New Insights into the Neuropsychological Profile and Intellectual Quotient Variability in Joubert Syndrome Compared to Other Congenital Cerebellar Malformations.

The neuropsychological characteristics of the cerebellar cognitive affective syndrome (CCAS) in congenital, non-progressive malformations of the cerebellum have been scarcely investigated, and even less is known for Joubert syndrome (JS), an inherited, non-progressive cerebellar ataxia characterized by the so-called molar tooth sign. The few studies on this topic reported inconsistent results about intellectual functioning and specific neuropsychological impairments. The aim of this research is to examine the neuropsychological profile of JS compared to other congenital cerebellar malformations (CM), considering individual variability of intellectual quotient (IQ) in the two groups. Fourteen patients with JS and 15 patients with CM aged 6-25 years were tested through a comprehensive, standardized neuropsychological battery. Their scores in the neuropsychological domains were inspected through descriptive analysis and compared by mean of MANOVA and ANOVA models, then replicated inserting IQ as covariate. The two groups showed a largely overlapping neuropsychological profile, consistent with CCAS. However, the JS group showed worse performance in visual-spatial memory compared to CM patients, although this difference was mitigated when considering IQ. These findings highlight a divergence between JS and other CM in visual-spatial memory, which might suggest a critical role of the cerebellum in recalling task-relevant memories and might inform rehabilitative interventions.

[Investigation of visuospatial memory in obsessive-compulsive disorder using the Rey-Osterrieth Complex Figure Test].

Based on previous results the cognitive profile of patients with obsessive-compulsive disorder (OCD) is determined by the impairment of executive and visual-spatial memory functions. The Rey-Osterrieth Complex Figure (ROCF) is a widely used tool for examining visual-spatial memory disorders. Several scoring systems can be used to evaluate the ROCF and the most widespread is the original Osterrieth evaluation system. The Boston Qualitative Scoring System (BQSS) is a new, much more detailed scoring system than the Osterrieth, which allows both quantitative and a more detailed qualitative analysis of ROCF. In our study, we analyzed the copying and immediate recall performance of 24 OCD and 24 age- and education-matched healthy control subjects using the Osterrieth and BQSS scoring systems. Our research had two main goals, (1) to examine the diff erences in visualspatial memory performance shown by the OCD group compared to the control group, and (2) to compare the Osterrieth and BQSS scoring systems in one clinical sample. Based on both the Osterrieth and BQSS scoring systems, our results show that the OCD group performed significantly worse in the recall phase, but not in the copy phase. According to our results both scoring systems can be effectively used to examine the functioning of visual-spatial memory in OCD patients. While the Osterrieth evaluation system is faster and more widespread, the BQSS scoring system examines detailed qualitative aspects in addition to quantitative indicators.

On-road assessment of fitness-to-drive in persons with MS with cognitive impairment: A prospective study.

BACKGROUND: Cognitive impairment is common in multiple sclerosis (MS). In other populations, cognitive impairment is known to affect fitness-to-drive. Few studies have focused on fitness-to-drive in MS and no studies have solely focused on the influence of cognitive impairment. OBJECTIVE: To assess fitness-to-drive in persons with MS with cognitive impairment and low physical disability. METHODS: Persons with MS, aged 18-59 years with EDSS ⩽ 4.0, impaired processing speed, and impairment on at least one measure of memory or executive function, were recruited. Cognition was assessed using the Minimal Assessment of Cognitive Function battery. A formal on-road driving assessment was conducted. Chi-square analysis examined the association between the fitness-to-drive (pass/fail) and the neuropsychological test results (normal/impaired). Bayesian statistics predicting failure of the on-road assessment were calculated. RESULTS: Of 36 subjects, eight (22.2%) were unfit to drive. Only the BVMTR-IR, measuring visual-spatial memory, predicted on-road driving assessment failure ( X2 ( df = 1, N = 36) = 3.956; p = 0.047) with a sensitivity of 100%, but low specificity (35.7%) due to false positives (18/25). CONCLUSION: In persons with MS and impaired processing speed, impairment on the BVMTR-IR should lead clinicians to address fitness-to-drive.

Prenatal and postnatal polybrominated diphenyl ether exposure and visual spatial abilities in children.

