The CERAD Neuropsychological Assessment Battery Is Sensitive to Alcohol-Related Cognitive Deficiencies in Elderly Patients: A Retrospective Matched Case-Control Study.

OBJECTIVES: Adverse effects of heavy drinking on cognition have frequently been reported. In the present study, we systematically examined for the first time whether clinical neuropsychological assessments may be sensitive to alcohol abuse in elderly patients with suspected minor neurocognitive disorder. METHODS: A total of 144 elderly with and without alcohol abuse (each group n=72; mean age 66.7 years) were selected from a patient pool of n=738 by applying propensity score matching (a statistical method allowing to match participants in experimental and control group by balancing various covariates to reduce selection bias). Accordingly, study groups were almost perfectly matched regarding age, education, gender, and Mini Mental State Examination score. Neuropsychological performance was measured using the CERAD (Consortium to Establish a Registry for Alzheimer's Disease). Classification analyses (i.e., decision tree and boosted trees models) were conducted to examine whether CERAD variables or total score contributed to group classification. RESULTS: Decision tree models disclosed that groups could be reliably classified based on the CERAD variables "Word List Discriminability" (tapping verbal recognition memory, 64% classification accuracy) and "Trail Making Test A" (measuring visuo-motor speed, 59% classification accuracy). Boosted tree analyses further indicated the sensitivity of "Word List Recall" (measuring free verbal recall) for discriminating elderly with versus without a history of alcohol abuse. CONCLUSIONS: This indicates that specific CERAD variables seem to be sensitive to alcohol-related cognitive dysfunctions in elderly patients with suspected minor neurocognitive disorder. (JINS, 2018, 24, 360-371).

Age-related differences in inhibitory control and memory updating in boys with Asperger syndrome.

Deficits in specific executive domains are highly prevalent in autism spectrum disorder; however, age-related improvements in executive functions (reflecting prefrontal maturational changes) have been reported even in individuals diagnosed with autism. The current study examined two components of cognitive flexibility (inhibition of prepotent responses and memory monitoring/updating) by using a random-motor-generation task (MPT) in a group of 23 boys with Asperger syndrome (AS) and 23 matched healthy controls. We found poorer inhibition and more repetitive responses in younger AS children solely, but comparable memory monitoring/updating skills across groups. Overall, our findings correspond well with previous studies and reveal that even in AS specific EFs may improve with age and, thus, call for a more differentiated view of executive (dys) function profiles in children diagnosed with AS. Tests such as the random-motor-generation task may help to disentangle more specific processes of executive deficits in autism spectrum disorder as compared to the more classical tests.

Language affects symbolic arithmetic in children: the case of number word inversion.

Specific language influences have been observed in basic numerical tasks such as magnitude comparison, transcoding, and the number line estimation task. However, so far language influences in more complex calculations have not been reported in children. In this translingual study, 7- to 9-year-old German- and Italian-speaking children were tested on a symbolic addition task. Whereas the order of tens and units in Italian number words follows the order of the Arabic notation, the order is inverted in German number words. For both language groups, addition problems were more difficult when a carry operation was needed, that is, when a manipulation within the place-value structure of the Arabic number system was particularly important. Most important, this carry effect was more pronounced in response latencies for children speaking German, a language with inverted verbal mapping of the place-value structure. In addition, independent of language group, the size of the carry effect was significantly related to verbal working memory. The current study indicates that symbolic arithmetic and the carry effect in particular are modulated by language-specific characteristics. Our results underline the fact that the structure of the language of instruction is an important factor in children's mathematical education and needs to be taken into account even for seemingly nonverbal symbolic Arabic tasks.

Evidence for Two Types of Task Conflict in a Color-Digit Stroop Task.

In the present study, we conducted a Stroop-like task in which the participants were required to decide whether the presented stimulus, which could be either a colored digit or a colored rectangle, consisted of more or less than five colors. Like other Stroop-like tasks, the stimuli could be congruent (the stimulus was a digit that was equal to the presented number of colors), incongruent (the stimulus was a digit that was different than the presented number of colors), or neutral (a colored rectangle). We utilized a two-to-one response setting so that in some incongruent trials the digit and the number of colors would elicit the same response (e.g., the digit 3 containing two colors; both are smaller than 5), while in some incongruent trials, the digit and the number of colors would elicit different responses (e.g., the digit 3 containing 6 colors). This enabled us to measure both conflicts arising from stimulus-stimulus and stimulus-response compatibilities. Our results indicated the existence of stimulus-stimulus compatibility (SSC), stimulus-response compatibility (SRC), and task conflict. Interestingly, these effects were in interaction with the number of colors, so that in small numbers, SSC and SRC were found, and in large numbers, SRC and task conflict were found. Moreover, the results suggest that our task includes two types of task conflict that are raised due to three different tasks: processing the meaning of the digit vs. estimating the number of colors and counting the number of colors vs. estimating the number of colors.

