Inhibition of return is a bias in attention that reduces the likelihood of returning attention to previously viewed locations. This attention bias develops during the first 6 months of life and is putatively mediated by midbrain structures. The present study evaluated the effects of perinatal lesions on the development of inhibition of return. Thirty-three children with perinatal injury resulting in spastic diplegic cerebral palsy were grouped based on magnetic resonance exams. Children with anterior (n = 5), posterior (n = 12), diffuse (n = 8), or no apparent (n = 8) lesions were compared with a group of age-matched children without neurologic injury (n = 39) on an orienting task designed to elicit inhibition of return. Short-delay trials demonstrated grossly intact facilitation of attention for all groups. Long-delay trials that produced inhibition of return in the control and posterior injury groups indicated a disruption of inhibition of return in the groups with anterior and diffuse lesions. The findings are consistent with previous reports that anterior regions are important for the developing attention system, and that bilateral injury can result in unilateral disruption of visual attention. (JINS, 2001, 7, 275–284.)

Cognitive impairments are among the most frequently reported and least investigated components of the chronic fatigue syndrome (CFS). As part of a multifaceted study of the CFS, the present study investigated the cognitive functioning of chronic fatigue patients. The performance of 20 CFS patients was compared to that of controls (N = 20) on 4 tests of working memory (WM). Digit Span Forward was used to assess the storage capacity of WM. Multiple aspects of central executive functioning were assessed using several standard measures: Digit Span Backward, and Trails A and Trails B. More recently developed measures of WM were used to assess control of processing under temporal demands (working memory task) and resistance to interference (a sustained attention task). Deficits were restricted to more demanding tasks, requiring resistance to interference and efficient switching between processing routines. The overall results clearly implicate deficits in the control aspects of central executive function in CFS. (JINS, 2001, 7, 285–293.)

Studies examining implicit memory performance in Alzheimer's disease (AD) have yielded inconsistent findings, with these patients demonstrating impaired performance within some priming studies and intact performance within others. The present study examined the role of task sensitivity in detecting impaired priming in memory-impaired patients. Twelve healthy older adults and 12 AD patients were administered a picture fragment identification test. Task sensitivity was increased by employing stimulus cues expected to produce larger and more variable priming effects than obtained in previous studies. A simple comparison of priming scores revealed that the AD patients demonstrated significantly impaired priming relative to normal control participants. However, further analysis of priming in relation to certain stimulus characteristics revealed that AD patients often demonstrated impaired priming when overall priming effects were large but relatively intact priming when priming effects were small. These findings suggest that the prevention of ceiling effects in control participants may aid in the detection of impaired priming in patient populations. (JINS, 2001, 7, 294–301.)

Previous research had demonstrated diminished interhemispheric Stroop effects in individuals with agenesis of the corpus callosum (ACC), suggesting an important role for the callosum in interhemispheric color-word and color-patch interactions. However, this outcome rested on the results of only 1 ACC participant, who had normal intelligence and a minimum of other neuropathology. In the research reported herein, the role of the corpus callosum in interhemispheric Stroop interference and facilitation was investigated in 9 individuals with complete or partial ACC and normal intelligence, and in non-ACC controls. Congruent, incongruent, or neutral stimulus pairs were presented either unilaterally (color-patch and color-word in the same visual field) or bilaterally (color-patch and color-word in different visual fields). Both unilateral and bilateral (interhemispheric) Stroop interference were found for both ACC and non-ACC groups, with no significant difference in magnitude, indicating that extracallosal pathways are sufficient for mediating this phenomenon. It is suggested that the anterior commissure is a more likely candidate for the interhemispheric transmission of the semantic information resulting in Stroop interference. (JINS, 2001, 7, 302–311.)

