Reported neurological symptoms after severe acute respiratory syndrome coronavirus type 2 infection: A systematic diagnostic approach.

BACKGROUND AND PURPOSE: Following increasing demands of patients with suspected neurological symptoms after infection with severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), the Department of Neurology at the Medical University of Vienna established a new outpatient clinic to systematically assess, diagnose, and document neurological complaints potentially associated with a prior SARS-CoV-2 infection. METHODS: The data presented here include prospectively collected 156 outpatients from May 2021 to April 2022. Patients underwent semistandardized interviewing about symptoms with reported onset after SARS-CoV-2 infection, neurological examination, and comprehensive diagnostic workup. RESULTS: Reported new onset symptoms after infection included fatigue (77.6%), subjective cognitive impairment (72.4%), headache (47.7%), loss of smell and/or taste (43.2%), and sleep disturbances (42.2%). Most patients had a mild coronavirus disease (COVID-19) disease course (84%) and reported comorbidities (71%), of which the most frequent were psychiatric disorders (34%). Frequency of symptoms was not associated with age, sex, or severity of COVID-19 course. A comprehensive diagnostic workup revealed no neurological abnormalities in the clinical examination, or electrophysiological or imaging assessments in the majority of patients (n = 143, 91.7%). Neuropsychological assessment of a subgroup of patients (n = 28, 17.9%) showed that cognitive impairments in executive functions and attention, anxiety, depression, and somatization symptoms were highly common. CONCLUSIONS: In this systematic registry, we identified fatigue, cognitive impairment, and headache as the most frequently reported persisting complaints after SARS-CoV-2 infection. Structural neurological findings were rare. We also suspect a link between the growing burden of the COVID-19 pandemic on personal lives and the increase in reported neurological and psychiatric complaints.

Electrophysiological correlates of conventional metaphor, irony, and literal language processing - An event-related potentials and eLORETA study.

Conventional metaphor, irony, and literal language processing were compared. Thirty right-handed participants (21-34 years) performed a sequential-statement ERP-paradigm. A left-frontal Late Anterior Negative Slow Wave (LANSW, 450-1000 ms) was significantly greater for metaphors and by visual tendency greater for irony, compared to literal statements. A centroparietal N400 (300-450 ms) and a centroparietal right-dominant "Late N400" (450-600 ms) were by statistical and visual tendency greater for metaphors. Left PCC and left lingual gyrus activity was significantly higher in metaphors compared to literal statements (eLORETA; 450-1000 ms). A statistical trend indicated higher parahippocampal gyrus activity in metaphors and ironies. N400 results are discussed considering changing processing techniques and a renewed semantic conflict. The Late N400 was associated with the construct of "associativeness". The LANSW was related to metaphorical mapping, frame-shifting processes, integration of meanings, and memory processes. eLORETA results were discussed considering metaphorical mapping, creation of mental images, conventionality, valence, memory processes, and divergent thinking.

Cognitive and affective Theory of Mind in adolescence: developmental aspects and associated neuropsychological variables.

Theory of Mind (ToM) is the ability to represent and attribute mental states to oneself and others. So far, research regarding ToM processing across adolescence is scarce. Existing studies either yield inconsistent results or did not or not thoroughly investigate aspects like higher order ToM and associated neuropsychological variables which the current study tried to address. 643 typically developing early, middle, and late adolescents (age groups 13-14; 15-16; 17-18) performed cognitive and affective ToM tasks as well as neuropsychological tasks tapping the cognitive or affective domain. Regarding both ToM types, 15- to 16-year-olds and 17- to 18-year-olds outperformed 13- to 14-year-olds, whereas females were superior regarding cognitive ToM. Across adolescence, cognitive and affective ToM correlated with attention and affective intelligence, whereas working memory, language comprehension, and figural intelligence additionally correlated with cognitive ToM. In early adolescence, attention correlated with both ToM types, whereas cognitive ToM further correlated with language comprehension and affective ToM with verbal intelligence, verbal fluency, and verbal flexibility. In middle and late adolescence, affective intelligence correlated with both ToM types, whereas cognitive ToM additionally correlated with working memory, language comprehension, and figural intelligence. The current study shows a developmental step regarding cognitive and affective ToM in middle adolescence as well as gender differences in cognitive ToM processing. Associations between neuropsychological variables and ToM processing were shown across adolescence and within age groups. Results give new insights into social cognition in adolescence and are well supported by neuroscientific and neurobiological studies regarding ToM and the integration of cognitive and affective processes.

