress in women. Health implications of altered PNS activity associated with PTSD deserve further study.

Serum leptin levels are associated with cognitive function in older adults.

Recent work suggests that leptin, a circulating adipokinine hormone, might contribute to age-related cognitive decline. The present study investigated the relationship between serum leptin levels and cognitive function in older adults. Thirty-five older adults (73.69+/-6.62 years of age) without significant neurologic or psychiatric history completed a fasting blood draw and a brief neuropsychological test battery. Partial correlations adjusting for demographic and medical conditions showed that higher leptin levels were associated with poorer performance on Trail Making Test B (r = .46, p = .01). These findings indicate that serum leptin levels are negatively associated with speeded executive function in older adults without significant neurological or psychiatric conditions. The mechanisms for this relationship are unknown and require further examination. Such studies may provide key insight into the mechanisms of age-related cognitive decline and identify possible interventions.

Light to moderate alcohol consumption is associated with S100beta and amyloid beta levels in healthy older adults.

Heavy alcohol consumption has been associated with several adverse neurocognitive outcomes in older adults, though little is known about lower consumption levels. No study has investigated the associations between S100beta and amyloid beta (Abeta) serum levels (biomarkers that provide evidence of neurological pathology) and light to moderate alcohol consumption in healthy older adults without neurological conditions. Thirty-five healthy older adults underwent neuropsychological testing and fasting blood draw with subsequent serum S100beta and Abeta 1-40 level quantification. Increased S100beta levels were associated with increased frequency of alcohol consumption and increased total monthly consumption of alcohol. Increased Abeta levels were associated with increased quantity of alcohol consumption. Further work investigating possible mechanisms is needed, particularly longitudinal studies and studies employing neuroimaging.

Multivariate neuropsychological prediction of seizure lateralization in temporal epilepsy surgical cases.

PURPOSE: Neuropsychological assessment can be of assistance in determining seizure lateralization in cases where EEG and MRI findings do not provide clear lateralizing data. While several studies have examined the lateralizing value of individual neuropsychological measures, clinicians are still in need of a statistically sound method that permits the incorporation of multiple neuropsychological variables to predict seizure lateralization in the individual patient. METHOD: The present study investigated the lateralizing value of several commonly used neuropsychological measures in a large sample of patients (n = 217) who eventually underwent surgical resection to treat their epilepsy. Side of surgery was used to operationally define seizure lateralization. A comparison of the relative utility of a multivariate versus univariate approach to predict seizure lateralization was conducted in temporal epilepsy cases. RESULTS: The results provide evidence for the incremental validity of neuropsychological measures, other than memory and IQ tests, in the prediction of seizure lateralization in patients with medically intractable epilepsy. These data indicate that a multivariate approach increases the accuracy of prediction of seizure lateralization for temporal lobe epilepsy cases. CONCLUSION: This study supports the use of a multivariate approach using neuropsychological measures to predict seizure lateralization in temporal epilepsy surgical candidates. Regression formulas are provided to enhance the clinical utility of these findings.