Previous studies conducted by our group have provided evidence for age-related reductions in cortical thickness in dorsal frontal and parietal regions between childhood and adulthood, and gray matter volume increases of mesial temporal and anterior diencephalic structures. The purpose of this study was to describe neurobehavioral correlates of these brain maturational changes using morphometric analyses of brain magnetic resonance images (MRI) and two tests of cognitive abilities. Participants were 35 normal children roughly stratified by age (7 to 16 years) and sex (20 boys and 15 girls) and frontal and mesial temporal regions were anatomically defined in each subjects' MRI data. The California Verbal Learning Test–Children's Version and the Rey-Osterrieth Complex Figure test were used as measures of verbal and visuospatial memory and organizational abilities. Analyses designed to show regionally specific relationships between the brain and behavioral measures revealed interesting results. Specifically, frontal lobe gray matter thinning was more strongly predictive of delayed verbal memory functioning than was the mesial temporal lobe gray matter volume, and this relationship did not appear to be mediated by factors indexed in chronological age. Similar, but less regionally specific relationships were observed for measures of visuospatial memory abilities and frontal lobe maturation. Functional imaging studies in the literature consistently report activation in frontal regions in adults during retrieval tasks. The relationship between frontal lobe maturation and delayed recall observed here may be reflective of the children's development towards the more adult-like frontal lobe function revealed in the functional imaging studies. (JINS, 2001, 7, 312–322.)

The present study explored the explanatory power of Mittenberg's “expectation as etiology” theory for the persistence of postconcussion syndrome (PCS) complaints. One hundred forty-one participants completed a PCS symptom checklist under 2 conditions. Normal controls, healthy athletes and depressed individuals reported current symptoms and symptoms expected following a hypothetical mild head injury. Head-injured athletes, chronic headache sufferers, and a 2nd sample of normal controls reported current symptoms and retrospective symptoms (prior to their injury/illness or from some point in the past). Depressed individuals reported more current symptoms than normal controls and healthy athletes, demonstrating that “PCS” symptoms are not specific to PCS. All groups expected more symptoms following mild head injury than currently experienced, supporting the idea that individuals expect negative consequences following head injury. However, healthy athletes expected fewer symptoms than normals or depressed individuals, possibly due to preexisting expectations for speedy recovery. Both head-injured athletes and headache sufferers reported more current symptoms than the past, but not at a rate lower than baseline of normal controls. Results suggest that the “expectation as etiology” hypothesis may be too specific, and that, following any negative event, people may attribute all symptoms to that negative event (the “good old days” hypothesis). (JINS, 2001, 7, 323–333.)

Patients with left spatial neglect following right hemisphere damage may show anomalies in ipsilesional-limb movements directed to targets on their affected side, in addition to their characteristic perceptual deficits. In this study we examined the extent to which visually guided movements made by neglect patients are susceptible to interference from concurrent visual distractors on the contralesional or ipsilesional side of a designated target. Eleven right hemisphere patients with visual neglect, plus 11 matched healthy controls, performed a double-step movement task upon a digitizing tablet, using their ipsilesional hand to respond. On each double-step trial the first component of the movement was cued to a common central target, whereas the second component was cued unpredictably to a target on either the contralesional or ipsilesional side. On separate trials lateral targets either appeared alone or together with a concurrent distractor in an homologous location in the opposite hemispace. In addition to being significantly slower and more error prone than controls, neglect patients also exhibited a number of interference effects from ipsilesional distractors. They often failed to move to left targets in the presence of a right-sided distractor, or else they moved to the distractor itself rather than to a contralesional target. The initial accelerative phase of their movements to contralesional targets tended to be interrupted prematurely, and they spent significantly more time in the terminal guidance phase of movements to contralesional targets in the presence of an ipsilesional distractor. In contrast, contralesional distractors had little effect on patients' movements to ipsilesional targets. We conclude that right hemisphere damage induces a competitive bias that favors actions to ipsilesional targets. This bias affects multiple stages of processing within the visuomotor system, from initial programming through to the final stages of terminal guidance. (JINS, 2001, 7, 334–343)