Electrophysiological Correlates of Basic and Higher Order Cognitive and Affective Theory of Mind Processing in Emerging and Early Adulthood-An Explorative Event-Related Potentials Study to Investigate First-, Second-, and Third-Order Theory of Mind Processing Based on Visual Cues.

Attributing mental states to others in social interactions [Theory of Mind (ToM)] often depends on visual social cues like eye gaze or mimic. This study presents an event-related potentials task (Brainy-ERP) that was developed in order to investigate the electrophysiological correlates of first-, second-, and third-order cognitive and affective ToM processing. The task was based on social visual cues and involved electroencephalographic event-related potential (ERP) analyses and exact low-resolution brain electromagnetic tomography analyses (eLORETA) source localization analyses. Results showed that in cognitive and affective conditions, first-order trials elicited greater Anterior P2 (180-370 ms) amplitudes. In the cognitive condition, third-order trials elicited greatest amplitudes in the broadly distributed early negative slow wave (eNSW, 260-470 ms) and the late NSW (LNSW, 460-1,000 ms). In the affective condition, third-order and second-order trials elicited greatest amplitudes in a broadly distributed NSW (250-1,000 ms). Regarding affective trials in the NSW time span, statistical significant differences and trends were shown regarding activation of underlying brain regions. Third-order trials elicited greatest activation in a number of regions typically associated with the ToM network, especially the posterior cingulate cortex (PCC), cuneus, and temporoparietal junction (TPJ). Furthermore, ToM low performers (participants with high accuracy but longer reaction times) showed by trend smaller Posterior N1 and significantly smaller eNSW amplitudes compared to average and high performers. This study offers new insights into electrophysiological correlates of basic and higher order cognitive and affective ToM processing and its precise time course.

Subjective emotional arousal: an explorative study on the role of gender, age, intensity, emotion regulation difficulties, depression and anxiety symptoms, and meta-emotion.

Subjective emotional arousal in typically developing adults was investigated in an explorative study. 177 participants (20-70 years) rated facial expressions and words for self-experienced arousal and perceived intensity, and completed the Difficulties in Emotion Regulation scale and the Hospital Anxiety and Depression scale (HADS-D). Exclusion criteria were psychiatric or neurological diseases, or clinically relevant scores in the HADS-D. Arousal regarding faces and words was significantly predicted by emotional clarity. Separate analyses showed following significant results: arousal regarding faces and arousal regarding words constantly predicted each other; negative faces were predicted by age and intensity; neutral faces by gender and impulse control; positive faces by gender and intensity; negative words by emotional clarity; and neutral words by gender. Males showed higher arousal scores than females regarding neutral faces and neutral words; for the other arousal scores, no explicit group differences were shown. Cluster analysis yielded three distinguished emotional characteristics groups: "emotional difficulties disposition group" (mainly females; highest emotion regulation difficulties, depression and anxiety scores; by trend highest arousal), "low emotional awareness group" (exclusively males; lowest awareness regarding currently experienced emotions; by trend intermediate arousal), and a "low emotional difficulties group" (exclusively females; lowest values throughout). No age effect was shown. Results suggest that arousal elicited by facial expressions and words are specialized parts of a greater emotional processing system and that typically developing adults show some kind of stable, modality-unspecific dispositional baseline of emotional arousal. Emotional awareness and clarity, and impulse control probably are trait aspects of emotion regulation that influence emotional arousal in typically developing adults and can be regarded as aspects of meta-emotion. Different emotional personality styles were shown between as well as within gender groups.

