Exploring Executive Functioning of Adults With Probable Developmental Coordination Disorder Using the Jansari Assessment of Executive Functions.

Many individuals with Developmental Coordination Disorder (DCD) demonstrate executive functioning difficulties on standardized assessments, yet these difficulties have not been investigated using ecologically-valid measures. 26 adults with probable DCD (pDCD), and 26 typically developing (TD) adults completed selected background measures and the Jansari assessment of Executive Functions (JEF©). JEF© is an ecologically-valid measure that provides measures of Planning, Prioritization, Selective-Thinking, Creative-Thinking, Adaptive-Thinking, and Action-, Event- and Time-Based Prospective Memory. pDCD participants were impaired relative to TD participants, with difficulties in Planning, Action-, and Event-Based Prospective Memory. These findings are consistent with self-reported difficulty and provide avenues for research investigating intervention.

Validation of a Persian version of an English language ecologically-valid assessment of executive functions through childhood and adolescence.

Childhood and adolescence are pivotal periods for cognitive development. Executive functions are crucial for efficient cognitive functioning, so accurate assessment is important. One ecologically-valid virtual reality test is the Jansari assessment of Executive Functions for Children (JEF-C©). In a cross-sectional study, we aimed at translating, adapting and validating JEF-C into Persian, and at investigating whether this Persian version (JEF-C (P)) can identify stages of development of executive functions in children aged from 8 to 16. Children and adolescents (N = 146) falling into three age groups participated: 8-10, 11-13 and 14-16 years old. They completed JEF-C (P) and the Wisconsin Card Sorting Test (WCST). There were acceptable Cronbach's alpha coefficients for JEF-C(P) total score (α = .72) and all constructs, except action-based prospective memory, had a positive impact on total internal consistency. There was an effect of age group on overall JEF-C (P) performance and of age on four constructs. There was also a correlation between the number of categories on WCST and the prioritization construct of JEF-C (P). It seems that JEF-C (P) is an ecologically valid executive function assessment sensitive to age and could be useful for both researchers and clinicians working with children.

Accelerated forgetting in healthy older samples: Implications for methodology, future ageing studies, and early identification of risk of dementia.

Accelerated long-term forgetting (ALF) has been reported in healthy older individuals, and is a possible early marker for risk of developing Alzheimer's disease (AD). The Verbal Associative Learning and Memory Test (VALMT) addresses methodological weaknesses in existing clinical tests and has detected ALF in epilepsy within an hour. We used VALMT to investigate learning and forgetting in healthy Older participants. Older (60-69 years) and Younger (19-31 years) participants were compared. Using VALMT, unrelated word pairs were learnt to criterion, then cued-recall tested at delays of 5, 30, and 55 min. Unique pairs were tested at each delay. Subjective memory complaints data was gathered, and the Wechsler Memory Scale Logical Memory test (WMS-LM; a standard clinical measure) was administered. VALMT identified a significant difference in delayed recall between Younger and Older groups by 55 min (d = 1.32). While "fast-learning" Older participants scored similarly to Younger participants, "slow-learning" Older participants were impaired at all delays. Forgetting rates suggested degradation of memory starts during early synaptic consolidation rather than later system-level consolidation. Increased subjective memory complaints were associated with reduced VALMT scores. By contrast, WMS-LM failed to identify significant differences between any groups, and did not correlate with memory complaints. We conclude that VALMT may be better able than WMS-LM to identify subtle impairments in healthy older adults within a single clinical visit, and VALMT results better reflect subjective experience. Older slow-learners forget faster and report more subjective memory complaints, which may indicate a group at risk of developing AD.

Understanding the relationship between apathy, cognition and functional outcome in schizophrenia: The significance of an ecological assessment.

