Evaluation of a non-auditory neurocognitive test battery in hearing-impaired according to age.

PURPOSE: Due to the demographic shift, the number of older people suffering from hearing loss and from cognitive impairment increases. Both are closely related and hard to differentiate as most standard cognitive test batteries are auditory-based and hearing-impaired individuals perform worse also in non-auditory test batteries. Therefore, reference data for hearing-impaired are mandatory. METHODS: The computer-based battery ALAcog assesses multiple cognitive domains, such as attention, (delayed) memory, working memory, inhibition, processing speed, mental flexibility and verbal fluency. A data set of 201 bilaterally hearing-impaired subjects aged ≥ 50 (mean 66.6 (SD 9.07)) was analysed. The LMS method, estimated curves for the 10th, 25th, 50th, 75th and 90th percentile were calculated, and classified according to age, starting from the age of 50. RESULTS: Cognitive function shows a decline in all subtests as people age, except for verbal fluency, which remains almost stable over age. The greatest declines were seen in recall and delayed recall and in mental flexibility. Age and hearing ability did not correlate (p = 0.68). However, as people age, inter-subject variability of cognitive test results increases. This was especially the case for inhibition. Cognitive function was not correlated with hearing ability (each p ≥ 0.13). CONCLUSION: The present results make an approach to establish reference data for a comprehensive non-auditory test battery in a large sample of elderly hearing-impaired people which can be used as a simple tool to better contextualise cognitive performance beyond mean and median scores.

Error processing in normal aging and in basal ganglia disorders.

Recently it has been shown that effects of aging and pathologically induced changes of basal ganglia structures may have quite similar effects on cognitive functions mediated by the medial prefrontal cortex. The question appears, if this pattern may be assignable to other cognitive functions that are mediated via the basal ganglia and medial prefrontal brain areas. Error processing is a component of executive functions that also depends on these areas and especially on the anterior cingulate cortex (ACC). Hence we ask, if error processing functions are differentially modulated by normal aging and basal ganglia diseases. Error processing mechanisms in these groups were investigated using a cognitive event-related potential (ERP), the error negativity. Enrolling an extended sample of young and elderly controls, as well as patients with Parkinson's and Huntington's disease, we show that modulations of error processing differ between aging, different basal ganglia diseases. Despite that the examined basal ganglia disorder groups (Parkinson's and Huntington's disease) differ in their age they show similar modulations in error processing, suggesting that aging effects are overridden by pathogenic effects. The study shows that it may be valuable to compare aging not only to different forms of basal ganglia disorders in order to gain knowledge about age- and disease-related mechanisms and the effects of these on cognitive functions. Diseases of the basal ganglia may impact error processing above and beyond the effects of normal aging. Although many aging, Parkinson's disease and Huntington's disease studies on error processing functions have already been published, this study ties together several related observations across all of these groups in one experiment.

[Cognitive competence of older workers]. / Kognitive Leistungsfähigkeit älterer Arbeitnehmer.

The article provides a short overview on cognitive strengths and weaknesses of older workers. The older people who are under the age of 65 years already exhibit changes in performance and neurophysiological measures in laboratory tasks that test fluid intelligence. Apart from deficits, the physiological data of the older people show clear evidence for compensatory strategies. Cognitive performance on the current job is usually less impaired. This can be explained by practice, learning, and selection, which are, however, often linked with higher effort. The cognitive competence of older employees varies exorbitantly, which is due to the influence of various factors like education, lifestyle, and in particular the type of work. Thus, the cognitive competence of older employees can be preserved and possibly even enhanced by changes in the work situation as well as by individual training procedures such as cognitive training.

Effect of selective attention on the latency of human frequency-following potentials.

While effects of attention on late and middle latency components of the evoked potential have been demonstrated, similar effects on brain stem evoked potentials--in particular on the human frequency-following potential (FFP)--are controversial. The FFP is a response to tone bursts in the frequency range of human language (optimum approximately 350 Hz). It has a latency of approximately 6.3 ms and is probably generated at a site peripheral to the inferior colliculus. We present data showing that the latency of the FFP can be shortened significantly (45 microseconds) if the subject is required to attend to the evoking auditory tone burst, while the amplitude of the FFP remains unaffected. This indicates an attention-controlled influence on signal processing in the earliest parts of the auditory pathway.