How influenceable is our metamemory for pictorial material? The impact of framing and emotionality on metamemory judgments.

Metamemory refers to the ability to monitor and control one´s own memory processes which plays an important role in everyday life when accuracy of memory is required. The present study intends to give new insights into the complex relationship between confidence in memory and accuracy of metamemory judgments for negative emotional and neutral pictorial stimuli. Judgments of learning (JOLs) were investigated in order to provide important theoretical information for practical applications in everyday life. A balanced 2×2 factorial experimental design was used to explore the impact of framing in terms of remembering or forgetting as well as emotionality on JOLs. With respect to the already known complex relationship of confidence in memory and accuracy of confidence statements, the present results emphasize this complexity by showing that there is no interaction between the factors framing and emotionality but significant main effects of these two factors with respect to JOLs. Furthermore, accuracy of JOLs is not influenced by framing in terms of remembering and forgetting. Both framing conditions lead to overconfident judgments, regardless of whether confidence in memory is influenced by framing. Emotionality, on the other hand, enhances memory accuracy regardless of whether the subjective feeling of remembering influences confidence in memory or not. The present findings highlight the need to strengthen the collective consciousness about the influenceability of confidence in memory and the fact that a high confidence in memory is not inevitably accompanied by accurate memories.

Developmental Steps in Metaphorical Language Abilities: The Influence of Age, Gender, Cognitive Flexibility, Information Processing Speed, and Analogical Reasoning.

PURPOSE: Metaphor is a specific type of figurative language that is used in various important fields such as in the work with children in clinical or teaching contexts. The aim of the study was to investigate the developmental course, developmental steps, and possible cognitive predictors regarding metaphor processing in childhood and early adolescence. METHOD: One hundred sixty-four typically developing children (7-year-olds, 9-year-olds) and early adolescents (11-year-olds) were tested for metaphor identification, comprehension, comprehension quality, and preference by the Metaphoric Triads Task as well as for analogical reasoning, information processing speed, cognitive flexibility under time pressure, and cognitive flexibility without time pressure. RESULTS: Metaphor identification and comprehension consecutively increased with age. Eleven-year-olds showed significantly higher metaphor comprehension quality and preference scores than seven- and nine-year-olds, whilst these younger age groups did not differ. Age, cognitive flexibility under time pressure, information processing speed, analogical reasoning, and cognitive flexibility without time pressure significantly predicted metaphor comprehension. CONCLUSIONS: Metaphorical language ability shows an ongoing development and seemingly changes qualitatively at the beginning of early adolescence. These results can possibly be explained by a greater synaptic reorganization in early adolescents. Furthermore, cognitive flexibility under time pressure and information processing speed possibly facilitate the ability to adapt metaphor processing strategies in a flexible, quick, and appropriate way.

Metaphor processing in middle childhood and at the transition to early adolescence: the role of chronological age, mental age, and verbal intelligence.

Metaphor development in conjunction with verbal intelligence and linguistic competence in middle childhood and at the transition to early adolescence was investigated. 298 individuals between seven and ten years (chronological age) who attended grades two-four (mental age) were tested for metaphor processing by the Metaphoric Triads Task, for linguistic competence (HELD), and verbal intelligence (WISC-III). Chronological age significantly predicted metaphor processing with a breakpoint of 8.2 years regarding identification and comprehension, and 10.2 years regarding preference. Fourth-graders showed highest metaphor processing scores. Verbal intelligence significantly predicted metaphor processing; this effect became stronger with increasing age. Attributional metaphors were best understood and most preferred. Chronological and mental age are associated with metaphor processing in an age span that is seemingly crucial for metaphor development. Verbal analogical reasoning, concept formation, verbal abstraction, and semantic knowledge predicted metaphor comprehension. Understanding facts, principles, and social situations, and resultant inferential verbal reasoning predicted metaphor preference.

Maternal bonding behavior, adult intimate relationship, and quality of life.

