The aims are to study personality characteristics of patients with memory complaints and to assess the presence of objective (OMI) versus subjective (SMI) memory impairment, the affective status, as well as potential gender differences. The patients were assessed by means of a neuropsychiatric examination and a neuropsychological test-battery. The Swedish version of the revised NEO Personality Inventory (NEO PI-R) and the Hospital Anxiety and Depression Scale (HADS) were used. The 57 patients (38 women, 19 men, mean age 56.9) differed from the Swedish normative group in three of the five personality factors: neuroticism, extraversion and agreeableness. This was mainly because of the scores of the female patients. Approximately half of the patients had OMI. No differences regarding personality factors or affective status were found between OMI and SMI patients. The female patients scored significantly higher than the male patients on symptoms of anxiety and depression. Neuroticism and symptoms of depression interacted with memory performance and gender. Our findings demonstrate the importance of applying an objective assessment of memory functions and a gender perspective when studying patients with memory complaints. (JINS, 2007, 13, 911–919.)

A meta-analysis was conducted on 25 longitudinal studies involving 901 initially non-demented Parkinson's disease (PD) patients to examine the magnitude of decline across multiple cognitive domains associated with disease progression. Pooled effect sizes reflecting the standardized difference between baseline and follow-up neuropsychological performance were calculated for 8 cognitive domains using a random-effects model. Relatively small effect sizes were found across all cognitive domains (d = .00 − .40). During a mean follow-up interval of 29 months, significant declines were detected in global cognitive ability (d = .40), visuoconstructive skills (d = .32), and memory (d = .29). Age showed a significant relation with decline in global cognitive ability and memory. Lower educational level was associated with greater decline in all cognitive domains. Studies with longer follow-up intervals yielded larger effect sizes for global cognitive ability. In non-demented PD patients, changes in cognitive functions over time appear to be modest. Educational level, age, and length of the follow-up interval are likely to affect the magnitude of decline in several domains. Methodological flaws, such as selection bias and uncontrolled practice effects, may have caused underestimation of the true extent of decline (JINS, 2007, 13, 920–932.)

The physical effects of sickle cell disease (SCD) begin in infancy or early childhood, yet most behavioral studies have focused on school-age children. We evaluated the impact of higher versus lower neurologic risk on language, motor abilities, executive functions, and temperament in toddlers and early preschoolers with SCD. Thirty-nine children with higher risk SCD were compared to 22 children with lower risk SCD. Language and motor abilities were lower in older compared with younger children but were unrelated to sickle cell subgroups. Executive functions, particularly working memory, were poorer in children with higher risk SCD regardless of age. Parent-reported activity level was also lower in children with higher risk. Specific behavioral influences of SCD are evident early in childhood and include working memory decrements. Executive function deficits in SCD can emerge early in life and may be an important context for other areas of cognitive and behavioral development. (JINS, 2007, 13, 933–943.)

This study examined phonemic (letters), semantic (animals) and action verbal fluency cues in twenty-four patients with FRDA, and twenty matched healthy control subjects. The Action Fluency Test (AFT) is a newly-developed verbal fluency cue that consists in asking the subject to rapidly generate verbs. Given the high presence of dysarthria and cognitive slowness in FRDA patients, control tasks were administered in order to dissociate motor/articulatory impairment and cognitive slowness from verbal fluency deficit. Results showed that patients and control subjects performed similarly on the semantic fluency task. In contrast, patients performed significantly poorer on phonemic and action fluency tests. Correlational analyses showed that the deficits cannot be attributed to dysarthria or cognitive slowness. Although executive processes are necessary for initiating and monitoring all verbal fluency tasks, phonemic and action fluency may place a greater burden on strategic processes, given that they require a more unusual type of lexicon search. Thus, the deficits found occur in tasks that require greater executive/prefrontal control. This impairment might be the result of an affectation of cerebellum-prefrontal cortex connections, although the possibility of a primary prefrontal dysfunction remains to be investigated. (JINS, 2007, 13, 944–952.)

Cognitive training improves mental abilities in older adults, but the trainability of persons with memory impairment is unclear. We conducted a subgroup analysis of subjects in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial to examine this issue. ACTIVE enrolled 2802 non-demented, community-dwelling adults aged 65 years and older and randomly assigned them to one of four groups: Memory training, reasoning training, speed-of-processing training, or no-contact control. For this study, participants were defined as memory-impaired if baseline Rey Auditory Verbal Learning Test (AVLT) sum recall score was 1.5 SD or more below predicted AVLT sum recall score from a regression-derived formula using age, education, ethnicity, and vocabulary from all subjects at baseline. Assessments were taken at baseline (BL), post-test, first annual (A1), and second annual (A2) follow-up. One hundred and ninety-three subjects were defined as memory-impaired and 2580 were memory-normal. Training gain as a function memory status (impaired vs. normal) was compared in a mixed effects model. Results indicated that memory-impaired participants failed to benefit from Memory training but did show normal training gains after reasoning and speed training. Memory function appears to mediate response to structured cognitive interventions in older adults. (JINS, 2007, 13, 953–960.)