Action monitoring, error detection, and the basal ganglia: an ERP study.

The error negativity (Ne or ERN) is an event-related brain potential component, which is assumed to reflect error detection. Recently it has been hypothesized that the basal ganglia are assumed to play a crucial role in error detection. In the present study we ask whether the Ne is altered in patients with Parkinson's disease (PD), who have an impaired function of the basal ganglia. We recorded the Ne in patients and in matched controls, while they performed different tasks that require a relatively high cognitive control, which is supposed to pose particular problems on PD. The Ne was in fact smaller in the patients than in the controls in all tasks. Our results suggest an impairment of error detection in PD for different types of demanding tasks. This supports the hypothesis that the basal ganglia do play an important role for error detection in action monitoring.

Late visual and auditory ERP components and choice reaction time.

Some relations between different late positive ERP components and choice reaction time (RT) were studied. In order to identify the different components we used visual and auditory stimuli, as well as simple and choice reaction tasks, since one of the components is thought to be modality dependent and the other one task dependent. In the paradigm the stimulus modalities were mixed, which was expected to lead to a maximum dissociation of the components after auditory stimuli (Hohnsbein et al. (1991). Electroencephalography and Clinical Neurophysiology, 78, 438-446). The results demonstrated the overlap of two positive waves in choice reaction tasks: a central one (P-SR), and a parietal one (P-CR). The latency of the P-SR varied greatly across modalities, but did not vary with RT, whereas the latency of the P-CR varied strongly with RT. The different overlap of these components on fast and slow trials caused amplitude and latency variations of the "P300" and the positive slow wave. Our results suggest a relation of the P-SR with stimulus evaluation (identification), and of the P-CR with response selection (stimulus-response mapping).

Effects of attention and time-pressure on P300 subcomponents and implications for mental workload research.

Our approach to objective measures of mental workload is establishing relationships between components of the event-related brain potential (ERP) and information processing stages. These relationships can be used to infer the influence of specific workload conditions on specific processing stages. We recently showed that the ERP component P300 in choice tasks is composed of two subcomponents, P-SR and P-CR, which are time-related to stimulus-evaluation and response-selection. With these relations we could specify which processing stages were affected when certain workload conditions are varied. When attention was divided between the visual and auditory modalities compared to (unimodal) focused attention, the choice reaction time (RT) was prolonged, primarily in the auditory modality. This delay was mainly reflected in the P-CR latency, which shows that the division of attention mainly impairs the response-selection process in the auditory modality due to a bias of attention towards the visual modality. When the time-pressure was increased, the latency of the P-CR (and not of the P-SR) was shortened, but less than the choice RT. This suggests a (limited) acceleration of response-selection but not of stimulus evaluation. Since the response-selection process was accelerated less than the overt choice RT, an increase of the error rate was consequently observed. In summary we showed that increases of mental workload can induce accelerations or decelerations of specific processing stages which can be monitored by observing latency changes of the affiliated ERP components.

ERP components on reaction errors and their functional significance: a tutorial.

Some years ago we described a negative (Ne) and a later positive (Pe) deflection in the event-related brain potentials (ERPs) of incorrect choice reactions [Falkenstein, M., Hohnsbein, J., Hoormann, J., Blanke, L., 1990. In: Brunia, C.H.M., Gaillard, A.W.K., Kok, A. (Eds.), Psychophysiological Brain Research. Tilburg Univesity Press, Tilburg, pp. 192-195. Falkenstein, M., Hohnsbein, J., Hoormann, J., 1991. Electroencephalography and Clinical Neurophysiology, 78, 447-455]. Originally we assumed the Ne to represent a correlate of error detection in the sense of a mismatch signal when representations of the actual response and the required response are compared. This hypothesis was supported by the results of a variety of experiments from our own laboratory and that of Coles [Gehring, W. J., Goss, B., Coles, M.G.H., Meyer, D.E., Donchin, E., 1993. Psychological Science 4, 385-390. Bernstein, P.S., Scheffers, M.K., Coles, M.G.H., 1995. Journal of Experimental Psychology: Human Perception and Performance 21, 1312-1322. Scheffers, M.K., Coles, M. G.H., Bernstein, P., Gehring, W.J., Donchin, E., 1996. Psychophysiology 33, 42-54]. However, new data from our laboratory and that of Vidal et al. [Vidal, F., Hasbroucq, T., Bonnet, M., 1999. Biological Psychology, 2000] revealed a small negativity similar to the Ne also after correct responses. Since the above mentioned comparison process is also required after correct responses it is conceivable that the Ne reflects this comparison process itself rather than its outcome. As to the Pe, our results suggest that this is a further error-specific component, which is independent of the Ne, and hence associated with a later aspect of error processing or post-error processing. Our new results with different age groups argue against the hypotheses that the Pe reflects conscious error processing or the post-error adjustment of response strategies. Further research is necessary to specify the functional significance of the Pe.

