Opening new vistas on obsessive-compulsive disorder with the observing response task.

Obsessive-compulsive disorder (OCD), a highly prevalent and debilitating disorder, is incompletely understood in terms of underpinning behavioural, psychological, and neural mechanisms. This is attributable to high symptomatic heterogeneity; cardinal features comprise obsessions and compulsions, including clinical subcategories. While obsessive and intrusive thoughts are arguably unique to humans, dysfunctional behaviours analogous to those seen in clinical OCD have been examined in nonhuman animals. Genetic, ethological, pharmacological, and neurobehavioural approaches all contribute to understanding the emergence and persistence of compulsive behaviour. One behaviour of particular interest is maladaptive checking, whereby human patients excessively perform checking rituals despite these serving no purpose. Dysfunctional and excessive checking is the most common symptom associated with OCD and can be readily operationalised in rodents. This review considers animal models of OCD, the neural circuitries associated with impairments in habit-based and goal-directed behaviour, and how these may link to the compulsions observed in OCD. We further review the Observing Response Task (ORT), an appetitive instrumental learning procedure that distinguishes between functional and dysfunctional checking, with translational application in humans and rodents. By shedding light on the psychological and neural bases of compulsive-like checking, the ORT has potential to offer translational insights into the underlying mechanisms of OCD, in addition to being a platform for testing psychological and neurochemical treatment approaches.

A digital teleneuropsychology platform for the diagnosis of mild cognitive impairment: from concept to certification as a medical device.

BACKGROUND: Innovative digital solutions are shaping a new concept of dementia care, opening additional venues for prevention, diagnosis, monitoring and treatment. Hereby, we report the development of a tablet-based teleneuropsychology platform (Tenèpsia®), from concept to certification as Medical Device (MD) Class IIA, as per new MD regulation 745/2017. METHODS: The platform was designed for the remote cognitive evaluation and created thanks to the effort of a collaborative working group including experts from three Italian scientific societies and Biogen Italia S.r.l. (hereafter "Biogen"), and developers from Xenia Reply and Inside AI. The development strategy was guided by converting traditional paper-and-pencil tests into digital versions while maintaining comparable neuropsychological features and optimizing patient accessibility and user experience. The experts focused on the choice and adaptation of traditional neuropsychology measures for a 45-min teleneuropsychology assessment. RESULTS: The developers created a web and a mobile interface, respectively, for the professional (neuropsychologist) and non-professional (patient and caregiver) use. Recording of voice, drawing and typing information was enabled. Instant dashboards provide a quick overview of the patient's condition. Simulation activities were performed to obtain MD certification, valid across Europe. CONCLUSION: Neuropsychology services will benefit from the implementation in clinics of harmonized digital tools with adequate scientific and technological standards. The use of digital cognitive testing for the diagnosis of mild cognitive impairment is expected to enhance patient and clinician outcomes through simplified, digital objective data collection, sparing of time and resources, with a positive impact on healthcare costs and access to treatments, reducing inequalities and delays in diagnosis and cure.

Integrating Clinical Neuropsychology and Psychotic Spectrum Disorders: A Systematic Analysis of Cognitive Dynamics, Interventions, and Underlying Mechanisms.

Background and Objectives: The study aims to provide a comprehensive neuropsychological analysis of psychotic spectrum disorders, including schizophrenia, bipolar disorder, and depression. It focuses on the critical aspects of cognitive impairments, diagnostic tools, intervention efficacy, and the roles of genetic and environmental factors in these disorders. The paper emphasizes the diagnostic significance of neuropsychological tests in identifying cognitive deficiencies and their predictive value in the early management of psychosis. Materials and Methods: The study involved a systematic literature review following the PRISMA guidelines. The search was conducted in significant databases like Scopus, PsycINFO, PubMed, and Web of Science using keywords relevant to clinical neuropsychology and psychotic spectrum disorders. The inclusion criteria required articles to be in English, published between 2018 and 2023, and pertinent to clinical neuropsychology's application in these disorders. A total of 153 articles were identified, with 44 ultimately included for detailed analysis based on relevance and publication status after screening. Results: The review highlights several key findings, including the diagnostic and prognostic significance of mismatch negativity, neuroprogressive trajectories, cortical thinning in familial high-risk individuals, and distinct illness trajectories within psychosis subgroups. The studies evaluated underline the role of neuropsychological tests in diagnosing psychiatric disorders and emphasize early detection and the effectiveness of intervention strategies based on cognitive and neurobiological markers. Conclusions: The systematic review underscores the importance of investigating the neuropsychological components of psychotic spectrum disorders. It identifies significant cognitive impairments in attention, memory, and executive function, correlating with structural and functional brain abnormalities. The paper stresses the need for precise diagnoses and personalized treatment modalities, highlighting the complex interplay between genetic, environmental, and psychosocial factors. It calls for a deeper understanding of these neuropsychological processes to enhance diagnostic accuracy and therapeutic outcomes.