Patients with schizophrenia have Wisconsin Card Sorting Test (WCST) deficits, which are commonly interpreted as reflecting frontal cortex-based executive dysfunction. One means of assessing the refractoriness of frontal-executive impairment is to utilize a training or modification strategy to improve WCST performance. In this study, 73 patients with schizophrenia were assigned to 1 of 2 groups. Group 1 received the standard WCST instructions for 64 cards (Condition 1). For the second 64-card deck, the patients were asked to verbalize the reason that they placed the card where they did after each sort (Condition 2). Group 2 received this modified instruction 1st (Condition 1) and then the standard instructions for the second deck (Condition 2). A group of normal comparison participants was also tested using standard instructions alone. Group 2 committed significantly fewer perseverative responses than did Group 1. Furthermore, there was no significant difference between Group 2 (Condition 1) and the normal participants. Group 1's performance improved when patients were exposed to the modified instructions (Condition 2). Additionally, poor premorbid factors and disorganized symptoms were associated with decreased benefit from the modified instructions across both groups. Cumulatively, these data suggest that a simple instruction may enhance executive function and impact WCST performance in patients with schizophrenia. (JINS, 2001, 7, 344–352.)

The effects of mesial temporal (MT) and cerebellar hypometabolism were studied using measures of verbal, visual and motor skill learning. Twelve patients with refractory temporal lobe epilepsy who showed asymmetrical mesial temporal lobe hypometabolism on [18F] fluoro-2-deoxy-glucose positron emission tomography (FDG-PET) were given tests involving 4 consecutive learning trials and a 30-min delayed recall trial. Delayed recognition was also assessed for the words and designs, and skill transfer was evaluated for mirror drawing. Compared to 9 normal control participants, patients with more marked MT hypometabolism on the left had impaired delayed recall of words and patients with more marked MT hypometabolism on the right showed impaired learning of novel designs, but normal retention over delay. Patients were not impaired in their mirror-drawing performance. The findings for MT hypometabolism correspond well to those obtained in other studies where patients have been classified on the basis of side of hippocampal atrophy or temporal lobe excision. (JINS, 2001, 7, 353–362.)

The Paced Auditory Serial Addition Test (PASAT) is a commonly used procedure that combines elements of both a working memory task and a test of information processing speed. Patients with multiple sclerosis (MS) have consistently been found to be impaired on this test and it has been recommended as a core outcome measure in clinical trials. The standard score for this task is the number of correct responses at each stimulus presentation rate but a concern has been raised that subjects may ignore some test items in order to chunk the information into manageable portions and avoid performing several cognitive tasks simultaneously. To account for this strategy, one can examine the proportion of correct responses that are consecutive (termed dyads), since such responses require that the task be performed according to the instructions. We compared a group of 35 mildly to moderately disabled MS patients and matched healthy controls on the PASAT. The MS patients made significantly fewer correct responses at the 2 slowest presentation rates (2.4, 2.0 s/digit) while their scores at faster rates (1.6, 1.2 s/digit) did not discriminate them from controls as well. Nevertheless, the MS patients' percentage of dyads was significantly lower than that of the control sample across all stimulus presentation rates. While our study supports the use of the PASAT as a test that distinguishes MS patients from healthy individuals, our results also illustrate problems that lie in the interpretation of this difference in performance. It appears that a chunking strategy may be common in the PASAT, particularly as task demands increase, and that this may mask actual performance differences. If so, the total correct response score alone is limited as a measure of working memory and information processing speed. More detailed analyses of PASAT performance, coupled with other measures of information processing, may help clarify the underlying cognitive deficits of MS patients. (JINS, 2001, 7, 363–372.)

This study evaluated the early cognitive and neurobehavioral outcomes of older adults with mild versus moderate traumatic brain injury (TBI). Thirty-five patients who were age 50 years and older and sustained mild or moderate TBI were prospectively recruited from acute care hospitals. Patients were administered cognitive and neurobehavioral measures up to 2 months post-injury. Demographically comparable control participants received the same measures. Patients and controls did not have previous histories of substance abuse, neuropsychiatric disturbance, dementia, or neurologic illness. Moderate TBI patients performed significantly poorer than mild TBI patients and controls on most cognitive measures, whereas the mild patients performed comparably to controls. In contrast, both mild and moderate patients exhibited significantly greater depression and anxiety/somatic concern than controls. The results indicate that the classification of TBI as mild versus moderate is prognostically meaningful as applied to older adults. The findings extend previous investigations in young adults by demonstrating a relatively good cognitive outcome on objective measures, but subjective complaints after a single, uncomplicated mild TBI in older persons. (JINS, 2001, 7, 373–383.)