Patients with severe traumatic brain injury (TBI) often demonstrate impairments in performance monitoring—an evaluative control process that can be measured using the error-negativity/error-related negativity (Ne/ERN) and post-error positivity (Pe). The Ne/ERN and Pe are event-related potential (ERP) components generated following errors, with current theories suggesting the Ne/ERN reflects automatic performance monitoring and the Pe reflects error processing and awareness. To elucidate the electrophysiological mechanisms of performance monitoring deficits following severe TBI, behavioral and ERP measurements were obtained, whereas participants with severe TBI and neurologically-healthy comparison participants performed a modified color-naming version of the Stroop task. Behaviorally, both groups demonstrated robust response-time (RT) and error-rate interference. Participants with TBI exhibited generalized RT slowing; no significant between-groups interactions were present for RTs or error rates. ERP results indicate Ne/ERN amplitude was attenuated in participants with TBI, whereas the pattern of Pe amplitude did not clearly differentiate groups. Findings suggest the Ne/ERN as a potential electrophysiological marker of evaluative control/performance monitoring impairment following TBI. Implications for future research and potential clinical application as well as potential limitations in conducting electrophysiological research in neurologically-impaired populations are discussed. (JINS, 2007, 13, 961–971.)

To date, minimal research has investigated the effect of combining dexamphetamine with standard naming therapy after stroke. The present study used a double-blind, placebo-controlled, multiple baseline, crossover design with two individuals in the chronic stage of stroke recovery. Each individual attended two 4-week blocks of naming therapy (two to three treatment sessions per week). Dexamphetamine (10 mg) was administered at the start of each session during one therapy block, while a placebo was administered during the other therapy block. Therapy progress on treated and untreated items was assessed by a confrontation naming task during and after each therapy block. Both individuals showed greater progress in therapy and maintenance of therapy gains when behavioral treatment was combined with dexamphetamine rather than placebo, although this gain was only statistically significant in one individual. There was no significant improvement on a control task (nonword reading) in either individual. The results provide preliminary evidence that dexamphetamine paired with combined semantic and phonological therapy may be beneficial for the treatment of naming disorders in chronic aphasia. (JINS, 2007, 13, 972–979.)

There are recent reports that alexithymia may be associated with brain dysfunction involving frontal lobes or right hemisphere regions. However, little is known about the relationship between alexithymia and cognitive deficits in Parkinson's disease (PD). The authors investigated the neuropsychological correlates of alexithymia in a population of 70 nondemented PD patients and 70 controls. Alexithymia was screened using the 20-item version of the Toronto Alexithymia Scale (TAS-20). Standardized scales that measure verbal episodic memory, executive functions, abstract reasoning, and visual–spatial and language abilities were adopted. PD patients with alexithymia performed worse than both PD patients without alexithymia and controls with or without alexithymia on tasks requiring visual–spatial processing. Moreover, regression analyses showed that, in PD patients, but not in controls, poor performance on a constructional praxis task predicted high scores on the TAS-20 subscale, which assesses difficulty in identifying emotions. These data evidence an association between alexithymia and visual–spatial processing alterations in PD patients, supporting the view that the right hemisphere could be specifically involved in the modulation of some facets of alexithymia. (JINS, 2007, 13, 980–992.)

All object-related actions are complex. Even the “simplest” of reach to grasp movements requires finely honed coordination of the muscles of the arm, hand, and fingers; is dependent upon exquisitely tuned feedforward and feedback mechanisms for motor control; is honed by learning; and is influenced by such cognitive factors as task goals. In this sense, then, the title of this Symposium, Complex Object-Related Actions, contains a redundancy. It is also true, however, that (as compared with, say, memory, language, executive function, attention, and spatial skills) the study of skilled action has been neglected within the fields of neuropsychology and cognitive neuroscience. One reason for this finding may be that many psychologists and neuroscientists do not view action as “cognitive” (Rosenbaum, 2005). As the work presented here illustrates, there is ample recent evidence suggesting that this view is inaccurate. We retain the word “Complex” in the title of the Symposium to emphasize the cognitive, psychological, and memory-related aspects of action that deserve broader interest. We suspect that the organizational principles and mechanisms that underlie cognition in many other domains will be found to play a role in the action system as well.