In recent years there has been an increasing interest in understanding the role apathy plays in mediating the relationship between cognitive impairment and functional outcome. In general, most studies measure cognition with traditional cognitive tests that give explicit instructions and guide the participants toward generating a response. However, given that apathy is defined by a decrease in self-initiated behavior, it is crucial to evaluate cognition with ecological tasks that do not explicitly direct the patient´s motivation to generate behaviors to assess the actual effect. This study investigated whether an ecological cognitive assessment (the Jansari Executive Function Assessment, JEF©) would uniquely contribute to the relationship between cognition, apathy, and functional outcome in schizophrenia. The Apathy Evaluation Scale (AES), neuropsychological tests and the JEF© were administered to 20 patients with schizophrenia. Hierarchical multiple regression and mediation analysis were performed to test the associations between the variables of interest. Results showed that JEF© explained a significant portion of the variance in AES (25%). In addition, apathy explained 36% of the variance in functional outcome. However, AES did not mediate between cognition and functional outcome. Our results highlight the importance of assessing cognition with tasks that require integration of cognitive functions needed for real life demands.

Hebrew version of the Jansari assessment of Executive Functions for Children (JEF-C©): Translation, adaptation and validation.

The Jansari assessment of Executive Functions for Children (JEF-C©) is a non-immersive computerized assessment of executive functions (EFs). This study aimed to create a cross-culturally adapted Hebrew version, JEF-C(H)© and to assess reliability and validity in the Israeli context. Forty typically developing Israeli children and adolescents, aged 11-18 years, were assessed with JEF-C(H)©. In addition, participants and their parents filled in the Behaviour Rating Inventory of Executive Function (BRIEF). JEF-C(H)© was found to be feasible in Israeli children and adolescents. The internal consistency was acceptable (Cronbach's alpha = 0.79). Most of the JEF-C(H)© subtests and the Average score showed significant positive moderate to high correlations with age, ranging from 0.40 to 0.78 demonstrating construct validity. Multiple significant correlations were also found between the JEF-C(H)© Average score and the BRIEF indices as well as total score in the Parent and Self-report questionnaires. These preliminary findings support the reliability and validity of this version. Current findings demonstrate the potential clinical utility of JEF-C(H)© as an ecologically valid tool for Israeli children and adolescents in the assessment of EFs.

Virtual-Reality Performance-Based Assessment of Cognitive Functions in Adult Patients With Acquired Brain Injury: A Scoping Review.

Individuals with acquired brain injury (ABI) commonly present with impairments in cognitive abilities. As these competencies seem to be predictive of patients' abilities to reintegrate into the everyday settings, it is crucial to assess them properly. However, previous research has indicated that patients may perform relatively well on standard tests of cognitive functioning, but may nonetheless encounter significant difficulties in organizing and executing everyday tasks. In order to overcome this issue, virtual reality (VR) methods have been introduced in clinical practice with the aim of creating assessments that simulate real-world activities and thus, provide a clearer picture of patients' functioning in everyday settings. This review offers an overview of VR assessment tools described in the scientific literature between 2010 and 2019. Overall, 38 relevant records describing 31 different tools were found. Among these tools, 16 assessed executive functions and prospective memory, while the other 15 assessed visuo-spatial abilities. Although promising results have been reported, our analysis indicated that about half of the tools deliver tasks that differ from everyday activities, thus limiting the generalizability of patients' performance to the real-world. Moreover, a variety of methodological shortfalls related to study Internal and External Validity have been highlighted, which hamper the possibility of drawing definite recommendations on tool choice. These limitations suggest the importance of putting considerable efforts into the improvement or development of VR tools for patients with ABI for both research and clinical purposes, considering the great potential of this form of assessment.

Executive Dysfunctions in Schizophrenia: A Critical Review of Traditional, Ecological, and Virtual Reality Assessments.