Continuity and discontinuity in the development of social relationships have been investigated by reviewing the course of social bonds and by analyzing the effects of a sound intimate relationship in adulthood in conjunction with recalled maternal bonding on the quality of life among students.A questionnaire-based study of 207 students was conducted. Perceptions of maternal bonding were designated as being representative of one of the two contrasting bonding types "optimal maternal bonding" and "affectionless maternal control" assessed by the Parental Bonding Instrument (PBI) and combined with perceptions of a sound intimate adult relationship measured by the Family Assessment Measure III Dyadic Relationships Scale (FAM-III-D). Quality of life and general health data were determined by using the World Health Organization Quality of Life (WHOQOL-BREF) instrument.Students who reported "optimal maternal bonding" had intimate relationships in adulthood that were of significantly higher quality than those who recalled "affectionless maternal control". Students who recalled "optimal maternal bonding" and described their intimate relationship as sound showed significantly higher scores in all domains of quality of life and indicated having better general health than those who reported "affectionless maternal control" and a sound intimate relationship.A sound intimate relationship in adulthood does not appear to compensate the impact of a recalled maternal bonding behavior in terms of affectionless control, on quality of life. Furthermore, results seem to support the hypothesis of continuity of the development of social relationships among psychologically well individuals based on the association between maternal bonding and later intimate relationships.

Screening for Specific Language Impairment in Preschool Children: Evaluating a Screening Procedure Including the Token Test.

Specific language impairment (SLI) comprises impairments in receptive and/or expressive language. Aim of this study was to evaluate a screening for SLI. 61 children with SLI (SLI-children, age-range 4-6 years) and 61 matched typically developing controls were tested for receptive language ability (Token Test-TT) and for intelligence (Wechsler Preschool-and-Primary-Scale-of-Intelligence-WPPSI). Group differences were analyzed using t tests, as well as direct and stepwise discriminant analyses. The predictive value of the WPPSI with respect to TT performance was analyzed using regression analyses. SLI-children performed significantly worse on both TT and WPPSI ([Formula: see text]). The TT alone yielded an overall classification rate of 79%, the TT and the WPPSI together yielded an overall classification rate of 80%. TT performance was significantly predicted by verbal intelligence in SLI-children and nonverbal intelligence in controls whilst WPPSI subtest arithmetic was predictive in both groups. Without further research, the Token Test cannot be seen as a valid and sufficient tool for the screening of SLI in preschool children but rather as a tool for the assessment of more general intellectual capacities. SLI-children at this age already show impairments typically associated with SLI which indicates the necessity of early developmental support or training. Token Test performance is possibly an indicator for a more general developmental factor rather than an exclusive indicator for language difficulties.

Cognitive and emotional demands of black humour processing: the role of intelligence, aggressiveness and mood.

Humour processing is a complex information-processing task that is dependent on cognitive and emotional aspects which presumably influence frame-shifting and conceptual blending, mental operations that underlie humour processing. The aim of the current study was to find distinctive groups of subjects with respect to black humour processing, intellectual capacities, mood disturbance and aggressiveness. A total of 156 adults rated black humour cartoons and conducted measurements of verbal and nonverbal intelligence, mood disturbance and aggressiveness. Cluster analysis yields three groups comprising following properties: (1) moderate black humour preference and moderate comprehension; average nonverbal and verbal intelligence; low mood disturbance and moderate aggressiveness; (2) low black humour preference and moderate comprehension; average nonverbal and verbal intelligence, high mood disturbance and high aggressiveness; and (3) high black humour preference and high comprehension; high nonverbal and verbal intelligence; no mood disturbance and low aggressiveness. Age and gender do not differ significantly, differences in education level can be found. Black humour preference and comprehension are positively associated with higher verbal and nonverbal intelligence as well as higher levels of education. Emotional instability and higher aggressiveness apparently lead to decreased levels of pleasure when dealing with black humour. These results support the hypothesis that humour processing involves cognitive as well as affective components and suggest that these variables influence the execution of frame-shifting and conceptual blending in the course of humour processing.