In humans, the neural circuitry underlying facial expressions differs, depending on whether facial expressions are spontaneously (i.e., limbic, subcortical) or voluntarily initiated (i.e., frontal cortex). Previous investigators have suggested that the “masked face” of Parkinson's disease involves spontaneous, but not intentional, facial expressions. In contrast, we hypothesized that intentional facial expressions may be slowed (bradykinetic) and involve less movement, in much the same way that other intentional movements are affected by Parkinson's disease. To test this hypothesis, we used sophisticated computer imaging techniques to quantify dynamic facial movement. Relative to controls, Parkinson patients had reduced facial movement (entropy) and were significantly slowed in reaching a peak expression (i.e., bradykinesia). These findings are consistent with the view that the basal ganglia play a role in affecting intentional facial movements. This possibly occurs because of diminished efficiency and/or activation of face representation areas in the frontal cortical regions (i.e., motor, premotor, and supplementary motor area) or because of movement-based suppression secondary to dopaminergic reduction in frontostriatal pathways. Taken together, the characterization of Parkinson's disease as a model system for the neuroanatomic dissociation between voluntary and spontaneous expressions may be unjustified. (JINS, 2006, 12, 765–773.)

Studies of patients with brain damage, as well as studies with normal subjects have revealed that the right hemisphere is important for recognizing emotions expressed by faces and prosody. It is unclear, however, if the knowledge needed to perform recognition of emotional stimuli is organized by modality or by the type of emotion. Thus, the purpose of this study is to assess these alternative a priori hypotheses. The participants of this study were 30 stroke patients with right hemisphere damage (RHD) and 31 normal controls (NC). Subjects were assessed with the Polish adaptation of the Right Hemisphere Language Battery of Bryan and the Facial Affect Recognition Test based on work of Ekman and Friesen. RHD participants were significantly impaired on both emotional tasks. Whereas on the visual-faces task the RHD subjects recognized happiness better than anger or sadness, the reverse dissociation was found in the auditory-prosody test. These results confirm prior studies demonstrating the role of the right hemisphere in understanding facial and prosodic emotional expressions. These results also suggest that the representations needed to recognize these emotional stimuli are organized by modality (prosodic-echoic and facial-eidetic) and that some modality specific features are more impaired than others. (JINS, 2006, 12, 774–781.)

This study assessed whether verbal memory performance indexed by the California Verbal Learning Test (CVLT) can organize and reduce the heterogeneity of schizophrenia. The temporal stability, cognitive and clinical validity of: (a) a putatively cortical-subcortical-normative typology derived from dementia patients' scores on the CVLT and (b) a memory performance dichotomy based on a psychometric criterion and 1 CVLT summary score were evaluated. These memory subtypes were examined in 102 schizophrenia patients, 55 of whom were assessed again 3 years later. The results indicate that both methods yield potentially valuable illness distinctions on a cross-sectional basis, but fail to show truly trait-like properties. Furthermore, the evidence favors the validity of a parsimonious dichotomy over a more complex dementia-based typology. (JINS, 2006, 12, 782–791.)

The relationship of psychological and cognitive factors in the development of the postconcussion syndrome (PCS) following mild uncomplicated traumatic brain injury (mTBI) has received little study. This may be because of the widely held belief that neurological factors are the cause of early PCS symptoms, whereas psychological factors are responsible for enduring symptoms. To further understand these relationships, the association between PCS and neuropsychological and psychological outcome was investigated in 122 general trauma patients, many of whom had orthopedic injuries, around 5 days following mTBI. Apart from verbal fluency, participants with a PCS did not differ in their performances on neuropsychological measures compared to those without a PCS. Individuals with a PCS reported significantly more psychological symptoms. Large effect sizes present on the psychological measures showed that the difference between participants with a PCS and without was greater on psychological than on neuropsychological measures. Analyses also revealed a relationship between opioid analgesia and depression, anxiety and stress, and opioids and reduced learning. The results suggest that psychological factors are present much earlier than has previously been considered in the development of the PCS. (JINS, 2006, 12, 792–801.)