Polybrominated diphenyl ethers (PBDEs) are associated with impaired visual spatial abilities in toxicological studies, but no epidemiologic study has investigated PBDEs and visual spatial abilities in children. The Health Outcomes and Measures of the Environment Study, a prospective birth cohort (2003-2006, Cincinnati, OH), was used to examine prenatal and childhood PBDEs and visual spatial abilities in 199 children. PBDEs were measured at 16±3 weeks gestation and at 1, 2, 3, 5, and 8 years using gas chromatography/isotope dilution high-resolution mass spectrometry. We used the Virtual Morris Water Maze to measure visual spatial abilities at 8 years. In covariate-adjusted models, 10-fold increases in BDE-47, -99, and -100 at 5 years were associated with shorter completion times by 5.2s (95% Confidence Interval [CI] -9.3, -1.1), 4.5s (95% CI -8.1, -0.9), and 4.7s (95% CI -9.0, -0.3), respectively. However, children with higher BDE-153 at 3 years had longer completion times (ß=5.4s, 95% CI -0.3, 11.1). Prenatal PBDEs were associated with improved visual spatial memory retention, with children spending a higher percentage of their search path in the correct quadrant. Child sex modified some associations between PBDEs and visual spatial learning. Longer path lengths were observed among males with increased BDE-47 at 2 and 3 years, while females had shorter paths. In conclusion, prenatal and postnatal BDE-28, -47, -99, and -100 at 5 and 8 years were associated with improved visual spatial abilities, whereas a pattern of impairments in visual spatial learning was noted with early childhood BDE-153 concentrations.

Patients with Parkinson's disease demonstrate deficits in visual-spatial memory in the Chinese Visual Retention Test.

OBJECTIVE: We aimed to explore the existence of visual-spatial memory deficit in patients with Parkinson's disease (PD) without dementia in the Chinese Visual Retention Test, as well as to assess whether their performance is related to age, duration, severity, stage, and dopamine (DA) dose. METHODS: Forty-two patients with PD and 30 healthy controls were included in our study. The Chinese Visual Retention Test was used to evaluate the visual-spatial memory of the subjects. Parameters of the Chinese Visual Retention Test were compared between the two groups. Correlation analysis and multiple linear regression analysis were used to explore the associations of the Chinese Visual Retention Test with age, duration, severity, stage of PD, and DA dose. RESULTS: Three correct scores in the Chinese Visual Retention Test were all significantly lower in the PD group than in the control group. The total error scores, error scores of omissions, deformation, and persistence in the PD group were significantly higher than those in the control group. Correlation analysis showed the total error scores in the Chinese Visual Retention Test was positively correlated with UPDRS III score and H-Y classification. Multiple linear regression analysis showed that the total error scores in the Chinese Visual Retention Test were associated with the UPDRS III score and H-Y classification. CONCLUSION: Patients with PD without dementia had visual-spatial memory deficits in the Chinese Visual Retention Test which may be affected by the severity and clinical stage of PD.

Intranasal insulin treatment ameliorates spatial memory, muscular strength, and frailty deficits in 5xFAD mice.

The 5xFAD mouse model shows age-related weight loss as well as cognitive and motor deficits. Metabolic dysregulation, especially impaired insulin signaling, is also present in AD. This study examined whether intranasal delivery of insulin (INI) at low (0.875 U) or high (1.750 U) doses would ameliorate these deficits compared to saline in 10-month-old female 5xFAD and B6SJL wildtype (WT) mice. INI increased forelimb grip strength in the wire hang test in 5xFAD mice in a dose-dependent manner but did not improve the performance of 5xFAD mice on the balance beam. High INI doses reduced frailty scores in 5xFAD mice and improved spatial memory in both acquisition and reversal probe trials in the Morris water maze. INI increased swim speed in 5xFAD mice but had no effect on object recognition memory or working memory in the spontaneous alternation task, nor did it improve memory in the contextual or cued fear memory tasks. High doses of insulin increased the liver, spleen, and kidney weights and reduced brown adipose tissue weights. P-Akt signaling in the hippocampus was increased by insulin in a dose-dependent manner. Altogether, INI increased strength, reduced frailty scores, and improved visual spatial memory. Hypoglycemia was not present after INI, however alterations in tissue and organ weights were present. These results are novel and important as they indicate that intra-nasal insulin can reverse cognitive, motor and frailty deficits found in this mouse model of AD.

The Effect of Cognitive Task Complexity on Healthy Gait in the Walking Corsi Test.

Dual-task activities are essential within everyday life, requiring visual-spatial memory (VSM) and mobility skills. Navigational memory is an important component of VSM needed to carry out everyday activities, but this is often not included in traditional tests such as the Corsi block tapping test (CBT). The Walking Corsi Test (WalCT) allows both VSM and navigational memory to be tested together, as well as allowing measures of gait to be collected, thus providing a more complete understanding of dual-task function. The aim of this study was to investigate the effect of an increasingly complex cognitive task on gait in a healthy adult population, using the WalCT and body-worn inertial measurement unit (IMU) sensors. Participants completed both the CBT and WalCT, where they were asked to replicate increasingly complex sequences until they were no longer able to carry this out correctly. IMU sensors were worn on the shins throughout the WalCT to assess changes in gait as task complexity increased. Results showed that there were significant differences in several gait parameters between completing a relatively simple cognitive task and completing a complex task. The type of memory used also appeared to have an impact on some gait variables. This indicates that even within a healthy population, gait is affected by cognitive task complexity, which may limit function in everyday dual-task activities.

