Acquired reading impairment following brain injury.

This large-scale patient study investigated the rate, unique signatures associated with acquired reading impairments, its neurocognitive correlates, and long-term outcome in 731 acute stroke patients using the sentence and non-word reading subtests of Birmingham Cognitive Screen (BCoS). The objectives for the study were to explore the (i) potentially different error patterns among adult patients, (ii) associative relationship between the different subclasses of reading impairment and performance in other cognitive domains, and (iii) recovery rates in patients nine months post-lesion compared with their initial performance. The study revealed distinctive reading impairment profiles in patients with left hemisphere (LH) and right hemisphere (RH) lesions. Some interesting associations between reading disorder and other cognitive functions were observed. Nine months post-lesion, both groups showed some recovery in reading performance compared with their baseline performance, but the rate of improvement was higher for the LH group. The study reveals unique reading profiles and impairment patterns among left and right hemisphere lesions. The findings of the study provide a deeper understanding of reading deficits that will inform clinical practice, planning of rehabilitative interventions of brain injured patients, and the scientific community.

Developing a simple risk metric for the effect of sport-related concussion and physical pain on mental health.

Risk factors associated with depression in athletes include biological sex, physical pain, and history of sport-related concussion (SRC). Due to the well-documented benefits of sport and physical activity on mental health, athletes and non-athletes were recruited to assess any differences. Beyond this, athletes were also grouped by sport-type (contact/non-contact sports) due to the increased prevalence of pain and SRC in contact sports. To our knowledge, there has been no research on how these factors influence the likelihood of depression. In the current study, 144 participants completed a short survey on the above factors and the Center for Epidemiological Studies Depression Scale. Sixty-two of these reported a history of concussion. Logistic regression revealed all the above predictors to be significantly associated with the depression scale. Individuals that had previously sustained SRC, were experiencing greater physical pain and females were more likely to display poor mental health. However, we provide further evidence for the benefits of engaging in sport and physical activity as those that took part in sport were less likely to report depression. Therefore, this study provides a simple risk metric whereby sportspeople can make a better informed choice of their sporting participation, making their own cost/reward judgement.

Systematic assessment of apraxia and functional predictions from the Birmingham Cognitive Screen.

OBJECTIVE: The validity and functional predictive values of the apraxia tests in the Birmingham Cognitive Screen (BCoS) were evaluated. BCoS was developed to identify patients with different forms of praxic deficit using procedures designed to be inclusive for patients with aphasia and/or spatial neglect. METHOD: Observational studies were conducted from a university neuropsychological assessment centre and from acute and rehabilitation stroke care hospitals throughout an English region. Volunteers from referred patients with chronic acquired brain injuries, a consecutive hospital sample of patients within 3 months of stroke (n=635) and a population based healthy control sample (n=100) were recruited. The main outcome measures used were the Barthel Index, the Nottingham Extended Activities of Daily Living Scale as well as recovery from apraxia. RESULTS: There were high inter-rater reliabilities and correlations between the BCoS apraxia tasks and counterpart tests from the literature. The vast majority (88.3%) of the stroke survivors were able to complete the screen. Pantomime and gesture recognition tasks were more sensitive in differentiating between individuals with left hemisphere damage and right hemisphere damage whereas the Multistep Object Use test and the imitation task had higher functional correlates over and above effects of hemiplegia. Together, the initial scores of the four tasks enabled predictions with 75% accuracy, the recovery of apraxia and independence level at 9 months. CONCLUSIONS: As a model based assessment, BCoS offers a quick and valid way to detect apraxia and predict functional recovery. It enables early and informative assessment of most stroke patients for rehabilitation planning.

Separating top-down and bottom-up cueing of attention from response inhibition in utilization behavior.

A single case study of a patient (FK) with utilization disorder following bilateral damage to medial frontal and anterior temporal cortices is reported. FK had to localize a search target following presentation of an earlier verbal or visual cue. Search was strongly affected by semantic/visual associations between the cue and search items. Although FK was unable to name the hue of an incongruent Stroop word, his attention was drawn to a color in the display matching the hue of the cue word. FK's ability to inhibit a response activated by the cueing of attention was impaired. There is dissociation between top-down attention cueing and response inhibition.

Working memory and target-related distractor effects on visual search.

We examined two forms of top-down effects on visual selection: (1) information held in working memory (WM) and (2) the semantic relations between targets and distractors. We found that items held in WM affected search for a different target. This WM-based interference effect generalized across different exemplars, even though participants could remember the specific exemplar on the trial. This argues against a memory top-up account of performance. In addition, there was interference from distractors that were not held in WM but were semantically related to the target. The effects of WM capture and the effects of capture by a distractor related to the target combined additively. The data suggest that task-irrelevant information in WM and task-relevant templates for targets compete separately for selection. The implications for understanding top-down processes in search are discussed.

Cross-modal information transfer and the effect of concurrent task-load.

