To characterize the developmental trajectory for expressive language representation and to test competing explanations for the relative neuroplasticity of language in childhood, we studied 28 healthy children and adolescents (aged 5–19 years) participating in a covert verb generation task in magnetoencephalography. Lateralization of neuromagnetic responses in the frontal lobe was quantified using a bootstrap statistical thresholding procedure for differential beamformer analyses. We observed a significant positive correlation between left hemisphere lateralization and age. Findings suggest that adult-typical left hemisphere lateralization emerges from an early bilateral language network, which may explain the pediatric advantage for interhemispheric plasticity of language. (JINS, 2011, 17, 896–904)

Objectives: A notable minority of children will experience persistent post-concussive symptoms (PCS) following mild traumatic brain injury (mTBI), likely maintained by a combination of injury and non-injury related factors. Adopting a prospective longitudinal design, this study aimed to investigate the relative influence of child, family, and injury factors on both acute and persistent PCS in young children. Methods: Participants were 101 children aged 2–12 who presented to an Emergency Department, with either mTBI or minor bodily trauma (control). PCS were assessed at time of injury, 1 week, and 1, 2, and 3 months post-injury. Predictors included injury and demographic variables, premorbid child behavior, sleep hygiene, and parental stress. Random effects ordinal logistic regression models were used to analyze the relative influence of these predictors on PCS at early (acute – 1 week) and late (1–3 month) post-injury phases. Results: Presence of mTBI was a stronger predictor of PCS in the early [odds ratio (OR)=18.2] compared with late (OR=7.3) post-injury phase. Older age at injury and pre-existing learning difficulties were significant predictors of PCS beyond 1 month post-injury. Family factors, including higher levels of parental stress, higher socio-economic status, and being of Anglo-Saxon descent, consistently predicted greater PCS. Conclusions: Injury characteristics were significantly associated with PCS for 3 months following mTBI but the association weakened over time. On the other hand, pre-existing child and family factors displayed an increasingly strong association with PCS over time. Follow-up for these “at-risk” children which also addresses family stress may minimize longer-term complications. (JINS, 2016, 22, 793–803)

Facial emotion recognition deficits have been widely investigated in individuals with schizophrenia; however, it remains unclear whether these deficits reflect a trait-like vulnerability to schizophrenia pathology present in individuals at risk for the disorder. Although some studies have investigated emotion recognition in this population, findings have been mixed. The current study uses a well-validated emotion recognition task, a relatively large sample, and examines the relationship between emotion recognition, symptoms, and overall life quality. Eighty-nine individuals with psychometrically defined schizotypy and 27 controls completed the Schizotypal Personality Questionnaire, Penn Emotion Recognition Test, and a brief version of Lehman’s Quality of Life Interview. In addition to labeling facial emotions, participants rated the valence of faces using a Likert rating scale. Individuals with schizotypy were significantly less accurate than controls when labeling emotional faces, particularly neutral faces. Within the schizotypy sample, both disorganization symptoms and lower quality of life were associated with a bias toward perceiving facial expressions as more negative. Our results support previous research suggesting that poor emotion recognition is associated with vulnerability to psychosis. Although emotion recognition appears unrelated to symptoms, it probably operates by means of different processes in those with particular types of symptoms. (JINS, 2010, 16, 474–483.)

This study tests the hypothesis that retrieval of object and action names declines at different rates with age. Uncued and cued performance on the Boston Naming Test (BNT) and the Action Naming Test (ANT) were examined for 171 individuals from 50 to 88 years old. To control for differences in item difficulty, a subset of items from each of the two tests was selected for which uncued performance was equivalent in individuals in their 50s. With this matched set of items, differences in action and object naming were tested in the 60s and 70+ age groups. Although age-related decline in name retrieval was observed for both the BNT and the ANT subsets, no differences between object and action retrieval were found. Our results, thus, do not confirm previous studies reporting that object names and action names are differentially retrieved with aging. We discuss these new findings in relation to evidence of dissociations in object and action naming in brain-damaged individuals. (JINS, 2002, 8, 764–770.)