The alternate-form reliability study of six variants of the Brief Visual-Spatial Memory Test-Revised and the Hopkins Verbal Learning Test-Revised.

Introduction: The revised Hopkins Verbal Learning Test-Revised (HVLT-R) and the Brief Visual-Spatial Memory Test-Revised (BVMT-R) are two widely used test involving verbal and visual learning and memory. In the two tests, six different versions are assembled, respectively, to prevent learning effects. Currently, no researchers have compared the six versions of the two tests. Thus, their usefulness in clinical studies requiring multiple follow-ups is limited. In this work, we confirm the equivalence of six HVLT-R and BVMT-R versions. Methods: 20 people completed all six HVLT-R and BVMT-R versions, while 120 people were randomly assigned to complete one of the six versions of each test. The Intelligence Quotient (IQ) level is measured using the short version of the Wechsler Adult Intelligence test. R4.2.0 is used for statistical analysis. The K-Related sample test (a non-parametric test) is used to observe the differences in test scores among the 20 subjects. The one-way Analysis of Variance (ANOVA) test is utilized to analyze the differences in test scores among the 120 subjects. The scores on different versions are compared using two similar sample tests. The HVLT-R Total Learning, the HVLT-R Delayed Recall, the BVMT-R Total Learning, and the BVMT-R Delayed Recall are indexes for comparison. Version and test scores are used as research factors, while different versions are used as research levels. Results: The results suggest that HVLT-R and BVMT-R versions 3, 5 and 6 are equally difficult, and relatively easy compared to versions 1, 2 and 4. HVLT-R versions 3, 5, and 6 show good reliability and can be used interchangeably when testing word learning ability or short-term memory; BVMT-R Versions 3, 5, and 6 show acceptable reliability and can be can be used interchangeably. Discussion: In the study of multiple follow-ups, it is a must to avoid discrepant versions and choose other equivalent versions. The results from this study could be used as a guide for upcoming studies and clinical applications in China.

[Formula: see text] Measuring visual matching and short-term recognition memory with the CANTAB® Delayed Matching to Sample task in schoolchildren: Effects of demographic influences, multiple outcome measures and regression-based normative data.

The study aims to establish demographically corrected, pediatric norms for the computerized Delayed Matching to Sample (DMS) test, a measure of "visual matching ability and short-term visual recognition memory, for non-verbalisable problems". The DMS was administered to n = 184 children aged 5.10 to 14.5 years old. The DMS is a 4-choice recognition task of non-verbal, abstract patterns. The child has "to select, among four different choice patterns, the one that matches a complex visual pattern presented," i.e., (the target stimulus). The DMS consists of two conditions: a) the overt condition in which the target stimulus and four choice patterns are shown simultaneously and b) the covert condition, in which the choice patterns are shown after the target pattern is covered. The DMS test provides three outcome measures: the accuracy score (i.e., the number of correct patterns selected), latency (i.e., the response speed) and the probability of making an error after an incorrect response. These outcome measures were calculated for both conditions and for both conditions combined. Results showed that demographic variables, such as age, sex, and/or level of parental education (LPE) affected scores on these outcome measures. Based on these data, demographically corrected norms were established for all outcome measures, per condition and for both conditions combined.

Early chronic low-level Pb exposure alters global exploratory behaviors but does not impair spatial and object memory retrieval in an object-in-place task in pre-adolescent C57BL/6J mice.

The mechanisms by which early chronic low-level lead (Pb) exposure disrupts the developing brain are not yet understood. Rodent models have provided promising results however behavioral tests sensitive to effects at lowest levels of exposure during development are needed. Preadolescent animals (N=52) exposed to low and higher levels of Pb via lactation from birth to PND 28 completed the Object-in-Place Task of visual spatial and visual object memory retrieval (at PND 28). Generalized linear mixed models were used, controlling for sex and litter as a random effect. As compared with controls, global vertical exploratory behavior (rearing) markedly increased during memory retrieval. The findings suggested that early chronic Pb exposure altered the development of critical exploratory functions needed for learning and survival. Behaviors exhibited in novel spatial and novel object zone perimeters suggested that the Object-in-Place task is a valid measure of visual spatial and visual object memory in pre-adolescent C57BL/6J mice. Additional studies are needed to understand how early chronic low-level lead exposure disrupts the trajectory and possible linkages of critical exploratory and perceptual systems during development.

The Effects of Prenatal Alcohol Exposure on Episodic Memory Functioning: A Systematic Review.