Different error types and error processing in spatial stimulus-response-compatibility tasks: behavioural and electrophysiological data.

We tested the hypothesis that in spatial stimulus-response-compatibility (SRC) tasks two different error types occur: A noise-induced 'general error' independent of SRC and reaction time and a 'position driven error' in incompatible trials with short RT being driven by the irrelevant stimulus position. A second issue was whether error detection is different for these two types of errors, which should be reflected by differences in the error negativity (Ne), since the Ne is seen as a neural correlate of error detection. To study these issues, we used a Simon- and a spatial Stroop-task. In incompatible (vs. compatible) trials we found more errors and a below chance accuracy in fast responses. Neither the amplitude nor the latency of the Ne were significantly affected by the experimental factors. This pattern of behavioural results supports the above hypothesis of two error types in such tasks. The Ne results indicate that error detection is similar for both types of errors.

The human frequency-following response (FFR): normal variability and relation to the click-evoked brainstem response.

The frequency-following response (FFR) was recorded from twenty human subjects (11 female and 9 male) over a frequency range of 128-832 Hz in order to study the normal variability of this evoked potential and its dependence on age and sex. Moreover the relation of the FFR to the click-evoked brain stem response (BER) was analyzed in order to contribute to the FFR source discussion. The FFR had a maximum amplitude of about 400 nV and a latency of about 6.4 ms for stimulus frequencies around 350 Hz; the inter-individual variance of the best frequency and of the shape of the frequency function was considerable. Large second harmonics were seen in the FFR to stimuli below about 200 Hz. The FFR amplitude tended to be larger in younger subjects, whereas no such effect was found for the BER. No significant sex effect was found for the FFR amplitude, whereas the BER waves IV and VI were larger for females than for males. There were no correlations between FFR and BER latencies. Significant correlations were found between the amplitudes of the FFR and BER components II, III and IV, but not of waves V and VI. The results support the notion that the FFR and the BER reflect different mechanisms. Moreover the results do not favor the common hypothesis that the inferior colliculus is the major source of the scalp-recorded human FFR, but rather point to lower brainstem levels.

ERP components in Go/Nogo tasks and their relation to inhibition.

In visual Go/Nogo tasks the ERP usually shows a frontal negativity after Nogo stimuli ("Nogo-N2"), which possibly reflects an inhibition process. However, the Nogo-N2 appears to be very small after auditory stimuli, which is evidence against the inhibition hypothesis. In the present study we tested this hypothesis by evaluating performance differences between subjects. Assuming that for Ss with a high false alarm rate the inhibition process is weakened and/or delayed, they should reveal a smaller and/or later Nogo-N2 than Ss with a low false alarm rate. This prediction was confirmed, which supports the inhibition hypothesis. However, the Nogo-N2 was again much smaller and had a different topography after auditory than after visual stimuli despite similar performance in both modalities. This modality asymmetry was explained by assuming that the inhibitory mechanism reflected in the Nogo-N2 is located at a pre-motor rather than at the motor level. In the second part of the study we compared the Nogo-N2 with a similar phenomenon, the error negativity (Ne), which occurs in trials with commission errors (false alarms). Earlier work suggests that the Ne is a correlate of error detection or inhibition. This raises the possibility that the Ne is a delayed Nogo-N2, i.e., the Ne may reflect a late and hence unsuccessful attempt to inhibit the response after a nontarget. However, the Ne amplitude showed no difference between performance groups and stimulus modalities, as found for the Nogo-N2. Moreover, Ne and Nogo-N2 had different scalp topographies. This suggests that different mechanisms and generators underlie the Ne and the Nogo-N2.