Neurophysiology, Neuropsychology, Epilepsy, 2022: Hills We Have Climbed and the Hills Ahead. Cognition and Sensory Systems in Healthy and Diseased Subjects.

This article summarizes selected presentations from a session titled "Cognition and Sensory Systems in Healthy and Diseased Subjects", held to highlight and honor the work of Dr. Marilyn Jones-Gotman. The session was part of a two-day symposium, "Neurophysiology, Neuropsychology, Epilepsy, 2022: Hills We Have Climbed and the Hills Ahead". The session presented research on epilepsy and sensory systems by colleagues and former trainees of Dr. Jones-Gotman. The extended summaries provide an overview of historical and current work in the neuropsychology of epilepsy, neuropsychological and neuroimaging approaches to understanding brain organization, sex differences in brain mechanisms underlying neurological disorders, dietary influences on brain function and cognition, and expertise in olfactory training and language experiences and their implications for brain organization and structure.

The Value of Bayesian Methods for Accurate and Efficient Neuropsychological Assessment.

OBJECTIVE: Clinical neuropsychology has been slow in adopting novelties in psychometrics, statistics, and technology. Researchers have indicated that the stationary nature of clinical neuropsychology endangers its evidence-based character. In addition to a technological crisis, there may be a statistical crisis affecting clinical neuropsychology. That is, the frequentist null hypothesis significance testing framework remains the dominant approach in clinical practice, despite a recent surge in critique on this framework. While the Bayesian framework has been put forward as a viable alternative in psychology in general, the possibilities it offers to clinical neuropsychology have not received much attention. METHOD: In the current position paper, we discuss and reflect on the value of Bayesian methods for the advancement of evidence-based clinical neuropsychology. RESULTS: We aim to familiarize clinical neuropsychologists and neuropsychological researchers to Bayesian methods of inference and provide a clear rationale for why these methods are valuable for clinical neuropsychology. CONCLUSION: We argue that Bayesian methods allow for a more intuitive answer to our diagnostic questions and form a more solid foundation for sequential and adaptive diagnostic testing, representing uncertainty about patients' observed test scores and cognitive modeling of test results.

Vestibular cognition: State-of-the-art and future directions.

Vestibular information has been traditionally considered as a specialized input for basic orienting behaviours, such as oculo-motor adjustments, postural control and gaze orientation. However, in the past two decades a widespread vestibular network in the human brain has been identified, that goes far beyond the low-level reflex circuits emphasized by earlier work. Because this vestibular cortical network is so widely distributed, it could, in principle, impact multiple neurocognitive functions in health and disease. This paper focuses on the relations between vestibular input, vestibular networks, and vestibular interventions by providing the authors' personal viewpoint on the state-of-the-art of vestibular cognitive neuropsychology, and its potential relevance for neurorehabilitation.

The Neurocognitive Bases of Human Volition.

Volition refers to a capacity for endogenous action, particularly goal-directed endogenous action, shared by humans and some other animals. It has long been controversial whether a specific set of cognitive processes for volition exist in the human brain, and much scientific thinking on the topic continues to revolve around traditional metaphysical debates about free will. At its origins, scientific psychology had a strong engagement with volition. This was followed by a period of disenchantment, or even outright hostility, during the second half of the twentieth century. In this review, I aim to reinvigorate the scientific approach to volition by, first, proposing a range of different features that constitute a new, neurocognitively realistic working definition of volition. I then focus on three core features of human volition: its generativity (the capacity to trigger actions), its subjectivity (the conscious experiences associated with initiating voluntary actions), and its teleology (the goal-directed quality of some voluntary actions). I conclude that volition is a neurocognitive process of enormous societal importance and susceptible to scientific investigation.