Within the last decade, various applications of two-way audio-visual telecommunication have been implemented in the Norwegian health care system to facilitate the delivery of medical services to patients located in rural areas away from the hospitals. This technology may also be useful to extend neuropsychological services to underserved areas and thereby reduce the patients' travel time and costs. In the current study, a total of 12 visual, verbal and performance tests were administered face-to-face and via videophones to 32 volunteer participants to examine the consistency and stability of test-scores when delivered via different formats. The obtained reliability coefficients ranged from .37 to .86 with a median value of .74. When testing for mean differences, the measures on verbal learning (WMS–Logical Memory I) and auditory attention (Seashore Rhythm Test) differed significantly due to administration format (t = 2.34, p = .024 and t = 2.37, p = .025, respectively). The findings imply that administration format does not appear to affect the reliability of measurement but neuropsychological test performance is significantly higher for the measures of attention and memory when delivered via videophone. Additional research on these cognitive domains is required, and if the observed differences due to testing format persist, separate normative data via telecommunication will be required before assessments are carried out. Also, since only normal participants were included in this study, the findings may have external validity for normal populations, but similar controlled trials with patients need to be completed before remote assessments can be implemented in regular clinical practice. (JINS, 2003, 9, 472–478.)

Persistent cognitive complaints are common following a mild head injury (MHI), but deficits are rarely detected on neuropsychological tests. Our objective was to examine the effect of symptom expectation on self-report and cognitive performance measures in MHI individuals. Prior research suggests that when MHI participants are informed they may experience cognitive difficulties, they perform worse on neuropsychological tests compared to MHI participants who are uninformed. In this study, undergraduate students with and without a prior MHI were either informed that the study's purpose was to investigate the effects of MHI on cognitive functioning (“diagnosis threat” condition) or merely informed that their cognitive functioning was being examined, with no mention of status (“neutral” condition). “Diagnosis threat” MHIs self-reported more attention failures compared to “diagnosis threat” controls and “neutral” MHIs, and more memory failures compared to “diagnosis threat” controls. In the “neutral” condition, MHIs reported higher anxiety levels compared to controls and compared to “diagnosis threat” MHIs. Regardless of condition, MHIs performed worse on only one neuropsychological test of attention span. “Diagnosis threat” may contribute to the prevalence and persistence of cognitive complaints made by MHI individuals found in the literature, but may not have as strong of an effect on neuropsychological measures. (JINS, 2011, 17, 219–229)

Previous research has identified cognitive impairment in children with sickle cell anemia (SCA, Hemoglobin SS) compared with controls, partly accounted for by overt neuropathology after clinical stroke, “covert” (“silent”) infarction, and severity of anemia. However, cognitive deficits have also been identified in children with SCA with no history of stroke and a normal T2-weighted magnetic resonance imaging (MRI) scan. Our aim was to investigate whether nocturnal hemoglobin oxygen desaturation and sleep fragmentation could be associated with cognitive impairment in children with SCA. We assessed 10 children with SCA (9 with normal MRI) using neuropsychological measures of executive function. Cognitive assessment was immediately followed by overnight polysomnography to record nocturnal hemoglobin oxygen saturation and sleep arousals. Decreases in hemoglobin oxygen saturation and/or increased sleep arousals were associated with reduced performance on cognitive assessment. Nocturnal hemoglobin oxygen desaturation and sleep fragmentation may be a contributing factor to executive dysfunction in SCA. (JINS, 2012, 18, 168–173)

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.)

To examine the relative influence of speed of information processing versus working memory ability, CFS participants with psychiatric comorbidity (CFS–Psych) and CFS without a psychiatric history (CFS–noPsych) were examined on tests of visual and auditory processing speed and visual and auditory working memory. Compared to healthy controls (HC) and a group of participants with rheumatoid arthritis (RA), the CFS–noPsych group displayed significantly reduced performance on tests of information processing speed, but not on tests of working memory. No significant differences were observed between the CFS–Psych group and any other group in the study. The implications of group heterogeneity on the understanding of cognitive impairment in CFS are discussed. (JINS, 2004, 10, 101–109.)