Predictive value of somatic and functional variables for cognitive deterioration for early-stage patients with Alzheimer's Disease: Evidence from a prospective registry on dementia.

Alzheimer's disease (AD) imposes a major burden on affected individuals, their caregivers and health-care systems alike. Though quite many risk factors for disease progression have been identified, there is a lack of prospective studies investigating the interplay and predictive value of a wide variety of patient variables associated with cognitive deterioration (defined as key feature of AD progression). Study participants were patients with probable and possible AD, that were assessed at four time points over a period of two years (T1-T4). The main results were threefold: (i) over time, significant changes were observed regarding patients' cognitive functioning, activities of daily living and caregiver load (but not depression, pain, neuropsychiatric symptoms); (ii) intercorrelations between caregiver load and patients' cognitive and functional variables were high, correlation patterns remaining rather stable across time; (iii) cognitive functioning at T4 was best predicted by patients' age, sex, atrial fibrillation and activities of daily living at T1; and (iv) across all four assessment points, cognitive functioning was best predicted by time (i.e., disease duration), age, sex, activities of daily living and depression. Overall, even in early stages of AD and during a short two-year period, functional changes were significant and tightly intertwined with caregiver load, thus stressing the need to consider caregiver load when diagnosing and treating patients with AD. A novel and clinically relevant finding is that even in early stages of AD, cognitive deterioration was best predicted by a combination of patients' demographic, somatic and functional variables.

Challenges in Understanding Numerical Learning: Editorial for Brain Sciences Special Issue "Neurocognitive Signatures of Math (Learning) across the Lifespan and Their Interrelation with Other Aspects of Cognition and Emotion".

Living in our information- and technology-driven society at the beginning of the 21st century requires the ability to understand and handle numbers not only for a successful career but also for coping with everyday life tasks [...].

On the development of Arabic three-digit number processing in primary school children.

The development of two-digit number processing in children, and in particular the influence of place-value understanding, has recently received increasing research interest. However, place-value influences leading to decomposed processing have not yet been investigated for multi-digit numbers beyond the two-digit number range in children. Therefore, we evaluated the separate influences of hundreds, tens, and units on three-digit number processing by means of the hundred distance effect, the decade-hundred compatibility effect, and the unit-hundred compatibility effect in a longitudinal design from Grade 2 to Grade 4. In a number magnitude comparison task, a strong hundred distance effect indicated that the magnitudes of the hundreds digits were predominantly processed. We also observed indexes of decomposed parallel processing of hundreds and units digits but not of hundreds and tens digits. Regarding the developmental trajectories, the hundred distance effect and the unit-hundred compatibility effect showed a reliable trend to increase with grade level. However, both the significance and the increase with grade level of decomposed parallel processing were observed to be less consistent than expected. The latter is discussed in terms of different processing strategies as well as specificities differentiating between two- and three-digit numbers. Taken together, these are the first data showing decomposed processing of three-digit numbers in children. Yet, it must be noted that the results also indicate that findings from two-digit number processing cannot simply be generalized to the three-digit number range.

Impaired Arithmetic Fact Retrieval in an Adult with Developmental Dyscalculia: Evidence from Behavioral and Functional Brain Imaging Data.

Developmental dyscalculia (DD) is a developmental disorder characterized by arithmetic difficulties. Recently, it has been suggested that the neural networks supporting procedure-based calculation (e.g., in subtraction) and left-hemispheric verbal arithmetic fact retrieval (e.g., in multiplication) are partially distinct. Here we compared the neurofunctional correlates of subtraction and multiplication in a 19-year-old student (RM) with DD to 18 age-matched controls. Behaviorally, RM performed significantly worse than controls in multiplication, while subtraction was unaffected. Neurofunctional differences were most pronounced regarding multiplication: RM showed significantly stronger activation than controls not only in left angular gyrus but also in a fronto-parietal network (including left intraparietal sulcus and inferior frontal gyrus) typically activated during procedure-based calculation. Region-of-interest analyses indicated group differences in multiplication only, which, however, did not survive correction for multiple comparisons. Our results are consistent with dissociable and processing-specific, but not operation-specific neurofunctional networks. Procedure-based calculation is not only associated with subtraction but also with (untrained) multiplication facts. Only after rote learning, facts can be retrieved quasi automatically from memory. We suggest that this learning process and the associated shift in activation patterns has not fully occurred in RM, as reflected in her need to resort to procedure-based strategies to solve multiplication facts.