ERP indices for response inhibition are related to anxiety-related personality traits.

Anxiety is often associated with impaired cognitive control and avoidance behaviour. The aim of this study was to investigate the effect of anxiety-related personality traits, such as anxiety sensitivity and trait anxiety, on event-related potentials of response inhibition in a standard Go/Nogo-paradigm. We focused on the Nogo-N2 and Nogo-P3 components, which probably represent different sub-processes of response inhibition. The Nogo-N2 was mainly influenced by trait anxiety, while it was slightly affected by anxiety sensitivity. In contrast, the Nogo-P3 was significantly associated with anxiety sensitivity, but was less affected by trait anxiety. Thus, anxious subjects seem to maintain a higher level of cognitive control to prepare and to monitor the outcome of their actions, which is differentially reflected in Nogo-N2 and Nogo-P3 potentials. Our results show that anxiety-related personality traits modulate electrophysiological responses related to cognitive control processes and should be taken into consideration in studies investigating response inhibition.

Paradoxical association of the brain-derived-neurotrophic-factor val66met genotype with response inhibition.

Response inhibition is a basic executive function which is dysfunctional in various basal ganglia diseases. The brain-derived-neurotrophic-factor (BDNF) plays an important pathophysiological role in these diseases. In the current study we examined the functional relevance of the BDNF val66met polymorphism for response inhibition processes in 57 healthy human subjects using event-related potentials (ERPs), i.e. the Nogo-N2 and Nogo-P3, which likely reflect different aspects of inhibition. Our results support the pre-motor inhibition theory of the Nogo-N2. We show that the BDNF val66met polymorphism selectively modulates the Nogo-N2. Response inhibition was better in the val/met-met/met group, since this group committed fewer false alarms, and their Nogo-N2 was larger, compared to the val/val group. This is the first study showing that met alleles of the BDNF val66met polymorphism confer an advantage for a specific cognitive function. We propose a neuronal model how this advantage gets manifest on a neuronal level.

Error processing in patients with Parkinson's disease: the influence of medication state.

One of the hallmarks of Parkinson's disease (PD) is a depletion of dopamine. Error processing, as reflected in a component of the event-related potential, the so-called error (related) negativity (Ne or ERN) is likely dependent on the midbrain dopaminergic system. In case of an unfavourable event such as an error, this system is assumed to send an error signal to the mediofrontal cortex, which elicits the Ne. Hence, the Ne should be altered in patients with PD. In fact, we earlier found a reduction of the Ne in medicated patients with PD in different tasks while another group found no such reduction in "off-medication" patients in a flanker task. In the present study, we reinvestigated this issue by measuring the Ne in a large group of treated PD patients in the "on"- and "off"-parkinsonian medication state and in matched control subjects in a flanker task. The Ne was found to be the same in the "on-medication" and "off-medication" state, while the motor score in the Unified Parkinson's Disease Rating Scale was different. In both medication states the Ne was smaller in the patients than in the controls. The results show that the Ne reduction found earlier is unaffected by short-term differences in parkinsonian medication. The question remains open whether the long-term medication could have contributed to the Ne reduction.

Response inhibition in borderline personality disorder: event-related potentials in a Go/Nogo task.

Borderline personality disorder (BPD) has been related to a dysfunction of anterior cingulate cortex, amygdala, and prefrontal cortex and has been associated clinically with impulsivity, affective instability, and significant interpersonal distress. We examined 17 patients with BPD and 17 age-, sex-, and education matched control participants with no history of Axis I or II psychopathology using event-related potentials (ERPs). Participants performed a hybrid flanker-Go/Nogo task while multichannel EEG was recorded. Our study focused on two ERP components: the Nogo-N2 and the Nogo-P3, which have been discussed in the context of response inhibition and response conflict. ERPs were computed on correct Go trials (button press) and correct Nogo trials (no button press), separately. Groups did not differ with regard to the Nogo-N2. However, BPD patients showed reduced Nogo-P3 amplitudes. For the entire group (n = 34) we found a negative correlation with the Barratt Impulsiveness Scale (BIS-10) and Becks's depression inventory (BDI). The present study is the first to examine Nogo-N2 and Nogo-P3 in BPD and provides further evidence for impaired response inhibition in BPD patients.

Executive control in obsessive-compulsive disorder: event-related potentials in a Go/Nogo task.