This study examined the relationships between regional cortical and hippocampal brain volumes and components of remote memory (recall, recognition, sequencing, and photo naming of presidential candidates) in 13 individuals with Alzheimer's disease (AD). Recognition and sequencing of remote memory for public figures were associated with regional cortical volumes. Specifically, lower recognition and sequencing scores were associated with smaller parietal–occipital cortical volumes; poorer sequencing was also associated with smaller prefrontal cortical volumes. By contrast, poorer anterograde but not remote memory scores were correlated with smaller hippocampal volumes. Within the constraints of the brain regions measured, these findings highlight the importance of the posterior cortical areas for selective remote memory processes and provide support for the dissociation between cortically mediated remote memory and hippocampally mediated anterograde memory. (JINS, 2001, 7, 384–390.)

Various factors influence the degree of leftward error (pseudoneglect) that typifies the performance of normal individuals in line bisection tasks. This experiment reveals that the eye through which stimuli are viewed also exerts a modulating influence on spatial attention, as indexed by significant alterations in the magnitude of pseudoneglect. Using a forced-choice tachistoscopic line bisection protocol, 24 participants (12 male; 12 female) bisected horizontally oriented lines (22.6° w × 0.39° h) presented to central vision in 3 conditions: left uniocular viewing (L), right uniocular viewing (R), and binocular viewing (B). Perceived line midpoint, a measure of bisection accuracy, deviated significantly leftward of veridical ( p < .05) in all viewing conditions, confirming a tonic asymmetry of visuospatial attention in normal young observers. In addition, a significant influence of viewing condition was found (p < .05) where pseudoneglect was greatest in the L condition, followed by the B and R conditions, respectively. Analysis of the slopes of the psychometric functions revealed significantly greater bisection precision in the binocular versus uniocular viewing conditions (p < .05). The results are interpreted to suggest that phasic effects on spatial attention can be produced by uniocular viewing via asymmetric retinotectal projections. The results are consistent with activation–orientation theories of attentional asymmetry. (JINS, 2001, 7, 391–395.)

This handbook is an extensive reference source for clinical neuropsychology. It emerged from a 1988 Italian text and has mostly Italian contributors. The book is well organized and well written. The chapters include both theoretical thinking about and anatomic correlates of neuropsychological disorders in addition to their clinical features. This reviewer particularly liked the numerous theoretical discussions. Animal or cognitive experiments generally are not discussed. The topics cover current thinking in most areas and it is exceptionally well referenced with over 5000 citations.

Today's neuropsychological practitioners have literally hundreds of assessment instruments in their toolbox, and every assessment entails decisions about which tests to use. In addition to practicality and relevance, a critical ingredient in the decision process concerns the availability of appropriate normative data on which to base clinical interpretation. The book by Mitrushina, Boone, and D'Elia goes a long way in making such valuable data readily available and in critically analyzing the current state of the art.

This volume is part of the series Human Brain Function: Assessment and Rehabilitation and aims to present information regarding how brain function is assessed with neuropsychological instruments. In general, this text is designed to cover assessment from the perspective of both behavioral neurologists and neuropsychologists. The book is divided into three sections: “Developmental Considerations,” “Clinical Considerations,” and “Specialized Assessment.”

Howard's edited volume does not reach the full challenge of its title in containing “everything you need to know about old age psychiatry,” but the information it does contain is well presented and among the important things for geriatric mental health professionals (including neuropsychologists) to know. The book consists of 19 chapters divided into three sections.

This is a very good book, perhaps even an excellent book. Professor Mackintosh is, interestingly, a well respected experimental psychologist who practices in the field of animal learning. His text, The Psychology of Animal Learning, is somewhat of a classic in the field. Thus, one wonders why Professor Mackintosh would take on the behemoth of the IQ ideology given his background. Indeed, the study of human intelligence is a subspecialty of psychology in its own right. I suspect Professor Mackintosh's motivation lies in the intellectual and academic challenge of this pursuit, and his resultant product reflects a true scholarly effort.