Self-efficacy matters: Influence of students' perceived self-efficacy on statistics anxiety.

Statistical knowledge is a key competency for psychologists in order to correctly interpret assessment outcomes. Importantly, when learning statistics (and its mathematical foundations), self-efficacy (defined as an individual's belief to successfully accomplish specific performance attainments) is a central predictor of students' motivation to learn, learning engagement, and actual achievement. Therefore, it is crucial to gain a better understanding of students' self-efficacy for statistics and its interrelations with statistics anxiety and students' belief in the relevance of statistics. Here, we present results showing development and validation of a self-assessment questionnaire for examining self-efficacy for statistics in psychology students (Self-Efficacy for Learning Statistics for Psychologists, SES-Psy). Upon using different methodological approaches, we demonstrate that the SES-Psy questionnaire has (1) sound psychometric properties, and within our sample of university students, (2) a robust latent structure disclosing three clearly distinctive profiles that are characterized by a complex and nonlinear interplay between perceived self-efficacy (for basic and advanced statistics), statistics anxiety, and students' belief in the relevance of statistics. Implications for educational settings and future research are discussed.

Pain and Associated Neuropsychiatric Symptoms in Patients Suffering from Dementia: Challenges at Different Levels and Proposal of a Conceptual Framework.

Old age is critically associated with multi-morbidity, chronic pain, and high risk for dementia. Recognizing and treating pain is very much dependent on language comprehension and production. Both may be impaired in dementia. Moreover, neuropsychiatric symptoms may interact with pain perception. The main aims of the present article were 1) to identify key areas for future research to elucidate the relation between pain and associated neuropsychiatric symptoms in dementia, and 2) to provide a conceptual framework for ameliorating the clinical process of recognizing, assessing, and managing pain in non-communicating patients with advanced dementia.

Developmental trajectories of magnitude processing and interference control: an FMRI study.

Neurodevelopmental changes regarding interference and magnitude processing were assessed in 3 age groups (children, n = 10; young adults, n = 11; elderly participants, n = 9) by using an functional magnetic resonance imaging version of the numerical Stroop task. Behaviorally, comparable distance and size congruity effects were found in all 3 age groups. Distance effects were most pronounced in the more difficult numerical task, whereas size congruity effects were comparable across tasks. In response to interference, an age-linear trend in the pattern of activation in left and right prefrontal and left middle temporal regions of the brain was observed. This implicates that with increasing age interference control requires increasing effort (possible explanations for children's relatively lower interference effects are provided). In contrast, the distance effect produced a negative linear trend in right prefrontal, supplementary motor area, and intraparietal cortex. This suggests that relative to old adults, children and young adults had to recruit a larger network upon processing magnitude. The latter findings are even more remarkable considering that the behavioral effects were similar across groups. In summary, the developmental trajectories of interference control and magnitude processing differ, although these cognitive functions activate partially overlapping brain regions.

Predictive validity of attentional functions in differentiating children with and without ADHD: a componential analysis.

AIM: The objective of this study was to investigate which attentional components are of predictive utility in differentiating children with attention-deficit-hyperactivity disorder, combined type (ADHD-C) from their peers without ADHD. METHODS: Thirty-four children participated in the study: 17 males with ADHD-C (mean age 10y 4mo, SD 1y 9mo) and 17 comparison children (12 males, 5 females; mean age 10y 8mo, SD 1.7y). Attentional functions were assessed using a computer-administered, child-friendly test series in German (i.e. Testbatterie zur Aufmerksamkeitsprüfung für Kinder; KITAP). The KITAP measures several attentional components, including alertness and executive attention (inhibition, divided attention, flexibility). RESULTS: The variable best able to discriminate between children with and without ADHD-C was found to be response time variability in a go/no go task, followed by, in order, number of errors in a divided attention task and response time variability in an alertness task. However, group discrimination was not facilitated by differences in either response latency or accuracy of response in visuospatial attention and attentional flexibility tasks. INTERPRETATION: The assessment of attentional functions proved to be a powerful instrument for discriminating between children with and without ADHD-C. Notably, the discriminative power of executive attention was found to be task dependent and dependent on processing demands.

Loneliness and Burden Perceived by Family Caregivers of Patients With Alzheimer Disease.