Many U.S. Gulf War-era veterans complained of poor cognition following the war. This study assessed neuropsychological functioning in veterans 10 years after the war through objective tests. 2189 Gulf War-era veterans (1061 deployed, 1128 non-deployed) were examined at 1 of 16 U.S. Veterans Affairs medical centers. Outcomes included neuropsychological domains derived from factor analysis and individual test scores. Deployed veterans performed significantly worse than non-deployed veterans on 2 of 8 factors (motor speed & sustained attention, analysis not corrected for multiple comparisons) and on 4 of 27 individual test variables (Trails A & B, California Verbal Learning Test – List B, and Continuous Performance Test sensitivity, with only Trails B surviving Bonferroni correction). Within deployed veterans, Khamisiyah exposure was negatively correlated with motor speed after controlling for emotional distress. Depressive symptoms and self-reported exposure to toxicants were independently and significantly associated with worse sustained attention. Other factors were also associated with self-reported exposures. The findings were not a result of differential effort across groups. Gulf War deployment is associated with subtle declines of motor speed and sustained attention, despite overall intact neuropsychological functioning. Evidence suggests that toxicant exposures influence both these functions, and depressive symptoms also influence attention. (JINS, 2009, 15, 717–729.)

The purpose of this study was to compare the neuropsychological outcome from blast-related versus non-blast related mild traumatic brain injury (MTBI). Participants were 56 U.S. military service members who sustained an MTBI, divided into two groups based on mechanism of injury: (a) non-blast related (Non-blast; n = 21), and (b) blast plus secondary blunt trauma (Blast Plus; n = 35). All participants had sustained their injury in theatre whilst deployed during Operation Iraqi Freedom or Operation Enduring Freedom. Patients had been seen for neuropsychological evaluation at Walter Reed Army Medical Center on average 4.4 months (SD = 4.1) post-injury. Measures included 14 clinical scales from the Personality Assessment Inventory (PAI) and 12 common neurocognitive measures. For the PAI, there were no significant differences between groups on all scales (p > .05). However, medium effect sizes were found for the Depression (d = .49) and Stress (d = .47) scales (i.e., Blast Plus > Non-blast). On the neurocognitive measures, after controlling for the influence of psychological distress (i.e., Depression, Stress), there were no differences between the Non-blast and Blast Plus groups on all measures. These findings provide little evidence to suggest that blast exposure plus secondary blunt trauma results in worse cognitive or psychological recovery than blunt trauma alone. (JINS, 2012, 18, 595–605)

This study examined the postulate that training production of syntactically complex sentences results in generalization to less complex sentences that have processes in common with treated structures. Three agrammatic aphasic patients were trained to produce wh-movement structures, object clefts and/or object extracted who-questions, while generalization between these structures was tested. One NP-movement structure, passive sentences, also was tested for control purposes. Wh-movement occurs from the direct object position to specifier position in the complementizer phrase [SPEC, CP] for both wh-movement structures. In who-questions movement occurs in the matrix sentence, whereas, in object clefts movement occurs within an embedded relative clause, rendering them the most complex. Results showed robust generalization effects from object clefts to matrix who-question for 1 participant (D.L.); however, no generalization was noted from who-questions to object clefts for another (F.P.), and 1 participant (C.H.) showed acquisition of who-questions, but not object clefts, during the baseline condition without direct treatment. As expected, none of the participants showed improved production of passives. These findings supported those derived from our previous studies, indicating that generalization is enhanced not only when target structures are related along dimensions articulated by linguistic theory, but also when the direction of treatment is from more to less complex structures. The present findings also support proposals that projections of higher levels in the syntactic treatment are dependent on successful projection of lower levels. For our participants, training movement within CP in a lower (embedded) clause resulted in their ability to project to CP at higher levels. (JINS, 1998, 4, 661–674.)