People's everyday lives offer plenty of situations where complex processing of information takes place, in which information needs to transfer across modalities to achieve a behavioral goal. The study examined the differential effects on object detection by a visual, verbal, or auditory cue held in working memory (WM), and the role of concurrent cognitive task-load on the final detection of that cue. Three experiments, all using same stimuli set but in different modalities, subjects held in memory a representation of a novel cue for a speeded detection in a search display at the end of each trial. The cue stimulus could be an image (visual), the name (verbal) or the sound (auditory) of a common animal or object. A mental arithmetic task was interleaved between the cue presentation and the cue detection. The results showed that information held in WM, either in verbal or auditory form, can efficiently transfer across modalities to complete a visual detection task for a representation of the initial WM-cue. The speed of detection was not affected by the cross-modal transfer of cue information but there was some detrimental effect on detection that could distinctively be attributed to the cognitive task-load. Together, these findings may provide some evidence for the role of the episodic buffer component of WM in integrating multimodal information originated from different sources, hence supporting the notion of the supramodal nature of WM. The results have been discussed in light of Baddeley's and Cowan's theoretical WM frameworks. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Constraints on task-based control of behaviour following frontal lobe damage: a single-case study.

What factors determine stimulus-driven responses in patients with utilization behaviour? We examined this question by assessing the influence of an irrelevant cue on visual search in a patient showing evidence of utilization behaviour (F.K.), following bilateral damage to the medial frontal and temporal lobes. Despite being able to repeat the instructions, F.K. often responded to an item in the search display that matched the cue rather than the target. This effect was reduced under certain conditions: (a) when the cue-search interval increased, (b) when F.K. paid less attention to the cue, and (c) when the target discrimination task was made more difficult. On the other hand, the effect arose even when the cue was always invalid. We suggest that information from the cue competed with the top-down set to determine search. F.K.'s lesion makes it difficult for him to impose top-down knowledge rapidly, leading to responses automatically being based on attended, but irrelevant, cues under short cue-display intervals.

The relation of object naming and other visual speech production tasks: a large scale voxel-based morphometric study.

We report a lesion-symptom mapping analysis of visual speech production deficits in a large group (280) of stroke patients at the sub-acute stage (<120 days post-stroke). Performance on object naming was evaluated alongside three other tests of visual speech production, namely sentence production to a picture, sentence reading and nonword reading. A principal component analysis was performed on all these tests' scores and revealed a 'shared' component that loaded across all the visual speech production tasks and a 'unique' component that isolated object naming from the other three tasks. Regions for the shared component were observed in the left fronto-temporal cortices, fusiform gyrus and bilateral visual cortices. Lesions in these regions linked to both poor object naming and impairment in general visual-speech production. On the other hand, the unique naming component was potentially associated with the bilateral anterior temporal poles, hippocampus and cerebellar areas. This is in line with the models proposing that object naming relies on a left-lateralised language dominant system that interacts with a bilateral anterior temporal network. Neuropsychological deficits in object naming can reflect both the increased demands specific to the task and the more general difficulties in language processing.

The BCoS cognitive profile screen: Utility and predictive value for stroke.

OBJECTIVE: We examined the utility of the Birmingham Cognitive Screen (BCoS) in discriminating cognitive profiles and recovery of function across stroke survivors. BCoS was designed for stroke-specific problems across 5 cognitive domains: (a) controlled and spatial attention, (b) language, (c) memory, (d) number processing, and (e) praxis. METHOD: On the basis of specific inclusion criteria, this cross-section observational study analyzed cognitive profiles of 657 subacute stroke patients, 331 of them reassessed at 9 months. Impairments on 32 measures were evaluated by comparison with 100 matched healthy controls. Measures of affect, apathy, and activities of daily living were also taken. Between-subjects group comparisons of mean performance scores and impairment rates and within-subject examination of impairment rates over time were conducted. Logistic regressions and general linear modeling were used for multivariate analysis of domain-level effects on outcomes. RESULTS: Individuals with repeated stroke experienced significantly less cognitive recovery at 9 months than those with a first stroke despite similar initial level of cognitive performance. Individuals with left hemisphere lesions performed more poorly than those with right hemisphere lesions, but both groups showed similar extent of recovery at 9 months. BCoS also revealed lesion-side-specific deficits and common areas of persistent problems. Functional outcome at 9 months correlated with domain-level deficits in controlled attention, spatial attention, and praxis over and above initial dependency and concurrent levels of affect and apathy. CONCLUSION: The study demonstrates how BCoS can identify differential cognitive profiles across patient groups. This can potentially help predict outcomes and inform rehabilitation.

Working memory enhances visual perception: evidence from signal detection analysis.

We show that perceptual sensitivity to visual stimuli can be modulated by matches between the contents of working memory (WM) and stimuli in the visual field. Observers were presented with an object cue (to hold in WM or to merely attend) and subsequently had to identify a brief target presented within a colored shape. The cue could be re-presented in the display, where it surrounded either the target (on valid trials) or a distractor (on invalid trials). Perceptual identification of the target, as indexed by A', was enhanced on valid relative to invalid trials but only when the cue was kept in WM. There was minimal effect of the cue when it was merely attended and not kept in WM. Verbal cues were as effective as visual cues at modulating perceptual identification, and the effects were independent of the effects of target saliency. Matches to the contents of WM influenced perceptual sensitivity even under conditions that minimized competition for selecting the target. WM cues were also effective when targets were less likely to fall in a repeated WM stimulus than in other stimuli in the search display. There were no effects of WM on decisional criteria, in contrast to sensitivity. The findings suggest that reentrant feedback from WM can affect early stages of perceptual processing.