The role of the neuropsychologist in memory clinics.

International recommendations and guidelines on the diagnosis and management of cognitive impairment highlight the relevance of a multidimensional approach with increasing attention to well-established cognitive evaluations and interventions. Memory clinics represent a model that offers the expertise of several health specialties. This commentary aims at detailing the contribution of the neuropsychologist in this setting, and highlighting the need of implementing its presence in all the dedicated services. The neuropsychologist can offer an expertise that can be employed both in clinical routes and research, being able to synergistically interact with all the other health specialists involved in memory clinics. The role of the neuropsychologist in cognitive impairment diagnosis includes the development and the administration of comprehensive test batteries and the determination of both the degree of impairment and the cognitive profile, thus contributing to differential diagnoses. In the management of cognitive impairment, the neuropsychologist expertise can contribute in care planning and monitoring, in administering cognition-focused interventions, and in measuring treatment response. In cognitive impairment research, beyond the development and administration of test batteries, the neuropsychologist can contribute actively to the choice of cognitive study outcomes, data analysis, and results interpretation within an interdisciplinary framework. An overview of the actual weight of neuropsychologists in Italian memory clinics shows that, despite the presence of a psychologist in the team could be felt as an added value, several difficulties are still encountered in the integration of this figure as a permanent member. Efforts need to be made in this direction.

Paradigm Shift Toward Digital Neuropsychology and High-Dimensional Neuropsychological Assessments: Review.

Neuropsychologists in the digital age have increasing access to emerging technologies. The National Institutes of Health (NIH) initiatives for behavioral and social sciences have emphasized these developing scientific and technological potentials (eg, novel sensors) for augmented characterization of neurocognitive, behavioral, affective, and social processes. Perhaps these innovative technologies will lead to a paradigm shift from disintegrated and data-poor behavioral science to cohesive and data-rich science that permits improved translation from bench to bedside. The 4 main advances influencing the scientific priorities of a recent NIH Office of Behavioral and Social Sciences Research strategic plan include the following: integration of neuroscience into behavioral and social sciences, transformational advances in measurement science, digital intervention platforms, and large-scale population cohorts and data integration. This paper reviews these opportunities for novel brain-behavior characterizations. Emphasis is placed on the increasing concern of neuropsychology with these topics and the need for development in these areas to maintain relevance as a scientific discipline and advance scientific developments. Furthermore, the effects of such advancements necessitate discussion and modification of training as well as ethical and legal mandates for neuropsychological research and praxes.

Multidimensional Evaluation of Virtual Reality Paradigms in Clinical Neuropsychology: Application of the VR-Check Framework.

Virtual reality (VR) represents a key technology of the 21st century, attracting substantial interest from a wide range of scientific disciplines. With regard to clinical neuropsychology, a multitude of new VR applications are being developed to overcome the limitations of classical paradigms. Consequently, researchers increasingly face the challenge of systematically evaluating the characteristics and quality of VR applications to design the optimal paradigm for their specific research question and study population. However, the multifaceted character of contemporary VR is not adequately captured by the traditional quality criteria (ie, objectivity, reliability, validity), highlighting the need for an extended paradigm evaluation framework. To address this gap, we propose a multidimensional evaluation framework for VR applications in clinical neuropsychology, summarized as an easy-to-use checklist (VR-Check). This framework rests on 10 main evaluation dimensions encompassing cognitive domain specificity, ecological relevance, technical feasibility, user feasibility, user motivation, task adaptability, performance quantification, immersive capacities, training feasibility, and predictable pitfalls. We show how VR-Check enables systematic and comparative paradigm optimization by illustrating its application in an exemplary research project on the assessment of spatial cognition and executive functions with immersive VR. This application furthermore demonstrates how the framework allows researchers to identify across-domain trade-offs, makes deliberate design decisions explicit, and optimizes the allocation of study resources. Complementing recent approaches to standardize clinical VR studies, the VR-Check framework enables systematic and project-specific paradigm optimization for behavioral and cognitive research in neuropsychology.