Although neurocognitive deficits are an integral characteristic of schizophrenia, there is inconclusive evidence as to whether they manifest across the schizophrenia-spectrum. We conducted two studies and a meta-analysis comparing neurocognitive functioning between psychometrically defined schizotypy and control groups recruited from a college population. Study One compared groups on measures of specific and global neurocognition, and subjective and objective quality of life. Study Two examined working memory and subjective cognitive complaints. Across both studies, the schizotypy group showed notably decreased subjective (d = 1.52) and objective (d = 1.02) quality of life and greater subjective cognitive complaints (d = 1.88); however, neurocognition was normal across all measures (d's < .35). Our meta-analysis of 33 studies examining neurocognition in at-risk college students revealed between-group differences in the negligible effect size range for most domains. The schizotypy group demonstrated deficits of a small effect size for working memory and set-shifting abilities. Although at-risk individuals report relatively profound neurocognitive deficits and impoverished quality of life, neurocognitive functioning assessed behaviorally is largely intact. Our data suggest that traditionally defined neurocognitive deficits do not approximate the magnitude of subjective complaints associated with psychometrically defined schizotypy. (JINS, 2013, 19, 1–14)

Deep brain stimulation (DBS) has the potential to significantly reduce motor symptoms in advanced Parkinson's disease (PD). Controversy remains about non-motor effects of DBS and the relative advantages of treatment at two brain targets, the globus pallidus internus (GPi) and the subthalamic nucleus (STN). We investigated effects of DBS on neuropsychological functioning in 42 patients with advanced PD randomly assigned to receive staged bilateral DBS surgery of either the GPi or STN. Patients underwent neuropsychological assessment prior to and 6 months after unilateral surgery. Twenty-nine subsequently underwent surgery to the contralateral side and completed a second follow-up neuropsychological evaluation 15 months later. Unilateral treatment resulted in small but statistically significant reductions in performance on several measures, including verbal fluency and working memory. A similar pattern was observed after bilateral treatment. Reductions in verbal associative fluency were significant only after left-sided treatment. There were few significant differences related to treatment at the two surgical targets. Supplementary analyses suggested that decrements in select neuropsychological domains following DBS are unrelated to age or post-surgical reduction in dopaminergic medication dose. Findings are discussed with reference to possible causes of neuropsychological decline and the need for further controlled studies of specific neuropsychological effects of DBS. (JINS, 2007, 13, 68–79.)

The purpose of this study was to examine regional cerebral blood flow using positron emission tomography (PET) during the performance of tasks related to visual confrontation naming. Ten healthy, young participants were scanned twice in each of 5 conditions; blood flow was measured using standard PET [15O]-water technology. Two major findings have replicated previous studies. First, the naming of visually presented objects, whether covert or overt, requires a region of the left inferior cortex including the fusiform gyrus. Second, during overt naming, there is an increase in activity in the inferior or frontal cortex and insula as a consequence of generating speech code. These data are consistent with other studies demonstrating the importance of the inferior temporal regions for semantic processing, and the frontal cortex for word form generation. (JINS, 1998, 4, 160–166.)

Traumatic brain injury (TBI) is the most common cause of brain damage, resulting in long-term disability. The “reserve” construct has been proposed to account for the reported mismatch between brain damage and its clinical expression. Although numerous studies have used various measures thought to reflect this construct, few studies have examined its underlying structure in clinical populations, and no studies have systematically studied this construct in TBI. In the present study, structural equation modeling technique was used to evaluate several models hypothesized to represent cognitive reserve (CR) in TBI. A broad range of data typically reported in the literature as representing CR was collected from 89 individuals who sustained moderate-to-severe TBI. Analyses revealed a best fitting model that consisted of three separate factors representing premorbid intelligence, socioeconomic status and leisure activity, with distinct pattern of associations among the three factors. Findings provide empirical support for the notion of a multi-factorial CR and suggest a coherent framework for further investigation. (JINS, 2013, 19, 1–8)

Recent investigations have emphasized the importance of the prefrontal cortex for humor processing. Although the prefrontal cortex is thought to be affected by normal aging, relatively little work has been carried out to investigate the effects of aging on humor processing. In the present investigation participants in three age groups were assessed on a humor comprehension task. They then answered mentalistic and nonmentalistic questions. Executive tasks were also administered. The older group selected significantly fewer correct punchlines from alternatives than the other groups. They were also poorer at answering mentalistic questions, but did not differ significantly for nonmentalistic questions. The findings of the present investigation showed altered in humor processing in normal aging, and this appeared to be related to mentalizing ability. (JINS, 2006, 12, 184–191.)