In recent years, interest has grown in measuring executive function in schizophrenia with ecological and virtual reality (VR) tools. However, there is a lack of critical analysis comparing those tools with traditional ones. This paper aims to characterize executive dysfunction in schizophrenia by comparing ecological and virtual reality assessments with traditional tools, and to describe the neurobiological and psychopathological correlates. The analysis revealed that ecological and VR tests have higher levels of verisimilitude and similar levels of veridicality compared to traditional tools. Both negative symptoms and disorganization correlate significantly with executive dysfunction as measured by traditional tools, but their relationships with measures based on ecological and VR methods are still unclear. Although there is much research on brain correlates of executive impairments in schizophrenia with traditional tools, it is uncertain if these results will be confirmed with the use of ecological and VR tools. In the diagnosis of executive dysfunction, it is important to use a variety of neuropsychological methods-especially those with confirmed ecological validity-to properly recognize the underlying characteristics of the observed deficits and to implement effective forms of therapy.

Virtual reality assessment of daily life executive functions in mood disorders: associations with neuropsychological and functional measures.

BACKGROUND: Mood disorders are often accompanied by cognitive difficulties that impede patients' functional capacity. However, neuropsychological tests provide limited insight into patients' ability to tackle daily life cognitive challenges. To address this challenge, we investigated the sensitivity and validity of the Jansari assessment of Executive Functions (JEF©) virtual reality test in patients with mood disorders and its associations with functional capacity. METHODS: In total, 21 patients with bipolar disorder or unipolar disorder in full or partial remission and 29 healthy control participants were recruited for the study. Participants attended one test session during which they underwent diagnostic assessments, mood ratings and assessments with JEF©, a battery of standard neuropsychological tests (RAVLT, Trial Making A and B, Fluency tests, letter-number sequencing and RBANS digit span and coding tests) and functional capacity measures (UPSA-B and FAST). RESULTS: Patients showed impaired executive functions on JEF© compared to the control group. Relative to the control group, patients were also impaired on neuropsychological sub-composite scores of executive function, verbal memory and processing speed as well as on a global cognition composite score. In addition, JEF© scores predicted performance on a global cognition composite based on neuropsychological tests, and a performance-based measure of functional capacity. LIMITATIONS: This study had a relatively small sample size and included a mixed group of patients with unipolar or bipolar disorder. CONCLUSIONS: JEF© is a sensitive and valid measure of daily life executive impairments in patients with mood disorders that is associated with functional capacity.

Using Virtual Reality to investigate multitasking ability in individuals with frontal lobe lesions.

Individuals with lesions in the prefrontal cortex often show impairments with the organisation of their behaviour in everyday life. These difficulties can be hard to detect using structured formal tests. The objective of this study was to use Virtual Reality (VR) to explore the multitasking performance of individuals with focal frontal lobe lesions, specifically using the Jansari assessment of Executive Functions (JEF©). Nineteen individuals with frontal lobe lesions were compared with 19 matched controls on the test and a group of commonly used clinical measures of neuropsychological functioning, as well as questionnaire measures of everyday activity, anxiety and depression. There was a significant difference between groups on the overall JEF© score and on five of the eight individual constructs, namely the planning, creative thinking, adaptive thinking, event-based Prospective Memory (PM) and time-based PM constructs. There were no differences between groups on the non-VR EF individual measures apart from on one EF control measure, Trail Making A. These results demonstrate the potential clinical utility of the JEF© and highlight the value of ecologically valid VR measures in detecting impairments in EF in individuals with frontal lobe lesions.

Assessment of executive functions in children and adolescents with acquired brain injury (ABI) using a novel complex multi-tasking computerised task: The Jansari assessment of Executive Functions for Children (JEF-C©).