OBJECTIVE: This paper systematically reviews the literature on the effects of prenatal alcohol exposure (PAE) on episodic memory. Specifically, the review focuses on recurring questions of whether memory deficits are consistent across memory domains, whether the impairments are consistent across the stages of episodic memory, and whether the impairments are primary episodic memory impairments or secondary to a global performance deficit or a higher order deficit. METHOD: In total, 33 relevant studies were identified through searches on electronic databases. Journal articles were limited to those that included human subjects and that were published in English-language journals. RESULTS: The vast majority of reviewed studies examined memory in school-aged children and adolescents. Twenty-three studies examined verbal memory and 19 studies examined visual-spatial memory. Although all of the reviewed studies examined encoding of new material, only 10 studies examined retention of the learned material over time. Ten studies controlled for IQ, either statistically or with matched controls, when analyzing memory task performance. CONCLUSION: In general, studies show that PAE results in impaired verbal and visual-spatial episodic memory performance in affected individuals and these impairments are unlikely to be secondary to a global impairment. However, impairments on some memory tests are specific to the encoding stage, whereas retention is relatively spared; suggesting that the episodic memory deficit might be influenced, at least in part, by higher order cognitive processes.

Multimodal MRI of the hippocampus in Parkinson's disease with visual hallucinations.

Visual hallucinations carry poor prognosis in Parkinson's disease. Here we tested the hypothesis that the hippocampus and visuospatial memory impairment play a central role in the pathology of PD with visual hallucinations. Multimodal magnetic resonance imaging of the brain was carried out in 12 people with PD and visual hallucinations; 15 PD individuals without hallucinations; and 14 healthy controls. Age, gender, cognitive ability, and education level were matched across the three groups. PD patients were taking dopaminergic medication. Hippocampal volume, shape, mean diffusivity (MD), and functional connectivity within the whole brain were examined. Visuospatial memory was compared between groups, and correlations with hippocampal MD, functional connectivity, and the severity of hallucinations were explored. There were no macrostructural differences across groups, but individuals with hallucinations had higher diffusivity in posterior hippocampus than the other two groups. Visuospatial memory was poorer in both PD groups compared to controls, and was correlated with hallucinations. Finally, hippocampal functional connectivity in the visual cortices was lower in those with hallucinations than other groups, and this correlated with visuospatial memory impairment. In contrast, functional connectivity between the hippocampus and default mode network regions and frontal regions was greater in the PD hallucinators compared to other groups. We suggest that hippocampal pathology, which disrupts visuospatial memory, makes a key contribution to visual hallucinations in PD. These findings may pave the way for future studies of imaging biomarkers to measure treatment response in those with PD who are most at risk of poor outcomes.

Neuropsychological Deterioration Predicts Tumor Progression in a Young Boy With Bithalamic Glioma.

A description is given of the clinical, neuropsychological, and neuroimaging evolution of a 12-year-old boy (CG) who presented with bilateral thalamic astrocytoma (World Health Organization Grade 2). CG underwent an extensive neuropsychological assessment immediately after biopsy prior to any medical therapies and was followed up for 3 years until death. Neuropsychological functioning was thoroughly investigated by means of a detailed battery that included intelligence and cognitive functions. Evolution was characterized by cognitive deterioration that preceded neuroimaging signs of tumor progression. Starting from normal cognitive organization, the child exhibited visuospatial memory deficits and, afterward, diffuse cognitive impairment. The role of neuropsychological assessment in detecting early disease progression is discussed, mainly for rare pathologies whose evolution may be extremely variable.

Executive functioning and visual working memory.

The matter of modality is controversially discussed in the context of working memory (WM). There is evidence that modality-specific processes are accompanied by amodal processes to some extent. We investigated the relationship between executive-functioning tasks and visual WM (VWM) and were especially interested in the issue of amodal processes. Our correlational analyses suggest modality-independent relations of the tasks. We also aimed to quantify to what extent executive functioning is meaningful for VWM performances. We therefore estimated the relationship between executive tasks and VWM performances in a healthy (n = 710) and a clinical traumatic brain injury sample (n = 151) as well as in the combined total sample. The results indicate a substantial relevance of the verbal task for VWM performances in the total and the clinical sample but a low relevance in the healthy sample. These results could support assumptions of resource-depending differences in the relations of executive functioning and VWM but need further validation due to limitations of our study.

Developmental delay in early childhood is associated with visual-constructive skills at school age in a brazilian cohort

We investigated differences in IQ and visual-constructive skills in school-age children evaluated as developmentally delayed or typically developed in early childhood. Sixty-four participants from a Brazilian cohort were evaluated in IQ (Wechsler Abbreviated Scale of Intelligence) and tasks of visual-spatial memory and visual-constructive skills through the Benton Visual Retention Test (BVRT) at school age. Neuropsychomotor development at 4 years of age was measured by Denver II. Developmentally delayed children showed lower IQs, lower scores, and more errors in copy and memory BVRT tasks when compared to typically developed children. Delay in neuropsychomotor development in early childhood may affect the subsequent cognitive development of children. (AU)