A Guide to Conducting a Meta-Analysis with Non-Independent Effect Sizes.

Conventional meta-analytic procedures assume that effect sizes are independent. When effect sizes are not independent, conclusions based on these conventional procedures can be misleading or even wrong. Traditional approaches, such as averaging the effect sizes and selecting one effect size per study, are usually used to avoid the dependence of the effect sizes. These ad-hoc approaches, however, may lead to missed opportunities to utilize all available data to address the relevant research questions. Both multivariate meta-analysis and three-level meta-analysis have been proposed to handle non-independent effect sizes. This paper gives a brief introduction to these new techniques for applied researchers. The first objective is to highlight the benefits of using these methods to address non-independent effect sizes. The second objective is to illustrate how to apply these techniques with real data in R and Mplus. Researchers may modify the sample R and Mplus code to fit their data.

Unconscious arithmetic: Assessing the robustness of the results reported by Karpinski, Briggs, and Yale (2018).

In 2012, a study by Sklar et al. reported that participants could solve invisible subtractions. This notion of unconscious arithmetic has been influential because it challenges current theories of consciousness. In 2016, Karpinski et al. published a direct replication reporting evidence for unconscious addition rather than subtraction. About a year later, the study was retracted due to a computation error in the analysis pipeline. After this error was corrected, no evidence for unconscious addition nor subtraction was obtained. Recently, Karpinski et al. republished the study by applying the exclusion criteria used in Sklar et al. The reanalysis found weak evidence for unconscious subtraction. To assess the robustness of these results, we examine how sensitive the results are to data analytic decisions. We outline a set of 250 analyses that we consider justified to perform. We show that none of the analyses indicates evidence for unconscious subtraction.

The neurobiology of individual differences in complex behavioral traits.

Neuroimaging, especially BOLD fMRI, has begun to identify how variability in brain function contributes to individual differences in complex behavioral traits. In parallel, pharmacological fMRI and multimodal PET/fMRI are identifying how variability in molecular signaling pathways influences individual differences in brain function. Against this background, functional genetic polymorphisms are being utilized to understand the origins of variability in signaling pathways as well as to model efficiently how such emergent variability impacts behaviorally relevant brain function. This article provides an overview of a research strategy seeking to integrate these complementary technologies and utilizes existing empirical data to illustrate its effectiveness in illuminating the neurobiology of individual differences in complex behavioral traits. The article also discusses how such efforts can contribute to the identification of predictive markers that interact with environmental factors to precipitate disease and to develop more effective and individually tailored treatment regimes.

Neuropsychological Measures in the Arab World: A Systematic Review.

Although Arabic is one of the most widely used languages in the world, little is known on the availability of standardized neuropsychological tests in Arabic. We review the literature published before 2016, using the keywords Arab*, cogniti*, and neuropsycholo*, as well as keywords for each Arab country. PubMed, PsycINFO, Education Source, Academic Search Complete, Education Resources Information Center, Shamaa, and Arabpsynet databases were searched, in addition to a selected number of Arabic medical and educational journals. After excluding case reports, studies conducted on Arab groups residing outside the Arab world or Israel, and studies that employed intelligence scales or cognitive screens without standardization, 384 studies were eventually reviewed. Tests with most extensive use, adaptation, validation and norming were identified. The Raven Matrices, with its variants, was the most normed cognitive test for Arab individuals (normed in 16 countries). The rate of neuropsychology publications from the Arab countries combined, per year, was less than half of that of each American journal (top 10 journals pertaining to cognition). Nonetheless, the rate in Arab countries has increased after 2010. Publications were mostly from Egypt and Saudi Arabia, but the ratio of test adaptation-to-publication was the largest in Jordan and Lebanon. Approximately half of these publications did not employ cognitive tests that were developed, translated, adapted, or standardized according to international guidelines of psychological measurement. We provide recommendations on improving clinical neuropsychology to better serve Arab patients.

The value of cognitive neuropsychology: The case of vision research.