We examined the long-term retention of a learned automatic cognitive process in 17 severe TBI participants and 10 controls. Participants had initially received extensive consistent-mapping (CM) training (i.e., 3600 trials) in a semantic category visual search task (Schmitter-Edgecombe & Beglinger, 2001). Following CM training, TBI and control groups demonstrated dramatic performance improvements and the development of an automatic attention response (AAR), indicating task-specific and stimulus-specific skill learning. After a 5- or 10-month retention interval, participants in this study performed a New CM task and the originally trained CM task to assess for retention of task-specific and stimulus-specific visual search skills, respectively. No significant group differences were found in the level of retention for either skill type, indicating that individuals with severe TBI were able to retain the learned skills over a long-term retention interval at a level comparable to controls. Exploratory analyses revealed that TBI participants who returned at the 5-month retention interval showed nearly complete skill retention, and greater skill retention than TBI participants who returned at the 10-month interval, suggesting that “booster” or retraining sessions may be needed when a skill is not continuously in use. (JINS, 2006, 12, 802–811.)

Stroke is the leading health care problem requiring rehabilitation services today (CDC, 2001; Lee et al., 1996) with the worldwide incidence estimated to be between 300 and 500 per 100,000 people (Sudlow & Warlow, 1997). In most recent years, the rates of mortality are decreasing, resulting in a significant increase in the number of survivors living with the disabilities/handicaps associated with stroke (Thorvaldsen et al., 1997). Not only is stroke a common health problem, but the cognitive disorders that result are common as well (Mayo, 1993; Paolucci et al., 1996).This article is based in part on a Presidential Address by the first author to the Annual meeting of the International Neuropsychological Society in Honolulu, Hawaii in February, 2002.

Individuals with left-hemisphere damage often have concomitant impairment of spoken and written language. Whereas some treatment studies have shown that reading paired with spoken naming can benefit both language modalities, little systematic research has been directed toward the treatment of spelling combined with spoken naming. The purpose of this study was to examine the therapeutic effect of pairing a lexical spelling treatment referred to as Copy and Recall Treatment (CART) with verbal repetition of target words. This approach (CART + Repetition) was compared with treatment using verbal repetition without the inclusion of orthographic training (Repetition Only). Two individuals with moderate aphasia and severe impairment of spelling participated in the study using a multiple baseline design across stimulus sets and treatment conditions. Both participants improved spelling of targeted words as well as spoken naming of those items, but improvement in spoken naming was marked for one individual in the CART + Repetition condition, while the other participant made smaller gains in spoken than written naming irrespective of treatment condition. Consideration of the participant profiles suggested that CART + Repetition provides greater benefit when there is some residual phonological ability and the treatment serves to stimulate links between orthography and phonology. (JINS, 2006, 12, 816–827.)

The complex process of cortical reorganization of language-related brain regions during recovery from aphasia and the effects of therapeutic interventions on brain systems are poorly understood. We studied two patients with chronic aphasia and compared their functional neuroanatomical responses to a younger control group on two tasks, an oral-reading task involving overt speech and a “passive” audiovisual story-comprehension task. Following identical therapy, we re-examined behavioral (language) and functional neuroanatomical changes using the same functional magnetic resonance imaging (fMRI) tasks. We hypothesized that better recovery would be associated with brain activation patterns more closely resembling healthy controls, whereas positive responses to language treatment would be associated with increased activity in undamaged left perisylvian areas and/or right-hemisphere areas homologous to the damaged regions. For the participant with a frontal lesion who was most responsive to therapy, brain activation increased in the right hemisphere during oral-reading, but decreased bilaterally in most regions on story-comprehension. The other participant with a temporal–parietal lesion showed decreased activation, particularly in the right hemisphere, during oral-reading but increased activation bilaterally on story-comprehension. Results highlight individual variability following language therapy, with brain activation changes depending on lesion site and size, language skill, type of intervention, and the nature of the fMRI task. (JINS, 2006, 12, 828–842.)

This investigation reports the results of a pilot study concerning the application of principles of use-dependent learning developed in the motor rehabilitation literature as Constraint Induced Therapy to language rehabilitation in a group of individuals with chronic aphasia. We compared treatment that required forced use of the language modality, Constraint Induced Language Therapy, (CILT) to treatment allowing all modes of communication. Both treatments were administrated intensively in a massed practice paradigm, using the same therapeutic stimuli and tasks. Results suggest that whereas both interventions yielded positive outcomes, CILT participants showed more consistent improvement on standard aphasia measures and clinician judgments of narrative discourse. These findings suggest that CILT intervention may be a viable approach to aphasia rehabilitation. (JINS, 2006, 12, 843–852.)