We assessed the prediction that object structural cues could benefit the learning of object–action relationships in ideomotor apraxia (IMA). A total of 15 patients with left-hemisphere stroke, 11 of whom exhibited IMA, and 10 healthy subjects were trained to match novel gestures to novel tool pictures that were either High- or Low-Afforded by their associated tools. Learning was assessed with recognition and production tests. Only IMA patients demonstrated better recognition of High- than Low-Afforded gestures, and their recognition of High-Afforded gestures was statistically comparable to the other groups. This finding suggests that apraxics may rely abnormally on object structure when learning to associate novel gestures and tools. Finally, the “affordance benefit” was associated with relative sparing of structures in the dorsal visual processing stream. These data are consistent with the proposal that two routes may mediate skilled action, one specialized for stored information, and the other responsive to object structure, and that deficient gesture learning may be compensated by “bootstrapping” intact dorsal stream coding of action. (JINS, 2007, 13, 997–1008.)

The influence of action knowledge associated with novel objects was investigated using functional magnetic resonance imaging. Participants were trained on complex actions associated with novel objects (“tools”) and had experience manipulating other visually similar novel objects (“shapes”). During scanning, participants viewed, imagined grasping, and imagined using the objects. Based on previous neuroimaging and neuropsychological findings, our primary goal was to examine frontal and parietal regions subserving action representations associated with visual objects, namely the left inferior parietal lobule (IPL), the left ventral premotor cortex (VPM) and the presupplementary motor cortex (pre-SMA). We predicted differences between the tool and shape stimuli, modulated also by task demands. In viewing, we found greater effect sizes in the left VPM and IPL for tools versus shapes. In grasping, there was similar activation with both object types. The largest differences existed in using, in which greater effect sizes were found for tools versus shapes in left IPL and pre-SMA, and marginally in the left VPM. We suggest that representations of tools extend beyond classically defined affordances and recruit processing about both graspability and known action plans in tasks involving visual memory, motor imagery, and motor execution. (JINS, 2007, 13, 1009–1020.)

Past research suggests that the similarity between the objects associated with actions impacts visual action identification and action production. Indeed, people often confuse actions that are visually similar, as well as actions that are associated with visually similar objects. However, because the action errors often involve actions that are visually similar and are associated with visually similar objects, it is difficult to disambiguate between the influences of object similarity and action similarity. In our experiments, healthy participants were asked to learn to associate nonword names and actions with novel objects. Participants were first shown each object and its action and were then asked to visually identify each object. In Experiment 1, participants were then asked to produce the action associated with each object, and in Experiment 2, they were asked to visually identify the action associated with each object. Actions were confused more often when they were associated with similar objects than when they were associated with dissimilar objects. Furthermore, following an object naming error, participants were more likely to produce the action associated with the erroneous name than any other erroneous action. The results suggest that the visual characteristics of the objects influenced action production and action identification. (JINS, 2007, 13, 1021–1034.)

We examined the role of schema knowledge in everyday action by assessing the use of unfamiliar implements by patients with subcortical and frontal lobe damage. Although the patients were relatively good at naming or showing how the unfamiliar implements could be used outside of the task context, the patients omitted using the objects in everyday life tasks more often than control participants—either omitting the action step involving the objects or performing the action using a familiar object that was not normally used for this purpose. The data suggest that knowledge about objects in the context of a task can play a determining role in how objects are used in everyday action. In patients with reduced attentional resources, the task schema can over-ride weak bottom-up cueing of action from the objects, with the result that unfamiliar implements are not used. (JINS, 2007, 13, 1035–1046.)

Informed consent is key to ethical clinical research and treatment, but partially rests on the ability of individual patients or research participants to use disclosed information to make a meaningful choice. Although the construct of decisional capacity emerged from legal and philosophical traditions, several investigators have begun examining the relationship of specific neuropsychological abilities to decisional capacity. This line of research may foster development of better consent procedures, as well as aid in refining the construct of decisional capacity toward a form that better reflects the underlying neurocognitive processes. We conducted a systematic search of the published literature and thereby identified and reviewed 16 published reports of empirical studies that examined the relationship between specific neuropsychological abilities and capacity to consent to research or treatment. Significant relationships between neuropsychological scores and decisional capacity were present across all the reviewed studies. The degree to which specific neuropsychological abilities have particular relevance to decisional capacity remains uncertain, but the existing studies provide a solid basis for a priori hypotheses for future investigations. These ongoing efforts represent an important conceptual and empirical bridge between bioethical, legal, and neuropsychological approaches to understanding meaningful decision-making processes. (JINS, 2007, 13, 1047–1059.)