Obsessive-compulsive disorder (OCD) has been related to a hyperactive cortico-striatal-pallidal-thalamic circuitry resulting clinically in an impaired inhibition of repetitive thoughts and behaviors. We examined thirteen patients with OCD and thirteen age-, sex-, and education matched healthy controls using event-related potentials (ERPs). Participants performed a hybrid flanker-Go/Nogo task while multichannel EEG was recorded. Our study focused on two ERP components: the Nogo-N2 and the Nogo-P3, which have been discussed in the context of response inhibition and response conflict. Artifact-free EEG-segments were used to compute ERPs on correct Go trials (button press) and correct Nogo trials (no button press), separately. Patients with OCD showed enhanced (more negative) Nogo-N2 amplitudes than controls, and a significant difference in amplitudes between Nogo-N2 and Go-N2 trials (more negative for Nogo trials) at central midline electrode positions. However, groups did not differ with regard to the Nogo-P3 and Go-P3. The present study replicates and extends previous findings of altered executive control processes in OCD patients.

Effects of stimulus-response compatibility in Parkinson's disease: a psychophysiological analysis.

The present study investigated the mechanisms underlying stimulus-response compatibility effects in Parkinson's disease patients and matched controls. Since basal ganglia are involved in the selection and inhibition of competing responses we examined whether basal ganglia dysfunction in Parkinson's disease leads to greater interference effects compared to the control subjects. Reaction times and lateralized movement-related cortical potentials (lateralized readiness potential: LRP) were recorded in two modified Eriksen flanker tasks. Both groups were influenced by compatibility conditions; interference was seen as enhanced reaction time and error rate, as well as incorrect early LRP and delayed late LRP in incongruent trials. Altogether, behavioral and electrophysiological measures showed the interference to be rather smaller for the patients than for the controls. In contrast, facilitation did not differ among groups. Hence the claim that Parkinson's disease patients are more influenced than controls by interfering directional stimuli appears not always valid.

Auditory distraction in young and middle-aged adults: a behavioural and event-related potential study.

Cognitive tasks involving distraction are associated with an early age-related decline in performance. Involuntary shifts in attention to irrelevant stimulus features and subsequent reorientation were studied in young and middle-aged subjects focussing on behavioural and event-related potential (ERP) measures. Subjects were asked to discriminate between equiprobable short and long auditory stimuli. Irrelevant rare frequency deviations prolonged reaction times (RT's), while an age-related effect on RT's was not observed. In contrast, notably after short deviant tones the error rate was considerably increased in the middle-aged subjects. ERP measures after deviant stimuli elicited a sequence of mismatch negativity (MMN), P3a and reorienting negativity (RON). The latency and amplitude of the MMN did not differ between age groups indicating an unchanged deviance detection. However, the consecutive process of attention orientation (P3a) was delayed and the subsequent reorienting (RON) to the primary task was strongly attenuated in the middle-aged subjects. After short deviants the RON was virtually absent in the middle-aged subjects, which might account for the observed decline of accuracy.

Effects of choice complexity on different subcomponents of the late positive complex of the event-related potential.

The effects of choice complexity on different subcomponents of the late positive complex were investigated. In a previous choice reaction study, two subcomponents of this complex were identified, called P-SR and P-CR, which seem to be related to stimulus evaluation and response selection, respectively. The present study attempts to show the dependence of the P-CR (and the independence of the P-SR) on response selection by manipulating response selection complexity. This was done by having the subjects perform either 2-way or 4-way choice reactions to single letter stimuli. To enhance the discriminability of P-SR and P-CR, visual and auditory stimuli were used, since the P-SR is modality-dependent. Moreover, the stimulus modalities were mixed ("divided attention paradigm"), which was expected to lead to a dissociation of P-SR and P-CR, especially after auditory stimuli. The choice reaction times were about 100 msec longer for difficult than for easy choices. The main ERP result was a 65 msec increase of the P-CR latency for the difficult as compared to the easy choice, while the P-SR latency remained constant. The P-CR latency difference precisely matched the onset difference of the lateralized readiness potential. The P-SR showed a modality-dependent latency and topography, while the P-CR did not. The present data confirm the close relation of one subcomponent of the late positive complex, the P-CR, to the cognitive response-selection process.