Naming of two semantically impaired aphasic patients was treated with the contextual repetition priming technique, which involves repeated repetition of names of pictures that are related semantically, phonologically, or are unrelated. Our previous studies using this technique have suggested that patients with impaired access to lexical-semantic representations benefit in the short-term from this treatment technique, but show no long-term improvement in naming. In contrast, patients with good access to semantics show short- and long-term benefits from this treatment. Here we report two studies of treatment for two individuals with aphasia affecting access to lexical semantics and anomia but spared access to input and output phonology and spared conceptual semantics. We predicted that they would show short-term facilitation from the contextual priming, but no long-term improvements in naming. The results confirmed the prediction. An account of this pattern is offered within the framework of an interactive activation model of word retrieval. Additionally, we discuss alternative techniques for addressing naming deficits when access to semantics is impaired. (JINS, 2006, 12, 853–866.)

Links between verbs and gesture knowledge suggest that verb retrieval may be particularly amenable to gesture+verbal training (GVT) in aphasia compared to noun retrieval. This study examines effects of GVT for noun and verb retrieval in nine individuals with aphasia subsequent to left hemisphere stroke. Participants presented an array of noun and verb retrieval deficits, including impairments of semantic and/or phonologic processing. In a single-participant experimental design, we investigated effects of GVT for noun and verb retrieval in two counterbalanced treatment phases. Effects were evaluated in spoken naming and gesture production to pictured objects and actions. Spoken naming improvements associated with large effect sizes were noted for trained nouns (5/9) and verbs (5/9); no improvements were evident for untrained words. Gesture production improved for trained nouns (8/9) and verbs (6/9), and for untrained nouns (2/9) and verbs (2/9). No significant differences were evident between nouns and verbs in spoken naming or gesture production. Improvements were evident across individuals with varied sources of word retrieval impairments. GVT has the potential to improve communication by increasing spoken word retrieval of trained nouns and verbs and by promoting use of gesture as a means to communicate when word retrieval fails. (JINS, 2006, 12, 867–882.)

Acquired disorders of face processing have long played an important role in our theorizing about how the brain encodes and matches faces to memory, because functional deficits in some, but not other aspects of face processing, reveal whether different processes operate independently. One striking dissociation is between the processing of face identity and facial emotion, which suggests that these two forms of information are, to some extent, processed independently. However, such dissociations can be over-interpreted; though identity and emotion processing can dissociate, the two processes could also rely on many common operations. To understand how facial identity and emotion are computed, we need to assess in more detail the nature of their breakdown in patients.

Prosopagnosia is currently viewed within the constraints of two competing theories of face recognition, one highlighting the analysis of features, the other focusing on configural processing of the whole face. This study investigated the role of feature analysis versus whole face configural processing in the recognition of facial expression. A prosopagnosic patient, SC made expression decisions from whole and incomplete (eyes-only and mouth-only) faces where features had been obscured. SC was impaired at recognizing some (e.g., anger, sadness, and fear), but not all (e.g., happiness) emotional expressions from the whole face. Analyses of his performance on incomplete faces indicated that his recognition of some expressions actually improved relative to his performance on the whole face condition. We argue that in SC interference from damaged configural processes seem to override an intact ability to utilize part-based or local feature cues. (JINS, 2006, 12, 884–895.)

Category and letter fluency tasks have been used to demonstrate psychological and neurological dissociations between semantic and phonological aspects of word retrieval. Some previous neuroimaging and lesion studies have suggested that category fluency (semantic-based word retrieval) is mediated primarily by temporal cortex, while letter fluency (letter-based word retrieval) is mediated primarily by frontal cortex. Other studies have suggested that both letter and category fluency are mediated by frontal cortex. We tested these hypotheses using voxel-based lesion symptom mapping (VLSM) in a group of 48 left-hemisphere stroke patients. VLSM maps revealed that category and letter fluency deficits correlate with lesions in temporal and frontal cortices, respectively. Other regions, including parietal cortex, were significantly implicated in both tasks. Our findings are therefore consistent with the hypothesis that temporal cortex subserves word retrieval constrained by semantics, whereas frontal regions are more critical for strategic word retrieval constrained by phonology. (JINS, 2006, 12, 896–900.)