Objectives: The Jansari assessment of Executive Functions for Children (JEF-C©) is a new non-immersive computerised assessment of executive functions. The objectives of the study were to test the feasibility and validity of JEF-C© in children and adolescents with acquired brain injury (ABI). Methods: Twenty-nine patients with ABI aged 10-18 years and 30 age-and gender-matched controls were tested. Participants performed JEF-C©, Wechsler Abbreviated Scale of Intelligence (WASI) and the Behavioural Assessment of the Dysexecutive Syndrome for Children (BADS-C), while parents completed the Behaviour Rating Inventory of Executive Function (BRIEF) questionnaire. Results: The JEF-C© task proved feasible in patients with ABI. The internal consistency was medium (Cronbach's alpha = 0.62 and significant intercorrelations between individual JEF-C© constructs). Patients performed significantly worse than controls on most of the JEF-C© subscales and total score, with 41.4% of participants with ABI classified as having severe executive dysfunction. No significant correlations were found between JEF-C© total score, the BRIEF indices, and the BADS-C. Significant correlations were found between JEF-C© and demographic characteristics of the sample and intellectual ability, but not with severity/medical variables. Conclusion: JEF-C© is a playful complex task that appears to be a sensitive and ecologically valid assessment tool, especially for relatively high-functioning individuals.

An in-depth cognitive examination of individuals with superior face recognition skills.

Previous work has reported the existence of "super-recognisers" (SRs), or individuals with extraordinary face recognition skills. However, the precise underpinnings of this ability have not yet been investigated. In this paper we examine (a) the face-specificity of super recognition, (b) perception of facial identity in SRs, (c) whether SRs present with enhancements in holistic processing and (d) the consistency of these findings across different SRs. A detailed neuropsychological investigation into six SRs indicated domain-specificity in three participants, with some evidence of enhanced generalised visuo-cognitive or socio-emotional processes in the remaining individuals. While superior face-processing skills were restricted to face memory in three of the SRs, enhancements to facial identity perception were observed in the others. Notably, five of the six participants showed at least some evidence of enhanced holistic processing. These findings indicate cognitive heterogeneity in the presentation of superior face recognition, and have implications for our theoretical understanding of the typical face-processing system and the identification of superior face-processing skills in applied settings.

The man who mistook his neuropsychologist for a popstar: when configural processing fails in acquired prosopagnosia.

We report the case of an individual with acquired prosopagnosia who experiences extreme difficulties in recognizing familiar faces in everyday life despite excellent object recognition skills. Formal testing indicates that he is also severely impaired at remembering pre-experimentally unfamiliar faces and that he takes an extremely long time to identify famous faces and to match unfamiliar faces. Nevertheless, he performs as accurately and quickly as controls at identifying inverted familiar and unfamiliar faces and can recognize famous faces from their external features. He also performs as accurately as controls at recognizing famous faces when fracturing conceals the configural information in the face. He shows evidence of impaired global processing but normal local processing of Navon figures. This case appears to reflect the clearest example yet of an acquired prosopagnosic patient whose familiar face recognition deficit is caused by a severe configural processing deficit in the absence of any problems in featural processing. These preserved featural skills together with apparently intact visual imagery for faces allow him to identify a surprisingly large number of famous faces when unlimited time is available. The theoretical implications of this pattern of performance for understanding the nature of acquired prosopagnosia are discussed.

Beyond visual imagery: how modality-specific is enhanced mental imagery in synesthesia?

Synesthesia based in visual modalities has been associated with reports of vivid visual imagery. We extend this finding to consider whether other forms of synesthesia are also associated with enhanced imagery, and whether this enhancement reflects the modality of synesthesia. We used self-report imagery measures across multiple sensory modalities, comparing synesthetes' responses (with a variety of forms of synesthesia) to those of non-synesthete matched controls. Synesthetes reported higher levels of visual, auditory, gustatory, olfactory and tactile imagery and a greater level of imagery use. Furthermore, their reported enhanced imagery is restricted to the modalities involved in the individual's synesthesia. There was also a relationship between the number of forms of synesthesia an individual has, and the reported vividness of their imagery, highlighting the need for future research to consider the impact of multiple forms of synesthesia. We also recommend the use of behavioral measures to validate these self-report findings.

An inability to exclude visual noise in migraine.