Cognitive neuropsychological evidence is widely viewed as inherently flawed or weak, despite well-reasoned arguments to the contrary by many theorists. Rather than attempting yet another defence of cognitive neuropsychology on logical grounds, we point out through examples that in practice, cognitive neuropsychological evidence is widely accepted as valid and important, and has had a major impact on cognitive theory and research. Objections offered in the abstract rarely arise in the context of actual studies. We develop these points through examples from the domain of vision, discussing cerebral achromatopsia and akinetopsia, selective impairment and sparing of face recognition, perception-action dissociations, and blindsight.

Neuroplasticity and the logic of cognitive neuropsychology.

More than thirty years ago, Alfonso Caramazza laid out assumptions for drawing inferences about the undamaged cognitive system from individuals with brain damage. Since then, these assumptions have been challenged including the transparency or subtractivity assumption, that the cognitive system does not reorganize following brain damage. It has been repeatedly demonstrated that brains are highly plastic. However, there is no clear connection between brain plasticity and cognitive reorganization. Brain plasticity research does not require a rethinking of the core logic of cognitive neuropsychology. Differences in task-based activation between damaged and undamaged brains provide little insight into the cognitive architectures of brain-damaged patients. Theory and methods are needed to understand cognitive neuroplasticity, or how neural reorganization that follows brain damage relates to reorganization of functions. We discuss alternative types of cognitive neuroplasticity that may occur in damaged brains and consider how they impact the basic logic of cognitive neuropsychology.

The assumptions of cognitive neuropsychology: Reflections on Caramazza (1984, 1986).

Approximately 30 years ago, Caramazza (1984. The logic of neuropsychological research and the problem of patient classification in aphasia. Brain and Language, 21, 9-20; 1986. On drawing inferences about the structure of normal cognitive systems from the analysis of patterns of impaired performance. Brain and Language, 5, 41-66) proposed that cognitive neuropsychology needs to make four assumptions in order for its inferences from pathological performance to the structure of intact cognitive systems to be justifiable. These assumptions were: fractionation, modularity, transparency and universality. Analysis of the current status of these assumptions leads me to conclude that all four remain defensible today.

Single-case cognitive neuropsychology in the age of big data.

Historically, single-case studies of brain-damaged individuals have contributed substantially to our understanding of cognitive processes. However, the role of single-case cognitive neuropsychology has diminished with the proliferation of techniques that measure neural activity in humans. Instead, large-scale informatics approaches in which data are gathered from hundreds of neuroimaging studies have become popular. It has been claimed that utilizing these informatics approaches can address problems found in single imaging studies. We first discuss reasons for why cognitive neuropsychology is thought to be in decline. Next, we note how these informatics approaches, while having benefits, are not particularly suited for understanding functional architectures. We propose that the single-case cognitive neuropsychological approach, which is focused on developing models of cognitive processing, addresses several of the weaknesses inherent in informatics approaches. Furthermore, we discuss how using neural data from brain-damaged individuals provides data that can inform both cognitive and neural models of cognitive processing.

The cart before the horse: When cognitive neuroscience precedes cognitive neuropsychology.

Cognitive neuropsychology (CN) has had an immense impact on the understanding of the normal cognitive processes underlying reading, spelling, spoken language comprehension and production, spatial attention, memory, visual perception, and orchestration of actions, through detailed analysis of behavioural performance by neurologically impaired individuals. However, there are other domains of cognition and communication that have rarely been investigated with this approach. Many cognitive neuropsychologists have extended their work in language, perception, or attention by turning to functional neuroimaging or lesion-symptom mapping to identify the neural mechanisms underlying the cognitive mechanisms they have identified. Another approach to extending one's research in CN is to apply the methodology to other cognitive functions. We briefly review the domains evaluated using methods of CN to develop cognitive architectures and computational models and the domains that have used functional neuroimaging and other brain mapping approaches in healthy controls to identify the neural substrates involved in cognitive tasks over the past 20 years. We argue that in some domains, neuroimaging studies have preceded the careful analysis of the cognitive processes underlying tasks that are studied, with the consequence that results are difficult to interpret. We use this analysis as the basis for discussing opportunities for expanding the field.