The idea that handedness indicates something about a person’s cognitive ability and personality is a perennial issue. A variety of models have been put forward to explain this relationship and predict a range of outcomes from higher levels of cognitive ability in left-handers or moderate right-handers to lower levels of achievement in left- or mixed-handers. We tested these models using a sample (n = 895) drawn from the BRAINnet database (www.brainnet.net). Participants completed a general cognitive ability (GCA) scale and a test of hand preference/performance. Moderate right-handers, as indexed by their performance measures, had higher GCA scores compared with strong left- or right-handers. The performance measure also showed lower levels of GCA for left-handers compared with right-handers. The hand preference data showed little or no association with cognitive ability—perhaps because this measure clusters individuals toward the extremes of the handedness distribution. While adding support to Annett’s heterozygous advantage model, which predicts a cognitive disadvantage for strong left- or right-handers, the data also confirm recent research showing a GCA disadvantage for left-handers. Although this study demonstrates that handedness is related to cognitive ability, the effects are subtle and might only be identified in large-scale studies with sensitive measures of hand performance. (JINS, 2010, 16, 585–592.)

We investigated the relative discriminatory efficacy of an event-based prospective memory (PM) task, in which specificity of the instructions and perceptual salience of the PM cue were manipulated, compared with two widely used retrospective memory (RM) tests (Rivermead Paragraph Recall Test and CERAD-Word List Test), when detecting mild cognitive impairment of suspected Alzheimer’s disease etiology (MCI-AD) (N = 19) from normal controls (NC) (N = 21). Statistical analyses showed high discriminatory capacity of the PM task for detecting MCI-AD. The Non-Specific-Non-Salient condition proved particularly useful in detecting MCI-AD, possibly reflecting the difficulty of the task, requiring more strategic attentional resources to monitor for the PM cue. With a cutoff score of <4/10, the Non-Specific-Non-Salient condition achieved a sensitivity = 84%, and a specificity = 95%, superior to the most discriminative RM test used (CERAD-Total Learning: sensitivity = 83%; specificity = 76%). Results suggest that PM is an early sign of memory failure in MCI-AD and may be a more pronounced deficit than retrospective failure, probably reflecting the greater self-initiated retrieval demands involved in the PM task used. Limitations include the relatively small sample size, and the use of a convenience sample (i.e. memory clinic attenders and healthy active volunteers), reducing the generalizability of the results, which should be regarded as preliminary. (JINS, 2009, 15, 154–159.)

Prominent apathy and/or irritability are frequently observed among individuals infected with the human immunodeficiency virus (HIV). Although these symptoms often occur as part of a mood disorder, compelling evidence suggests that they may occur independently of depression in neurologic disease/disorder. The current study examined the prevalence of both apathy and irritability among a sample of HIV-infected individuals and explored the degree to which these neuropsychiatric (NP) phenomena were associated with performance on neurocognitive measures thought to be sensitive to the potential CNS effects of HIV-1. Clinician-administered rating scales assessing apathy and irritability were administered to 65 HIV-seropositive (HIV+) and 21 HIV-seronegative (HIV−) participants who also completed a dual-task reaction time paradigm and the Stroop task. NP disturbance was significantly more prevalent among HIV+ participants compared with HIV− controls and was associated with specific neurocognitive deficits suggestive of executive dysfunction. Relative to both HIV− controls and to neuropsychiatrically intact HIV+ participants, those HIV+ individuals with evidence of prominent apathy and/or irritability showed deficits in dual-task, but not single-task, performance and on the interference condition of the Stroop. Unexpectedly, NP disturbance did not show a robust relationship with HIV disease stage. These results suggest that the presence of prominent apathy and/or irritability among HIV+ individuals may signify greater HIV-associated CNS involvement. In HIV/AIDS, the disruption of frontal–subcortical circuits may be a common mechanism causing both executive dysfunction and NP disturbance. (JINS, 2000, 6, 336–347.)