BACKGROUND: The present study aimed at investigating loneliness and burden experienced by family members caring for relatives diagnosed with Alzheimer disease. METHODS: Participants were 40 caregivers of inpatients with Alzheimer disease. Correlation and multiple regression analyses were conducted to investigate whether caregivers' loneliness (uni- and multidimensional) and burden are associated with and predicted by (1) specific caregiver characteristics and/or (2) patients' dementia severity and neuropsychiatric symptoms. RESULTS: Loneliness was significantly correlated with caregivers' sex, age, and living circumstances, while burden was significantly correlated with caregivers' education solely. Regression analyses revealed that caregivers' sex and living circumstances contributed significantly to variance explanation of loneliness (but not burden), while the additional consideration of patient variables did not improve model fit. CONCLUSIONS: Loneliness reported by caregivers of relatives diagnosed with dementia is significantly modulated by caregiver (but not patient) characteristics. Notably, both uni- and multidimensional loneliness scales seem to be sensitive diagnostic tools.

Developmental dyscalculia: compensatory mechanisms in left intraparietal regions in response to nonsymbolic magnitudes.

BACKGROUND: Functional magnetic resonance imaging (fMRI) studies investigating the neural mechanisms underlying developmental dyscalculia are scarce and results are thus far inconclusive. Main aim of the present study is to investigate the neural correlates of nonsymbolic number magnitude processing in children with and without dyscalculia. METHODS: 18 children (9 with dyscalculia) were asked to solve a non-symbolic number magnitude comparison task (finger patterns) during brain scanning. For the spatial control task identical stimuli were employed, instructions varying only (judgment of palm rotation). This design enabled us to present identical stimuli with identical visual processing requirements in the experimental and the control task. Moreover, because numerical and spatial processing relies on parietal brain regions, task-specific contrasts are expected to reveal true number-specific activations. RESULTS: Behavioral results during scanning reveal that despite comparable (almost at ceiling) performance levels, task-specific activations were stronger in dyscalculic children in inferior parietal cortices bilaterally (intraparietal sulcus, supramarginal gyrus, extending to left angular gyrus). Interestingly, fMRI signal strengths reflected a group x task interaction: relative to baseline, controls produced significant deactivations in (intra)parietal regions bilaterally in response to number but not spatial processing, while the opposite pattern emerged in dyscalculics. Moreover, beta weights in response to number processing differed significantly between groups in left - but not right - (intra)parietal regions (becoming even positive in dyscalculic children). CONCLUSION: Overall, findings are suggestive of (a) less consistent neural activity in right (intra)parietal regions upon processing nonsymbolic number magnitudes; and (b) compensatory neural activity in left (intra)parietal regions in developmental dyscalculia.

Children's early mental number line: logarithmic or decomposed linear?

Recently, the nature of children's mental number line has received much investigation. In the number line task, children are required to mark a presented number on a physical number line with fixed endpoints. Typically, it was observed that the estimations of younger/inexperienced children were accounted for best by a logarithmic function, whereas those of older/more experienced children were reflected best by a linear function. This led to the conclusion that children's mental number line transforms from logarithmic to linear with age and experience. In this study, we outline an alternative interpretation of children's performance in a number line task. We suggest that two separate linear representations for one- and two-digit numbers may exist in young children and that initially the integration of these two representations into the place value structure of the Arabic number system is not fully mastered. When testing this assumption in a sample of more than 120 first graders, we observed that the two-linear model consistently provided better fit indexes. We conclude that instead of assuming a transition from logarithmic to linear coding, performance differences could also be accounted for by an improvement in integrating tens and units into the Arabic place value system.

Math Anxiety and Math Ability in Early Primary School Years.

Mathematical learning disabilities (MLDs) are often associated with math anxiety, yet until now, very little is known about the causal relations between calculation ability and math anxiety during early primary school years. The main aim of this study was to longitudinally investigate the relationship between calculation ability, self-reported evaluation of mathematics, and math anxiety in 140 primary school children between the end of first grade and the middle of third grade. Structural equation modeling revealed a strong influence of calculation ability and math anxiety on the evaluation of mathematics but no effect of math anxiety on calculation ability or vice versa-contrasting with the frequent clinical reports of math anxiety even in very young MLD children. To summarize, our study is a first step toward a better understanding of the link between math anxiety and math performance in early primary school years performance during typical and atypical courses of development.

A developmental fMRI study of nonsymbolic numerical and spatial processing.