Individuals with Alzheimer's disease (AD) experience difficulties with socioemotional functioning, and it has been proposed that cognitive disinhibition may be one potential mechanism that contributes to difficulties in this area. To test this possibility, twenty individuals with AD and 20 demographically matched controls were administered self-report measures of depression, emotion regulation and empathy, in addition to a behavioral measure that has proven to be very sensitive to inhibitory failures (the Hayling Sentence Completion Test). Relative to controls AD participants exhibited increased inhibitory failures on the Hayling, and self-reported significantly reduced cognitive empathy, but did not differ with respect to affective empathy, depression or perceived capacity for emotion regulation. Controlling for general cognitive status, in the AD (but not the control) group, reduced cognitive inhibition was associated with lower levels of depression. The theoretical and practical implications of these results are discussed. (JINS, 2007, 13, 1060–1064.)

Difficulties in social communication in individuals with Klinefelter syndrome (XXY chromosomal pattern) have largely been attributed to deficits in left hemisphere-mediated, language functions. This study examined the ability of XXY men to decode emotions from tone of voice, a pragmatic aspect of social communication that may be associated with right hemisphere functioning. A total of 26 XXY men and 20 men from the general population completed tasks involving emotion discrimination in speech, based on verbal content or tone of voice. The XXY group displayed relative difficulties in discriminating emotions in tone of voice, and, to a lesser extend, in verbal content. This finding suggests that the XXY chromosomal pattern may not only be associated with difficulties in semantic aspects of language, but with prosodic aspects, as well. Our findings may contribute to the development of more comprehensive models addressing the role of the X chromosome in normal and abnormal development of social communication. (JINS, 2007, 13, 1065–1070.)

Handbook of Functional Neuroimaging of Cognition, Second Edition. 2006. Roberto Cabeza and Alan Kingstone (Eds.), Cambridge, MA, The MIT Press, 480 pp., $65.00 (HB)

The first edition of the Handbook of Functional Neuroimaging of Cognition, edited by Roberto Cabeza and Alan Kingstone, was a welcome addition to the cognitive neuroscience field when it was published in 2001. There were chapters on the history of neuroimaging and analysis, and all the major cognitive areas that had been studied at the time, written by senior people in their respective areas. That a second edition has appeared so soon after the first is a testament to the rapid growth of the cognitive neuroscience field, which is both gratifying and somewhat daunting to those of us who vainly attempt to keep up with this burgeoning literature. The same authors as in the previous edition write some chapters, but many have been penned by different authors, equally well known in the field, which is also a sign that the field is healthy and growing.

Brain Development: Normal Processes and the Effects of Alcohol and Nicotine. Michael W. Miller (Ed.). 2006. New York: Oxford University Press, 424 pp., $98.50 (HB)

The process of brain development is an essential yet often overlooked area in the neuropsychological literature. The topic has a natural appeal to those who work with children where developmental disorders predominate. However, it is often more difficult for those who work with adults to appreciate the role of developmental aberrations and their contribution to pathological processes that may seem far removed from the early developmental history of our patients. The tendency for some to deemphasize early developmental influences may stem in part from a lack of clarity about how common toxin exposures, such as alcohol and nicotine, alter normal brain development and contribute to changes in cognitive function. Increasingly, evidence of early developmental influences has emerged in a host of epigenetically-based developmental disorders and neuropathological conditions, such as schizophrenia, and these influences are also implicated in theoretical models, such as cognitive reserve.

Social Neuroscience: Integrating Biological and Psychological Explanations of Social Behavior. Eddie Harmon-Jones and Piotr Winkielman (Eds.). 2007. New York: The Guilford Press, 512 pp., $65.00 (HB)

I reviewed this book shortly after reading The Neuroscience of Human Relationships, by Louis Cozolino (2006), hoping that this book, which addresses how our brains exist in relationship to other brains, would be an adequate prerequisite for Social Neuroscience. I had concerns that its focus would be the biology of social psychology proper (rather than the biology of social relationships) for which I would be less qualified and less interested. A quick perusal convinced me that the book was indeed about the biological basis of human social behavior. With that information and a review of a similar title, Social Neuroscience: People Thinking About Thinking People (Fein, 2006), I proceeded.

Minutes from the Thirty-Fifth Annual International Neuropsychological Society Meeting, Portland, Oregon.