Background: Despite its inhibitory control requirements, antisaccade deficits have been consistently associated with working memory impairments in schizophrenia. We investigated whether variance in antisaccade performance could be better accounted for in terms of a specific inhibitory function. Method: We assessed 48 clinically stable out-patients with schizophrenia on an antisaccade task, as well as on measures of spatial and verbal working memory, sustained selective attention, and a simple motoric go/no-go measure of response inhibition. Results: In a stepwise multiple regression analysis, go/no-go task performance accounted for a considerably greater percentage of variance in antisaccade performance (25.3%) than either working memory (8.4%) or sustained selective attention task (9.1%). Discussion: We conclude that antisaccade deficits in schizophrenia appear to be better understood in terms of a specific deficit of inhibitory control than in terms of more general difficulties with context maintenance or goal neglect. (JINS, 2006, 12, 901–906.)

Pathological Gambling is an impulse control disorder. Impulsivity has been investigated separately by neuropsychological tests and self-report scales. Although some studies have tried to correlate these approaches, their interaction has not been sufficiently explored among pathological gamblers (PG). In this study, we have compared 214 PG (162 with comorbidity and 52 with no comorbidity) to 82 healthy volunteers regarding the reaction time and number of errors at Go/No-go tasks, and scores on the Barratt Impulsiveness Scale (BIS). PG have committed more errors at the Go/No-go tasks and presented higher scores on the self-report scale. The neuropsychological tests and BIS composed a multinomial logistic model that discriminated PG from non-gamblers better than models having one or another type of measure. Impulsivity seems to be a multi-dimensional phenomenon, and PG a heterogeneous population in which different types of impulsivity are present. (JINS, 2006, 12, 907–912.)

The Amnesias: A Clinical Textbook of Memory Disorders, by Andrew C. Papanicolaou. 2005. New York: Oxford University Press, 336 pp., $57.50 (HB).

Memory is one of the best-studied complex cognitive functions described in the neuropsychological literature. Excellent textbooks and research articles about memory and the brain are, and continue to be, published. Yet, it is difficult to integrate clinical and applied features of memory disorders with basic science data. This may be due to our uncertainty about whether a damaged brain functions like a healthy brain and whether results about cerebral functioning and memory processes for a healthy individual can be applied equally well to someone who has incurred brain damage. Brain circuitry is altered in the presence of brain injury, including the mechanisms of remembering and forgetting. Basic clinical studies of normal memory teach us what is “not” normal but we have learned far less about “how” the brain really functions in the presence of amnesia.

A Compendium of Neuropsychological Tests, Third Edition: Administration, Norms, and Commentary, by Esther Strauss, Elisabeth M.S. Sherman, and Otfried Spreen. 2006. New York: Oxford University Press, 1216 pp., $99.00 (HB).

Many regard A Compendium of Neuropsychological Tests as an essential reference text. Principally valued for its test reviews, normative data, administration instructions, and commentary, its reviews of cognitive domains have also provided a useful overview of the field of neuropsychology. Published eight years after the second edition, one might expect the Third Edition to feature revised entries for updated tests, new entries for recently published tests, pruning of tests that are no longer in general use, and other minor revisions where appropriate. In fact, the new edition of the Compendium delivers dramatically more. As stated in the preface, the goal for this edition was to create a user-friendly reference work that covered all the relevant details of the most frequently used neuropsychological tests, and to provide a general overview of issues “germane to neuropsychological assessment.” In short: To help you “know your tools” and to function as a guidebook to the practice of neuropsychology. These goals are surely met—beyond all expectations.

A Casebook of Ethical Challenges in Neuropsychology. Shane S. Bush (Ed.). 2005. New York: Psychology Press. 300 pp., $87.50 (HB).

The publication of Ethical Principles of Psychologists and Code of Conduct by the American Psychological Association (2002) became an impetus for A Casebook of Ethical Challenges in Neuropsychology, edited by Shane Bush. Dr. Bush was also senior co-editor of Ethical Issues in Neuropsychology (Bush & Drexler, 2002), a volume that was specifically intended to aid neuropsychologists who were struggling with ambiguities related to the general guidelines in the APA 1992 Ethics Code. Both volumes are part of the Taylor and Francis series entitled Studies on Neuropsychology, Development, and Cognition. In the current volume's Foreward, Richard Naugle acknowledges how difficult it can be to obtain an overview of the ethics code and emphasizes how important it is that psychologists both understand the code and provide reasoned responses based on its standards in order to engage in ethical practice. His endorsement of this volume as a means to that end is not misguided.

Recent and relevant.