This functional magnetic resonance imaging (fMRI) study systematically investigates whether there is a neurofunctional overlap of nonsymbolic numerical and spatial cognition in (intra)parietal regions in children and adults. The study also explores the association between finger use and (nonsymbolic) number processing across development. Twenty-four healthy individuals (12 children, 12 adults) were asked to make nonsymbolic numerical and spatial (experimental tasks) as well as color discriminations (control task). Using identical stimulus material across the three tasks disentangled nonsymbolic number representations from general attentional mechanisms, visual-spatial processing and response selection requirements. In both age groups, behavioral distance effects were obtained upon processing numerical (but not spatial and/or color) stimuli. Baseline imaging effects revealed age-dependent, partly overlapping activations of nonsymbolic numerical and spatial processing in the right posterior superior parietal lobe (PSPL) in adults only. Interestingly, regions more activated in children relative to adults were centred on bilateral supramarginal gyrus (SMG) and lateral portions of the anterior intraparietal sulcus (IPS), further extending to adjacent right post- and precentral gyrus, the latter of which has been reported to support grasping previously (Simon et al., 2002). Overall, our results are first evidence for an age-dependent neurofunctional link between areas supporting finger use and nonsymbolic number processing and furthermore, might be suggestive of a special role of fingers for the development of number magnitude representations and early arithmetic.

An fMRI study of the numerical Stroop task in individuals with and without minimal cognitive impairment.

Aim of this functional magnetic resonance imaging (fMRI) study was to dissociate normal aging and minimal cognitive impairment (MCI) concerning magnitude processing and interference control. We examined the neural correlates of a numerical Stroop task in elderly individuals with and without MCI. Fifteen elderly participants (six patients with MCI and nine controls) were subjected to a numerical Stroop task requiring numerical/physical magnitude classifications while inhibiting task-irrelevant stimulus dimensions. Effects of distance and congruity were examined. Behaviourally, robust distance and congruity effects were observed in both groups and tasks. Imaging baseline conditions revealed stronger and more distributed activations in MCI patients relative to controls which could not be explained by the higher error rates committed by patients. Across tasks, conjunction analysis revealed highly significant activations in intra-parietal and prefrontal regions suggesting that both groups recruit comparable brain regions upon processing magnitude and interference, respectively. MCI patients exhibited stronger pre-/postcentral and thalamic activations, possibly reflecting more effortful response-selection processes or alternatively, deficient inhibitory control. Moreover, MCI patients exhibited additional activations in fronto-parietal (magnitude) and occipital/cerebellar (congruity) regions. To summarize, though MCI patients needed to recruit more distributed activation patterns conjunction analysis revealed common activation sites in response to magnitude processing and interference control.

Basic number processing deficits in ADHD: a broad examination of elementary and complex number processing skills in 9- to 12-year-old children with ADHD-C.

ADHD (attention-deficit hyperactivity disorder) and academic difficulties are frequently associated, but to date this link is poorly understood. In order to explore which components of number processing and calculation skills may be disturbed in children with ADHD we presented a series of respective tasks to 9- to 12-year-old children with ADHD-combined type and matched children without ADHD (of any type) without concomitant dyscalculia and/or dyslexia. Overall, group differences were not significant regarding overlearned and explicitly trained simple and complex calculation skills. More basic number processing skills are - for instance - the ability to compare one-digit numbers according to their magnitude (so-called magnitude comparison), to count or to transcode numbers, i.e. to write down an Arabic number '21' in verbal dictation. Significant differences favouring control children in basic number processing skills were obtained in a number comparison task and in a dot enumeration task. Importantly, our results cannot be explained by group differences regarding specific working memory and executive function components. Thus, number processing skills and in particular the processing of numerical magnitude should be investigated in children diagnosed with ADHD even when no comorbid learning disabilities are reported.

Gestational age modulates neural correlates of intentional, but not automatic number magnitude processing in children born preterm.

Premature birth is a significant risk factor for learning disabilities in general and mathematics learning difficulties in particular. However, the exact reasons for this relation are still unknown. While typical numerical development is associated with a frontal-to-parietal shift of brain activation with increasing age, influences of gestational age have hardly been considered so far. Therefore, we investigated the influence of gestational age on the neural correlates of number processing in 6- and 7-year-old children born prematurely (n=16). Only the numerical distance effect - as a measure of intentional number magnitude processing - elicited the fronto-parietal activation pattern typically observed for numerical cognition. On the other hand, the size congruity effect - as a measure of automatic number magnitude processing - was associated with activation of brain areas typically attributed to cognitive control. Most importantly, however, we observed that gestational age reliably predicted the frontal-to-parietal shift of activation observed for the numerical distance effect. Our findings seem to indicate that human numerical development may start even before birth and prematurity might hamper neural facilitation of the brain circuitry subserving numerical cognition. In turn, this might contribute to the high risk of premature children to develop mathematical learning difficulties.