PURPOSE: People with migraine are relatively poor at judging the direction of motion of coherently moving signal dots when interspersed with noise dots drifting in random directions, a task known as motion coherence. Although this has been taken as evidence of impoverished global pooling of motion signals, it could also arise from unreliable coding of local direction (of each dot), or an inability to segment signal from noise (noise-exclusion). The aim of this study was to determine how these putative limits contribute to impoverished motion processing in migraine. METHODS: Twenty-two participants with migraine (mean age, 34.7 ± 8.3 years; 16 female) and 22 age- and sex-matched controls (mean age, 34.4 ± 6.2 years) performed a motion-coherence task and a motion-equivalent noise task, the latter quantifying local and global limits on motion processing. In addition, participants were tested on analogous equivalent noise paradigms involving judgments of orientation and size, so that the specificity of any findings (to visual dimension) could be ascertained. RESULTS: Participants with migraine exhibited higher motion-coherence thresholds than controls (P = 0.01, independent t-test). However, this difference could not be attributed to deficits in either local or global processing since they performed normally on all equivalent noise tasks (P > 0.05, multivariate ANOVA). CONCLUSIONS: These findings indicate that motion perception in the participants with migraine was limited by an inability to exclude visual noise. We suggest that this is a defining characteristic of visual dysfunction in migraine, a theory that has the potential to integrate a wide range of findings in the literature.

Effect of mindfulness meditation on brain-computer interface performance.

Electroencephalogram based brain-computer interfaces (BCIs) enable stroke and motor neuron disease patients to communicate and control devices. Mindfulness meditation has been claimed to enhance metacognitive regulation. The current study explores whether mindfulness meditation training can thus improve the performance of BCI users. To eliminate the possibility of expectation of improvement influencing the results, we introduced a music training condition. A norming study found that both meditation and music interventions elicited clear expectations for improvement on the BCI task, with the strength of expectation being closely matched. In the main 12 week intervention study, seventy-six healthy volunteers were randomly assigned to three groups: a meditation training group; a music training group; and a no treatment control group. The mindfulness meditation training group obtained a significantly higher BCI accuracy compared to both the music training and no-treatment control groups after the intervention, indicating effects of meditation above and beyond expectancy effects.

Comparing implicit and synaesthetic number-space associations: Visuospatial and verbal spatial-numerical associations of response codes.

In the theory of the mental number line, number, and space are implicitly associated, giving rise to the spatial-numerical association of response codes (SNARC) effect, in which smaller numbers are more readily associated with the left side of space and larger numbers with the right, during a parity judgement task. Others, however, have argued that the SNARC effect is flexible and better explained by verbal rather than spatial associations. A few single-case studies on the SNARC effect have tested number-space synaesthetes, who make explicit associations between number and space. Here, we present data from experiments conducted on groups of synaesthetes and nonsynaesthetes on the classic SNARC parity judgement task with lateralized response keys and a modified version in which they responded to labels appearing on screen. Synaesthetes' behaviour was expected to differ from nonsynaesthetes' behaviour due to the explicit, fixed nature of their number-space associations, but both experiments show the two groups behaving in the same way, indicating that parity judgement tasks may not be tapping the same representation of number that gives rise to synaesthetic number-space experiences.

Visual experience facilitates allocentric spatial representation.

Representing the position of the objects independently from our own position is a fundamental cognitive ability. Here we investigated whether this ability depends on visual experience. Congenitally blind, late blind and blindfolded sighted participants haptically learnt a room-sized regularly shaped array of objects, and their spatial memory was tested to determine which spatial reference frame was used. Crucially, the use of an object-based reference frame requires representing the regular structure of the array. We found that blindfolded sighted and late blind participants, that is those with visual experience, showed a preferential use of the object-based or 'allocentric' reference frame. On the contrary, congenitally blind participants preferred a self-based, or egocentric, reference frame. This suggests that, due to its developmental effect on the multisensory brain areas involved in spatial cognition, visual experience is necessary to develop a preference for an object-based, allocentric reference frame.